Can you have DD Breast Implants and not get a Breast Lift?

I want double d’s. Big voluptuous breasts that make people look when I walk by. As I do my research though it looks like might need a lift too. Is it always required to get a lift along with such a large implant? I honestly do not want to deal with a lift, but if I have to I guess that’s just the way the cookie crumbles.


F, 42, Tennessee

Tags:age 35-44 B to DD cup

The short answer is "yes".

It's possible to get DD implants and not get a breast lift. But whether getting larger breast implants makes sense without a mastopexy depends entirely on the individual patient's anatomy.

As women age, it's common to loose natural breast fullness. This loss of fullness can leave excessive loose skin, and cause the level of the nipples to fall lower on the breast mound. If you've experienced a loss of fullness and the position of your nipples has fallen below the fold -- a large breast implant size alone will not correct the nipple position. In these cases a breast lift would likely be required.

You should also give some consideration to the long term likelihood of larger breast implants to fall lower on the chest over time.

Before choosing sizes, I recommend contacting an experienced plastic surgeon. Your surgeon should be able to show you a before and after photo gallery of past successes and breast implants pictures of different sizes. I also recommend reviewing photos of breast implants alone vs. augmentation mastopexy.

Breast lifts aren't always required with large breast implants. The answer depends on what your breast enhancement goals are and on your current breast anatomy.

Keep in mind that even if you don't need a breast lift with your breast augmentation now, larger breast implants do tend to drop over time. Needless to say, the extent to which breast implants sink lower is directly related to breast implant size. With larger implants it's important to think ahead and consider whether or not you want to return for a revision if the implants do drop in the future.

The biggest consideration when deciding whether or not you need a breast lift during the same plastic surgery is whether or not your nipples have dropped significantly. If your nipple position has descended below the fold, you will need a breast lift to provide support and to re-center the nipples higher on the breast mound.

If there's a likelihood that you'll need to return to your plastic surgeon for a breast surgery revision, I would advise you to consider getting a breast lift concurrently with your implants. One of the reasons cosmetic surgeries are often performed at the same time is to reduce the total amount of time you spend in recovery. Getting implants now, only to return a year or two later for a breast lift is probably not the most appealing choice.

As a word of advice: I would caution against picking a cup size before visiting a plastic surgeon. Not only is it not always possible to go from a smaller size directly to a larger size, but there are many physical and aesthetic considerations which impact size selection. These include the size of your rib cage, your weight, and the overall sense of proportion and body shape. A good plastic surgeon should help patients determine what the right size is for them, in each particular case.

I encourage you to consult with a board-certified plastic surgeon, review before and after photos of previous work, and to try on silicone sizers to make sure you're comfortable with extra large silicone implants.

Frederic Corbin has 1 Breast lift before & after:

Breast lift before image performed by Dr. Frederic CorbinBreast lift after image performed by Dr. Frederic Corbin

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The question of whether a breast lift is necessary with a breast augmentation depends on the anatomy of each individual patient.

A large silicone or saline breast implant will increase the volume but have no effect on the elevation of the breast. Additionally, large DD size implants are more likely to sag over the long term.

The amount of sagging that women experience over time depends on age, weight, natural breast size, and the amount of loose skin resulting from pregnancy or weight loss.

Implants alone may also leave the nipple-areolar complex in too low a position, which can only be corrected with a breast lift. Larger DD size implants are also more likely to sag over the long term.

My advice is that you consult with a plastic surgeon who has experience with large breast implants to see if implants without additional plastic surgery make sense in your specific case.

The quick answer is yes, but getting large implants without getting a breast lift may not be the best idea.

Please note that when discussing implant sizes, plastic surgeons don't think in terms of cup size or what size bra you want to wear after the surgery.

There's no specific "D-cup," "DD-cup," or "F-cup" implant size. Plastic surgeons think in terms of ccs and not bra cup sizes. It's very common for patients to ask for a "DD-cup implant," but resulting bra sizing may depend on your pre-existing breast tissue, weight, and frame.

Also, whether or not you will need a D- or DD-cup bra depends heavily on your personal preferences in terms of bra-fitting and preferred style of bra.

To communicate your cosmetic surgery goals to your plastic surgeon, it's far more helpful to meet directly with a cosmetic surgeon, try different silicone gel sizers and view before and after photographs.

Remember that the same size implants on two different-sized women can look extremely different. When you meet with your surgeon, he or she will take your body dimensions, body weight, and existing breast size into account. Your surgeon will also walk you through many other options including the desired amount of implant projection (medium profile vs. high profile) and different implant types.

After your surgeon has taken your measurements, he or she will also recommend whether or not you will require a breast lift to reach your desired breast size. I can't give you any specific advice without a direct consultation but, generally speaking, it's not a good idea to get large implants without a lift as gravity will eventually take its toll without support.

Remember to always consult with an experienced, board-certified plastic surgeon when considering any cosmetic surgery procedure.

Thanks for the question.

One way to know if you need a breast lift is to perform the “pencil test.” Put a pencil in the fold under the breast. If your breast falls over the pencil and holds it in place (or if you have to significantly pick up your breast to be able to set the pencil there), you most likely are a candidate for a breast lift. This is an important part of determining whether you can achieve your cosmetic breast surgery goals with implants alone, a lift alone, or in combination.

Breast lifts reposition the nipple by moving it with a column or mound of breast tissue that stays attached to the nipple. In order to reposition the nipple, the surgeon must place an incision around the whole nipple-areola complex. The so-called periareolar or Benelli mastopexy involves tightening the breast with the removal of a donut of skin around the nipple. This is appropriate for a modest lift. Patients needing more than a few centimeters of lifting require a vertical and/or horizontal scar as well.

If you already have some looseness to the skin, or your nipple is below the fold, or you have significant deflation of the upper breast pole, you may need a lift to provide support, especially if you are putting in large implants. However, it is impossible to know for sure without photos and an exam. A good teaching tool for out-of-town patients is surgical simulation software. We use Crisalix software in our office, which is great at helping to show a patient the effects of lifting and implants on the breasts, which can help you make an informed decision. Happy to set you up for a video consultation and a subsequent simulation!

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Tim Sayed has 4 Breast augmentation (Saline breast implants), Breast lift, Extended abdominoplasty before & afters:

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There's no single answer that applies to all patients. Depending on how much skin laxity you have, and depending on how large your breasts are pre-op, it may be possible to get large implants without a lift.

Some things to bear in mind: You can't go directly from having an AA cup to a DD cup. If you have small breasts now, there may not be enough skin available to accommodate the large implants.

Also, remember that large implants tend to be very heavy. You should consider how your breasts will look post-op and over the years to come. If extra large implants begin to droop with age, you're still going to need a breast lift a little further down the road. As such, it's usually a better idea to do both procedures at once.

Still, there are many examples where large implants without a breast lift have worked very well. The only way to know for sure is to schedule an initial consultation with an experienced cosmetic surgeon.

No, a breast lift isn’t always required along with large breast implants, but whether this is a good decision for you depends on your age and anatomy.

The reason mommy makeovers combine a breast lift with implants and liposuction is because these three procedures are often needed in combination to restore an aesthetic shape and to contour. In other words, implants alone don’t necessarily make sense in all cases.

It's normal for breasts to sag with age, and a breast lift will correct that sagging by raising the position of the breasts on the chest. Size DD implants alone may give you the cup size you want but not any added lift.

You should be aware that when you have size D cup or DD cup implants, your breasts will sag at a faster rate in the future. Even if they look great right after the surgery, gravity will likely cause them to sag over time.

While I can't give you any specific advice without a direct examination, I would advise you to think about the long term effects of your breast surgery and suggest you consult with a board-certified plastic surgeon to determine whether breast implants without a breast lift make sense for you.

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

Breast augmentation, Breast lift before image performed by Dr. Neil  ZemmelBreast augmentation, Breast lift after image performed by Dr. Neil  ZemmelBreast augmentation, Breast lift before image performed by Dr. Neil  ZemmelBreast augmentation, Breast lift after image performed by Dr. Neil  Zemmel

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There's really no way of answering that question without a personal consultation because the answer depends on a number of different factors. These include your existing breast tissue, the degree of skin laxity and the position of the nipples on the breast mound. It doesn't matter if you're aiming for C-cup, D-cup or DD-sized breasts -- if you have excessive skin laxity above the breasts, and your nipples have dropped below the fold, you may still need a breast lift for support.

Bear in mind that it may not be possible to go straight to a DD-cup from your existing breast size. If you are currently an A-cup or a B-cup, we may need to use a smaller size implant before moving up to a larger implant.

Exactly what implant size represents a “perfect fit” for any individual patient depends on overall body measurements and proportions. Assuming that your current anatomy can safely accommodate large implants, the question of whether or not you'll also need a breast lift depends on your own aesthetic choices.

Remember that a larger breast size won't automatically lift the position of your breasts any higher on your chest. If bigger breasts and bra size are all that matter to you, then a lift may not be required. But I would advise against this.

It’s important to keep in mind that D- or DD-cup size breasts will add a significant amount of weight to your chest. As your breasts continue to drop with age, you will likely need a breast lift at a later date. Getting both procedures done at once is usually preferable in terms of cost and in terms of recovery time.

I suggest meeting for a free consultation with a board-certified plastic surgeon who has extensive experience with breast augmentation. Look at before and after photos, try on sizers, and discuss what size and profile implants work best for you. Good luck achieving your cosmetic surgery goals.

That's a difficult question to answer without a direct examination by a plastic surgeon. Whether or not you'll need a breast lift together with a large implant size depends largely on your existing anatomy.

If you're already experiencing excessive sagging and have a large amount of loose skin -- which is common after weight loss or childbirth -- you will likely need an augmentation mastopexy (a breast augmentation combined with a breast lift).

Another issue to keep in mind when considering breast enlargement is your current nipple position. If your nipples are already close to your inframammary breast fold, then you'll likely need a lift because the breast implants may appear to sit too high otherwise.

On the other hand, if you currently have a very small breast size you may not need a breast lift -- but you should be aware that it is not always possible to go directly to a DD cup size. If you are currently an A cup, there may not be sufficient breast tissue to go straight to large breast implants. It would be necessary to perform an interim breast implant surgery with smaller implants first.

When considering large implants, it's important to evaluate your existing anatomy, overall frame and your personal goals. I encourage you to contact a board-certified plastic surgeon who has experience with larger implants. Be sure to do your research carefully, and ask to review their breast augmentation photos -- particularly of women with a similar size and build.

Breast lift isn't always necessary prior to large implants. It depends upon the outcome you're looking for as well as your body type and size implants selected. Here in San Antonio, Texas, large breast implants are common. We often achieve nice results with large implants without breast lift, but it is a very individual thing. I would recommend consultations with plastic surgeons who have a specialty in breast augmentation and who have good experience with large implants.