Select Page
Breast Lift – Should I or Shouldn’t I? Above or Below the Muscle?

Breast Lift – Should I or Shouldn’t I? Above or Below the Muscle?

Breast Lift – Should I or Shouldn’t I? Above or Below the Muscle?

Q: After two pregnancies and nursing I have been left with empty and saggy breasts.. I ‘ve consulted with a few doctors and have been advised to go under the muscle to achieve the fullness I am looking for as well as over the muscle to avoid a lift. I am 5’9″, 135lbs, Sternal NotchtoNipple=22cmR,22.5cmL, NippletoFold=8.5cmR&L. Ultimately I’d like to achieve the appearance of a fuller and less droopy breast. Can this be accomplished with an augmentation alone? It seems most of you are suggesting a lift but I wanted to be a bit more specific. In considering a lift I’m not thinking about ending up with super perky breasts. I actually like the way they fall and in a perfect world I’d like to have less of my breast resting on my rib cage and am only interested in gaining an inch of vertical lift with of course volume. Can I do this with augmentation alone?

A: If your goal was to be super perky, I would definitely recommend a lift, but since you are happy with how your breasts fall against your chest, I think you would have a great result with a dual plane breast augmentation using a silicone implant. The dual plane approach. allows me to position the breast implant partially under the muscle. Unlike implants placed completely under the pec muscle, with a dual plane approach, the implant can settle nicely into your breast skin envelope. I would recommend silicone for you since you have little breast tissue. A dual plane breast augmentation is great for giving the appearance of less droop without creating breast lift scars. Please click this link for one of my patients whose before pics are similar to yours.

Breast Lift – Should I or Shouldn’t I? Above or Below the Muscle?

Can I Get a Breast Revision to Minimize the Gap and Achieve Full Cleavage?

Can I Get a Breast Revision to Minimize the Gap and Achieve Full Cleavage?

Q: I had a breast augmentation last January with 330cc. I had almost nothing pre-op – maybe a 34AA. I’m developing a capsular contracture in my right breast and definitely need to undergo surgery to fix this issue but I’m wondering if its possible for me to minimize this wide gap between my breasts right away. I’m really unhappy with the gap. Is there much risk if I was to get the pocket readjusted to bring them closer together? Is it possible for me to achieve full cleavage – if so, how?

A: You have widely spaced breasts. When you look at the pre-op pictures you provided, you can see that you have always have widely spaced breasts, it is just more noticeable now that your breasts are larger. This is just how you are made and it is difficult to correct. Unfortunately, if we try to move the breast pocket more centrally on your chest, we run the risk of creating a “unaboob,” or synmastia. A better way to address the issue is with fat grafting to the upper and middle parts of your breasts. I am concerned, though, that you may not have enough fat to harvest given your slim build.

Breast Lift – Should I or Shouldn’t I? Above or Below the Muscle?

I Have Tuberous Breasts What Are my Options for Surgery?

I Have Tuberous Breasts What Are my Options for Surgery?

Q: I have severe tuberous breasts A plastic surgeon told me they were not constricted but I had a great deal of ptosis I WILL NOT accept anything less than a DD implant I find small size breasts disgusting I will do anything for a huge size breast Could you guys please list my options I am willing to pay any amount and go anywhere but average breasts are not an option. I want 2000 cc implants I would consider bigger I want to keep my nipples but I am willing to consider a mastectomy BIG/PERKY/EVEN

A: I am concerned that you are not a good candidate for plastic surgery at this point. I don’t think any plastic surgeon would be able to meet your expectations. I am not trying to upset or anger you, but you mention several concerning things in your post such as willingness to undergo a mastectomy without having breast cancer or a genetic predisposition for breast cancer, your desire for 2000 cc implants, your refusal to accept anything less than a certain size and the statement that average is not an option. I think the best course at this point is to continue to research breast augmentation surgery and the results that can realistically be achieved with this procedure.

Breast Lift – Should I or Shouldn’t I? Above or Below the Muscle?

Under the Muscle Vs. over the Muscle?

Under the Muscle Vs. over the Muscle?
Q: I am 35 year old mother of two breast fed infants left with with saggy size B breasts. I keep reading that UNDER the muscle is a better choice but my surgeon has recommended over the muscle. WHY?
A: You have a lot of options when restoring breasts after pregnancy and breastfeeding. Without seeing you, or at least a photo, it is hard to tell which option would be best for you. Because you mention sagging, I would encourage you to explore your breast lift options in addition to breast augmentation. In general, if you have sagging breasts and a breast implant is placed under the muscle WITHOUT performing a breast lift, you will be left with a double bubble – the implant will sit securely under the muscle and then your breast tissue will continue to sag below. Placing an implant on top of the muscle without a lift allows you to increase volume, avoid the double bubble, but will NOT correct the sagging. Additionally, breast implants placed on top of the muscle are usually more visible, more easily felt and they can interfere with mammography. I try to avoid placing implants over the muscle (subglandular) whenever possible. A dual plane approach is a nice “happy medium” for many women with MINIMAL sagging (usually women whose nipple is at – not below – the inframammary fold). With the dual plane approach the implant is placed partially under the muscle, but the lower portion of the pec muscle is freed from the chest wall allowing the implant to settle nicely into the breast envelope. If you have more than minimal sagging, a breast lift with implant (augmentation mastopexy) may be your best option to create firm, perky breasts with increased volume.

Breast Lift – Should I or Shouldn’t I? Above or Below the Muscle?

Can Breast Asymmetry Be Fixed with JUST an Augmentation; No Lift on Larger Side?

Can Breast Asymmetry Be Fixed with JUST an Augmentation; No Lift on Larger Side?
Q: I have a normal A cup on one side and a slightly droopy C on the other. Nipple of larger breast does not need repositioned. If I were to get implants in both breasts, is there a chance the smaller one would lay even with the larger breast? Does everyone with asymmetry need a lift on the larger side? I can’t provide a photo at the moment, I just want to know if this is possible.
A: It’s very hard to advise you without seeing at least a picture. The answer depends on your expectations. If you are happy only addressing the size difference between your breasts, then you can just have the augmentation. You need to understand, though, that you will likely still have one sagging breast and one perky breast. I counsel many of the women in my practice that a breast lift along with augmentation will give the most pleasing result. Many decide not to have a lift to avoid the scars. This is a personal decision, but it is essential to set your expectations appropriately. If one breast sags and the other does not, full correction will likely require a breast lift.