Breast augmentation - do I need a lift? Would over or under the muscle be best? (Photos)

Hello, for people with some degree of breast sagging, the decision whether to have a lift comes down to many factors, such as tolerance of the extra scars, expectations of the result (are you ok with lower breasts that are larger, or do you want them lifted higher), costs, additional risks of the breast lift, the surgeon's advice, etc. As for breast implants pockets, they have unique advantages and disadvantages. Implants inserted in front of the muscle tend to drop faster and fill out the lower breast, but there is not as much tissue coverage. Implants placed under the muscle have more coverage, but they might sit too high on the chest, leaving the lower breast looking loose and unfilled. A compromise of the two pockets called the "dual plane" pocket is also an option, but it also has unique risks (like "windowshading", in which the muscle moves abnormally when contracted). I realize this is just a general discussion of options, because specific advice can only be provided during a thorough in-person consult. The consultation process involves deterring the patient's overall health and their cosmetic goals, then doing a proper breast exam including detailed measurements to check the degree of sagging and asymmetry. Next, I explain the different operations and their risks, before showing examples of the different outcomes on my photo gallery. I hope your procedure goes well.

Your concern is very understandable, many people hope for a simple augmentation but find out a lift might be recommended, which can affect both cost and decision-making.

Your nipples are located below your breast fold and since the implants are centred behind the nipples, they would sit low on your chest and not offer any fullness in the upper pole. For this reason, a lift would be recommended.

Thanks for your question! Without a doubt, you need a breast lift to get a good result. Implants, without a lift, would look droopy and mispositioned. It appears as though you are very thin in the upper chest, so I think subpectoral would give you the most natural look. Best of luck!

From the submitted photos your nipple is located below the level of the breast fold which generally indicates that a lift is recommended. You can elect to have either above or below muscle placement for the augmentation portion. Below muscle offers some benefits in that it carries a lower risk of capsular contracture and the muscle provides some implant coverage on the upper portion of the breast. I've included a video I hope you find helpful.