Can I fix saggy breasts by getting implants without a lift?

I really don’t want to get a breast lift because I don’t want massive scars for the rest of my life. I have saggy D cups and want to restore them to what they used to look like when I was 20. I am almost 40 now. Is it possible to do this with implants only?


F, 41, New York

Tags:age 35-44 scar sagging breasts scarring lift

Many women long to restore the youthful lift and shape of their breasts and wonder if this can be achieved with breast implants alone. There is a simple test you can carry out at home to give you a rudimentary answer to this question: examine your breasts in a mirror. If your nipples fall at the inframammary fold (the breast crease) or beneath it, this is generally a strong indicator that you have significant breast sagging and would benefit from a breast lift procedure.

If your breasts are only slightly sagging and the nipples are still elevated above the breast crease, there is a small chance that the appearance of the breasts could be improved with implants alone by lowering the level of the inframammary fold. This allows the implant to be placed at a lower position on top of the mound of the slightly drooping breast, which gives the illusion that the breast has been lifted when it has not. This is known as a low-profile implant.

However, if the sagging is substantial and your nipples are already positioned below the breast fold, then a breast lift is your best option. As you have a moderate amount of breast volume already, it is likely that the weight of your breast tissue has resulted in significant sagging which cannot be corrected with breast implants alone. Only a breast lift can remove excess skin and raise the nipple position on the breast.

Undergoing a breast augmentation procedure without a breast lift may result in a deformity commonly referred to as a "double bubble", where the mound of the implant will be in the place where the breast should be positioned on the chest wall, with the natural breast tissue hanging off the implant, resulting in an unsightly result. Furthermore, large implants will create further weight in the breasts, causing more drooping.

If you desire both lift and upper pole fullness in your breasts, a combined breast lift and breast augmentation procedure will give you optimum results. The two procedures can be performed at the same time, or in stages to increase the predictability of the final outcome.

While it’s entirely understandable that you are wary of undergoing mastopexy because of the possibility of scarring, you are far more likely to achieve a more aesthetically beautiful and long-lasting result with a breast lift or a combination of a breast lift and augmentation. Instead of focusing on scars, it is better to focus on selecting the right surgeon--an experienced board-certified plastic surgeon who specializes in breast surgery will be able to help you achieve the results you desire.

In addition, bear in mind that most women who undergo a breast lift are delighted with their results, even with some scarring. They like how they fit in clothing and come away from the procedure feeling more youthful and self-confident. In general, the majority of breast lift scars fade over time and can be further minimized with treatments such as Fraxel Laser once the wounds have properly healed.

Neil Zemmel has 2 Breast augmentation, Breast lift before & afters:

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No.  I feel confident in saying that unless you want to be another Dolly Parton, you do not want implants alone. You will need a very large implant to fill out saggy D cups and then you will be large and saggy. I have not seen "massive" scars from breast lifts. It is true that there are extensive scars, which is not the same as massive, but in most cases they are quite thin and fade nicely with time. The improvements of a lift are usually well worth the scars. A lift will make your breasts more compact and so it is possible that you might desire implants after a lift to provide more volume. I believe that it is always better to do the lift first and implants later. I rarely combine these operations because they work counter to each other and the risks rise precipitously. Implant surgery is very easy after a lift, which is not the case when the reverse is done. You should see a board-certified plastic surgeon with experience in this type of work. 

The answer depends on how much droopiness you have and your expectations for outcome. If you have nipples that are at or slightly below the level of your inframammary crease and you are OK with being a little droopy afterwards, then there is certainly nothing wrong with putting in implants first- then going back and doing a breast lift later if you feel you want to. 

If you have significant breast ptosis, considered 2nd or 3rd degree, an implant alone would be a bad choice because you would have excess skin falling off the implant.

See a board certified plastic surgeon to determine your level of ptosis.

Best regards,

Jack Peterson MD 

Many women feel an aversion to undergoing a breast lift procedure because they are concerned about the scarring that may result. However, mastopexy or breast lift surgery is often critical to restoring the youthful appearance of saggy breasts.

During the procedure lax skin is removed, the nipple is shifted to a more elevated position on the breast, and breast tissue is redistributed to achieve an aesthetically beautiful shape. However, in order to achieve this, there will be visible scars afterward.

It is important to recognize, however, that in the hands of an experienced board-certified plastic surgeon, scarring will be minimized as much as possible, and in most cases the scars will fade considerably over time.

The kind of scar you can expect will depend on the variation of breast lift procedure that you undergo and extent of lift required: there is a lift which leaves a crescent shape above the nipple areola complex, a lift which leaves a circular scar around the nipple areola complex, a lift technique which results in a lollipop-shaped scar, and another that results in an anchor-like scar.

Based on your unique characteristics and the extent of your ptosis (breast skin sagging), the surgeon will make a decision on the technique that will allow the most lift with the least scarring. A plastic surgeon will also take into account a range of factors such as your age, weight, skin elasticity, breast tissue density and distribution, and whether you have had children before settling on the most appropriate technique for your breast lift.

While it is possible in some cases to achieve a minimal degree of lift with implants alone, it’s generally not advised. Breast augmentation surgery and mastopexy are two separate procedures that achieve distinct goals. Breast implants will increase your breast volume but not raise the position of your nipples or correct severe sagging. If your nipple sags below the breast crease either mildly or severely, a breast lift will provide the best results as it is the only procedure that can elevate the nipples to a higher position on the breast and eliminate loose skin. You may choose, however,  to undergo both procedures to simultaneously achieve both lift and augmentation in your breasts.

This is a good question. However, implants alone usually will not lift your breasts. Implants add extra volume and weight. In order to lift your breasts removal of excess skin and tightening of your remaining skin would have to be performed. This requires some scars, which are placed low on your breast where they are not as visible and fade with time.

Without seeing your pictures, it is hard to give you an answer.  However, in general, if you get implants without a lift, and your breasts are saggy,  then they will only sag more over time with the implants making it worse.  It would be best to go for a consultation to discuss your particular situation.  Best of luck!

If the sogginess is very minor, then implants might benefit you, but generally speaking implants are not going to accomplish what a breast lift does. Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. Be certain your surgeon is properly certified.  

Typically, implants are not a good substitute for breast lifting when you need to fix sagging.  You should meet with a plastic surgeon in person for an examination and to find out what your options are, and what the expectations would be with each option.   Best of luck!

Implants are placed beneath the nipples.  If you nipples are low on your chest, then the implants will also be low.  If you try to place the implants higher, then the rest of the breast will be hanging off the implants -- still low, and it would not look right.

Sometimes you have to bite the bullet (and accept a scar, which may not be as bad as you imagine) if you want a certain look.  That is why oftentimes surgeons will recommend a lift with implants to correct droopy breasts.

Dr Jacobs 

Elliot Jacobs has 1 Breast lift before & after:

Breast lift before image performed by Dr. Elliot Jacobs Breast lift after image performed by Dr. Elliot Jacobs

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There is a limit to "lifting by filling"! Get in front of the mirror and place a pencil under your breasts. If the nipple lies at or above the pencil, then your answer is yes. If not, a lift may be needed.

You should consider doing 3D photo imaging to see exactly what you will look like with just the implants.  Here is a link to an article:

I always advise my patients to do the augmentation first and live with that for 6 months before going forward with the lift.  The scars from the lift are permanent and many patients are happy with just the extra volume. 

It really depends on your situation. You may want to consider a new technique, called Bellesoma which offers less scarring than traditional breast lifts and avoids an implant. Thanks for your question!

Shim Ching has 6 Breast Lift before & afters:

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Without seeing you or photos it is hard to give you an honest answer. However you will never have the breasts you had at 20 again. If your breast are sagging you most likely need a breast lift. Age, gravity and children all play a part in causing breast ptosis, or sagging. Make sure you see a board certified plastic surgeon.

Arthur Shektman has 2 Breast augmentation, Breast lift before & afters:

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