At Valley Plastic Surgery many patients present for breast enhancement – but many women are also unsure if what they want are breast implants or if they require a lift (mastopexy) procedure, with or without implants. So how do you know if you need breast implants or breast lift?

To be entirely sure, a complete assessment by a fully qualified plastic surgeon such as Dr Raymond Goh, based at Valley Plastic Surgery, who is highly experienced in breast enhancement surgery is necessary. However, there are a few tips that patients can apply to get a fairly close idea as to which procedure is required to give them the result they are looking for.

The Easy, “Look in the Mirror” Assessment

Patients can gain a quick assessment just by looking at the mirror (with arms down by your side) or at photographs taken of them. Try to avoid ‘selfies’ of breasts as these are often taken at incorrect angles and distances, rendering them distorted and inaccurate.

When you look at the mirror, make a note of where your inframammary fold or breast crease is – this is simply the place where the breast and the chest meet. The folds on each side may be at different levels, and this factor in breast asymmetry is common and can be considered normal. Once you have determined where your breast fold is, take note of the following:

• The nipple position – is this above the fold, at the fold, or below the fold?
• The bulk of your breast tissue – is this above the fold, at the fold, or below the fold?

Choice Based on Your Individual Assessment & Wishes

Once the above questions have been answered, Dr Goh has most of the necessary information required to determine which is the best operation to perform; this however has to be balanced with what result you are aiming for, as there are sometimes limitations caused by the patient’s anatomy.

In general, if your nipple and most of your breast tissue lies above the breast fold, then you should get a very good and long-lasting result with just implants. On the flip side, if your nipple and most of your breast tissue lies below the fold, then you will not be able to get a good result with implants alone. You will in this case require a breast lift, with or without implants (depending on what volume you wish to achieve).

The tricky judgement call arises when the nipple and/or the bulk of the breast tissue lies at around the breast fold level. These ‘borderline’ situations demand one other important question to be answered – what size or volume increase are you looking for?

In cases of borderline droopiness, the patient may be able to get away with a reasonable result with an implant alone; however, the caveat is that implant must be of a large enough size that will allow the loose lower skin to be filled.

The result of such an approach may give a satisfactory result, but it certainly won’t be as ‘perky’ a result when compared with a lift or the result gained with implants in a non-droopy patient. If you are a borderline case and only looking for a small increase in size/volume, then a lift is often advised.

The trade-off with a lift (with or without implants) is, of course, the inevitable scarring. A breast lift (or mastopexy) involves elevating the nipple areolar complex to a higher, more desirable position, removal of lax breast tissue, and tightening of the breast skin envelope. This scarring in most patient will fade with time and become quite inconspicuous.

This is a quick and simple analytical process that enables you a fairly good idea to see if you are a good candidate for breast implants alone or if you require a breast lift. Remember, nothing beats a comprehensive assessment with Dr Goh at Valley Plastic Surgery. This way you can know what kind of result you are looking for in terms of both shape and size. Discuss these with Dr Goh to see if they are achievable.

NOTE** These photographs of before and after results are examples only, and do not constitute an implied or any other kind of certainty for the result of surgery or a non-surgical procedure. All surgery carries risks, you should seek a professional opinion before proceeding.