Does a Breast Lift Require Implants?

Publish on June 25th, 2019

Unpadded bras have become your sworn enemy. Your swimsuit drawer has been overtaken by mismatched foam cups. You can’t remember the last time you set your girls free for a day, and you’re pretty sure the underwire indents near your armpits are permanent.

We know what’s happening: your breasts are sagging (cue horror movie scream).

The bad news is that it’s unavoidable. No matter how strong your pecs are or how well-supported your breasts have been since your teens, there’s no stopping time and gravity. The good news is that you don’t need to imprison your breasts in those hefty beige boob-traps that your great-aunt calls “brassieres” for the rest of your life. A cosmetic surgery called a breast lift, or mastopexy, is designed to counteract breast sagging by raising fallen breast tissue and adjusting nipple position for a perkier, more projected look — even when you’re au naturel.

Breast lifts are fully customized procedures that can involve a number of modifications. One of the most common additions is the use of breast implants, which add volume to the breasts and can enhance breast shape, symmetry and fullness. But not every woman who chooses a breast lift will need — or want — implants, and a breast lift doesn’t always require implants to get the best results. As you explore the possibility of giving your breasts a new lease on life, you should understand why your surgeon may or may not recommend using implants with your breast lift. Dr. Daniel Barrett, board-certified Beverly Hills plastic surgeon, offers more details on differentiating between mastopexy with and without implants.

When Bigger Isn’t Always Better

Since breast augmentation with implants is the most widely performed type of breast enhancement (and has in fact been the top cosmetic surgery, period, since 2006), many women first think of using implants when they want to change the way their breasts look. What’s more, breast sagging often causes a flattened, deflated look, and it’s easy to assume that adding an implant will fill in the empty space and fix the problem.

But implants are specifically for increasing the size of the breasts. An augmentation on its own only makes the breasts bigger, and does not address concerns like nipple placement, stretched skin or migrated breast tissue — all of which are at the root of breast sagging, and all of which are corrected by a breast lift. Also consider that larger breasts are more prone to sagging, which means that many women who seek a mastopexy already have a good amount of natural breast tissue and don’t need an implant to achieve the breast size they want. Instead, their breast tissue can be redistributed more evenly between the upper and lower breast to create a rounded, fuller shape. Many women discover that their breasts appear larger or have more cleavage after a breast lift for this very reason. So, if breast augmentation is the popular girl of plastic surgery, the breast lift is her artsy older sister: perhaps not as well-known, but excelling within the right niche. If you’re happy with your breast size but you just need a little pick-me-up, a mastopexy likely offers everything you need to get back to your perky self.

Turn Up the Volume

While breast sagging is often simply a product of aging, breast volume loss after pregnancy or weight fluctuation is also a common contributor. Volume loss can result in breasts that sag, and that are also too small to complement a woman’s body type. Other women have naturally smaller breasts that have begun to droop, and they want to improve both size and lift at the same time.

For either type of client, a breast lift alone will not be able to deliver her best results — but neither will an augmentation alone, because concerns will also include stretched skin, migrated tissue or downturned nipples. This is where combining implants with a breast lift would likely be recommended. In these cases, the surgeon uses breast lift techniques to reposition a woman’s natural breast tissue, remove loose skin and raise the nipple-areola complex, and also uses an implant to make the breasts larger and more proportional to the rest of her body.

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Keep in mind, too, that if your surgeon recommends implants, it doesn’t mean you’ll end up with breasts that look dramatically larger and rounder (unless that’s what you want!). Breast implants come in a truly impressive variety of shapes and sizes. Some increase volume throughout the breast, while others are designed to provide extra volume in the upper half; some are rounder for more dramatic cleavage, while others are teardrop-shaped and offer a natural look. Your surgeon can even use two different implant sizes to correct noticeable asymmetries in breast volume. With so many options and uses, implants offer a way to customize your mastopexy, create your ideal curves and let your breasts live their best life.

Work With What You’ve Got

We’ve talked about breast lifts with and without implants, but… Surprise! There’s a third option. Some women are candidates for a newer approach to combined mastopexy/augmentation that uses transferred body fat instead of an implant. This option is most common for women who are interested in liposuction as well as a breast lift, because it allows the surgeon to take fat tissue from one area and move it into the breasts.

If you’ve ever wished you could move that stubborn belly fat to your boobs (let’s be honest, who hasn’t?), this procedure might be sounding pretty good. It’s likely also appealing if you need to add breast volume, but you’re not into the idea of using an artificial implant. Before you get too excited, we should probably tell you that there are a few crucial limitations on this type of breast lift.

First, your new breast size is restricted to the amount of body fat that your surgeon is able to extract safely. If you don’t have very much body fat or if you need to add more than a cup size of volume, this may not be your best option. And second, transplanted fat will have some amount of resorption after the surgery — that is, your body will re-absorb some of the fat tissue, leaving you with breasts that may be smaller or more asymmetrical than anticipated. In the end, however, it can deliver a very natural result: your new breasts will feel like real breast tissue, will have a soft shape and texture and will grow and shrink with future weight fluctuations.

Ready to Learn More?

Each of these options can be a great way to give your breasts (and your confidence!) the boost they need. If you want to find out which type of breast lift will be best for your needs and body, you should schedule a consultation with a board-certified plastic surgeon who has demonstrated experience providing all three types of breast lifts. After an in-person evaluation, they’ll be able to offer their professional recommendation and answer other questions you might have. In Beverly Hills, Dr. Daniel Barrett provides breast lifts with and without implants as well as breast lifts with fat transfer for women of all ages and body types. Contact Barrett Plastic Surgery today at (310) 598-2648 to schedule your consultation.

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