Q: I am very interested in breast augmentation. I have been pregnant four times and between weight gain and loss my breasts are in need of some repair. Do you think I will need a breast lift also?
A: The anatomic determination of whether any breast needs lifting is based on where the nipple is sitting relative to where the lower breast crease or fold is. If the nipple is at or above the lower fold, one will not need a lift in combination with breast implants. If the nipple sits below the fold, whether it be a little or down so far the nipple points to the floor, then a combination implant and lift will be needed to get a well shaped breast that has the nipple centrally positioned on the mound and pointing forward.
When a women has had more than two pregnancies, it is almost a certainty that a breast lift will be needed. I do not recall ever seeing in my Indianapolis plastic surgery practice a patient with three or four pregnancies who has not needed one. When you combine the number of pregnancies with up and down body weight, there has undoubtably been a lot of stress and strain on the breast skin. This translates into breast skin that is loose, deflated and has a low nipple position. This will happen to most breasts whether one has breastfed or not.
A breast implant will add volume to the mound but will not significantly lift a downturned or low nipple position. That is exactly what a breast lift does…get the nipple back up to where it once was or close to it.
Dr. Barry Eppley