Has anyone had breast lifted,no silican or saline put in, I dont like the idea that puting saline or silican in you will need to replace in 15 to 20 years, I had a friend whos ruptured,one did and looked mightly strange.

Hi Slimmy120,

You do not have to have an implant with a breast lift and there are some surgeons out there who don't even like to do both at the same time.

However, if you haven't already, you should look at photos of breast lifts with and without implants, and see what you like best. Also, you should get your Dr.'s recommendation about what would work best for you.

Once I started looking at photos and focusing in on this issue, I immediately decided that I prefer the "look" of a breast lift with implants. My husband on the other hand seems to like the look of breasts without implants. (Even though I love my husband dearly, these are my breasts, and I'm going with the implants .)

As you can see, there are different ways you can go about this and the decision is pretty much up to you.

Using an implant during a breast lift after weight loss helps in 2 ways:

1. It helps restore the volume that has been lost during weight loss. Most women's bresats are over 50% fat tissue, so as you lose weight, you will also lose volume in your breasts.

2.It helps adds fullness to the upper portion of the breasts. After weight loss, this upper part, or superior pole, becomes very flat. A breast lift (without implants) often does not add much volume to this upper pole of the breast.

There are newer techniques that have been developed specifically for women who have undergone weight loss, desire more volume (particularly in the upper pole) but do not want an implant used. Experience bariatric plastic surgeons can perform this technique and give the appearance of implants...even though there were none used.

Here are two examples of women who wanted the look of an implant...without the implant. The technique uses the extra skin from the side ("bra roll, "side roll") and transfers it to the breast to act as an "implant" of your own tissue.

Example 1

Example 2

I hope this information helps.

Nice work doc! I've been wondering the same thing myself. Looks like I can still be me only improved!

Beautiful work Dr. Schulman!

It amazes me how many different things can be done nowadays, and it's great that you are taking the time to explain and show us some of these new techniques.

I'm very intrigued by this and it looks fabulous, but for me, I think I still prefer the perfect shape and symmetry of an implant.

My only real concern going into this is that I get the right size implant because I don't want to go much larger than a small "C" cup (anything larger would not be commensurate with my look or body type). My Dr. is thinking 400cc silicone implant, but this still seems a bit large to me..............

I'm hopefully going to have breast lift later this year. I've had similar advice to what Dr Schulman has said above though, that I'd probably need an implant to go along with it, to get a good result. My upper chest is so flat that my actual sternum sticks out further than my breasts. And we were lying in bed this morning when Eliza came in (mother's day, sigh) and laughing at this puddle of skin lying on the sheet in front of me - it was what used to be my right boob, boo hoo.

Trouble is, I'm a D cup. I do not want ginormous plastic tits. So I'm really not sure what I'm going to do but I also dont want to pay what is serious money at our stage of life for a mediocre result. And I used to have GREAT boobs and I want them back!

I'm not sold on the safety of implants, that's the trouble. What I dont understand is that they wont last my lifetime so will have to be upgraded at some point in time. I'm 40 now. Will I really be wanting a new set of breast implants at 60? And if I dont, what on EARTH are my poor boobs going to look like by then?

Its a lot to think about. Dr Schulman's Example 1 is almost exactly what I look like now, I would be absolutely THRILLED with a result like that if I could get it from just a lift. I'm really similar in size and shape to that patient.

Edited May 10, 200818 yr by Jachut

When I went to see a plastic surgeon earlier in the year, he said it was not necesarily the case that a person would need their implants replaced at any stage. That it would differ from person to person depending on their circumstances. I guess its safer to bank on the fact that you *might* need them replacing, but you also might not. That made me think twice about wanting implants if/when I get a lift in the future. Because I couldn't think of anything worse than needing to go in and get and "upgrade" every 10 years like a car or something!

You make some good points ladies, but my feeling about this is that 15 years from now, my body will have shifted enough that I will probably want to have some additional PS done anyhow. This is not to say that I want to have more surgery or spend the money again, but as we age that's just the reality of things.

As far as the longevity of the implant, I too have heard from my Dr. that they may or not need to be replaced. In fact my Dr. told me that he recently told a patient who had 15 year old saline implants that they were fine and did not need to be replaced at this time.

I am actually more concerned about the implant I already have now, my Lap Band. When I read some of the stories from people who have had their bands for 5 years or more, I'm really beginning to wonder if that will need to be replaced. I hope not because it will give me zero satisfaction to replace a piece of hardware on the inside of my body..........

I've decided against implants. My doctor discussed the technique that Dr. Schulman describes to get the fullness in the upper pole and I've decided that I'll be happy with those results. My main issue with implants is adding yet another foreign object to my body that could fail. I too am concerned about future complications with the band and not having implants will be one less thing to worry about. I like the look of implants, but not enough to add that extra concern.

Or the cost! A lift here in Australia will cost me less than $7,000, with implants it will almost double. But I'm going to get several opinions, I really want to sort this particular detail out. I'm not going under the knife unless it really worth it.

Hi Dr. Schulman,

I have a question for you, when you are doing a breast lift with silicone implants, is there a particular type of incision that you find yourself using more frequently using than others? If so, what would that be?

Jachut, I wonder why implants double the cost of this surgery in Oz? That's definitely not the case here in the US. My silicone implants are adding 2K to the price of the surgery, and if I had gone with saline, it would have been 1K.

Hi Dr. Schulman,

I have a question for you, when you are doing a breast lift with silicone implants, is there a particular type of incision that you find yourself using more frequently using than others? If so, what would that be?

Jachut, I wonder why implants double the cost of this surgery in Oz? That's definitely not the case here in the US. My silicone implants are adding 2K to the price of the surgery, and if I had gone with saline, it would have been 1K.

When performing breast lift with implants in a weight loss patient, I almost always use an anchor incision. Yes, this is a more extensive incision, but most weight loss patients require more extensive "remodeling" of their breast tissue. In other patients (not weight loss) I am usually able to do the surgery with just an incision around the nipple-areola-comlex. There is an occassional weight loss patient that will do ok with the smaller incision, but in my experience, this often leaves them "undercorrected."

Regarding the cost of breast implants.....doing a breast lift with implants can be a complicated procedure - especially in weight loss patients. It is not accurate to think of it as just doing a breast lift, then putting in implants. The cost will reflect this and there is great variability between surgeon and region (or country). I can tell you that a pair of silicone implants costs around $1800 and saline about $900.....this is just the cost to buy them, and does not reflect the procedure cost.

I can only comment specifically about my fees. My fee for a breast lift is around $6,000-8,000, and my fee for breast augmentation is around $8,000-10,000. A breast lift with implants is usually around $10,000-12,000.

Hopefully this information helps. The fees are a guideline and will vary between surgeons and regions - I am in NYC and the prices tend to be slightly higher than in other regions.

Thank you so much for the info Dr. Schulman. My Dr. told me that he would need to use an anchor incision and it's good to have confirmation that any other type of an incision is probably not an option for me given my circumstances. I'm sure nobody wants to have the anchor incision unless it's necessary, and it sounds like it is necessary for me.

Thanks again for the feedback !

Frangi, a friend of mine told me she got a lift + augmentation - she is 6'0 tall and simply gorgeous, and she went with a DD size :rolleyes2:

She looks superb. She showed me her work 1 year post op (at first a little odd my friend whipped off her shirt, but hey, we're all friends here right?? LOL) and I gotta tell ya, no wonder she's flashing people! The lollipop/anchor scar was smooth with the rest of her skin and faded really nicely after 1 year. I know people are all different in how they scar, but I was really impressed with the work her doc did.

I was considering implants but I was blessed with enough tissue to keep my D's. Even if I end up with C's I'm not complaining...I, like Becky, want to keep it simple. Who knows, 10 years from now I might want rockets on my chest! But for now, I'm very happy with the naturals. Then again, I've been told my shape is pretty decent by 2 docs and the anchors will not be extensive as other WL patients, so again, it depends on your body type.

(I think implants look gorgeous tho!)

Thanks for the feedback Kate,

My Dr. does stunning breasts, I love the look of implants, and everyone I know who has silicone is extremely happy with them, so there's no doubt in my mind about any of these things.

The only question mark in my mind at this point is the scarring. It was was therefore great to read what you thought about your friend's scar one year post-op. My breasts are small and they won't be made very much larger, because shape is far more important to me than size. (Although I am going to go up one cup size to a small "C" because there is just no way I am paying thousands of dollars for a "B" cup -- it just isn't a good "value" :rolleyes2:.)

My Dr. told me that he will be doing the anchor, but I'm hoping that since my breasts are not very large (or even very droopy), that he will be able to minimize the size of the incision and the scarring.

If anyone else has any feedback regarding the anchor incision and scarring, I would be happy to hear more.