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Do I Need A Breast Lift Or Breast Augmentation?

Breast augmentation is one of the most popular cosmetic surgery procedures for good reason. When performed on the right candidate, breast augmentation can result in beautiful, full, natural appearing breasts.

However, performed on the wrong candidate, breast augmentation can result in seemingly high riding implants with natural breast tissue hanging off the front, resulting in a “Snoopy nose" breast appearance. So how do you know if you need a breast lift or breast augmentation?

Below are some questions to consider when determining what procedure is right for you.

  • Are you generally pleased with the appearance of your breast but wish they were larger and fuller?
  • Are your breasts perky, without significant sagging or loose skin?
  • Are your breasts similar in size and shape, and symmetric?

If you answered yes to these questions then breast augmentation might be the right choice for you. Our patient shown below was happy with the look of her breasts but wanted larger, fuller breasts. Given she had no significant sagging or asymmetry, breast augmentation alone provided her the cosmetic result she was seeking.

However, if you answered no to any of the above questions consider the following:

  • Do you like the size of your breasts but are concerned because your breasts appear saggy or have lost their shape and volume?
  • Do your nipples point downward?
  • Do you desire firmer, perkier breasts?
  • Does your skin appear stretched and your areolas enlarged?

If you answered yes to the these questions, breast lift or mastopexy may be the better choice.

Our patient shown above liked the size of her breast but was unhappy with the sagging and downward pointing nipple, and desired firmer, perkier appearing breasts. In this case a mastopexy helped her meet her cosmetic goals.

Think you know what procedure will be best for you? A critical step in chosing the right procedure is determing if you have significant ptosis. Or, how saggy is too much sagginess?

An easy, at home way to assess breast ptosis or sagging is the pencil test. The pencil test is performed in front of a mirror and requires a standard number 2 pencil. Lift your breast with one hand, place the pencil horizontally in your natural breast crease, release your breast and then the pencil. If the pencil falls, you do not have any significant ptosis or sagging. If the pencil stays in place, then some degree of ptosis exists and the next step is to determine how much.

Look in the mirror and note the pencils position in relationship to your nipple. If your nipple is above the level of the pencil you likely have pseudoptosis. Psuedoptosis is common in women who have lost weight or breast fed, and the breast often appears deflated. If your nipple is at the same level as the pencil, you likely have mild or grade I ptosis. Grade II ptosis is suggested if your nipple is below the pencil. If your nipple is pointing downward, or is at the lowest point of your breast, you likely have grade III ptosis.

Pseudoptosis and grade I ptosis typically do not require a breast lift and you can obtain good cosmetic results by adding more volume through breast augmentation with implants. Breast lift or mastopexy is usually a good idea with grade II and III ptosis.

I have provided a few quick, do-it-yourself assessment tools to help you understand whether a breast augmentation or breast lift is right for you. Ultimately, each patient is unique and should consult with her trusted cosmetic surgeon to determine which procedure will help her reach her cosmetic goals. Please contact us if we can be of any assistance in helping you decide what is right for you.