Breast lift surgery, called mastopexy, is a great procedure used to reshape the breast. There is a lot of confusion though as most woman think that you need to have an implant to lift the breasts. This is not true. As with many things there is a range of “sagginess”. In general the saggier the breast the more scars are needed to give the best result. The scars come in three basic patterns, the peri-areolar (circular scar completely around the areola), the “lollipop” (periareolar plus straight down vertical), and the anchor (around, down and underneath the breast). With mastopexy alone the skin is lifted up, uncovering the breast tissue. The breast tissue is then reshaped and tightened in a number of different ways. Then the skin is wrapped around the new tighter breast and the extra skin is removed. The breast should end up tighter, higher and perkier. The cup size should remain pretty close though could go down perhaps a half cup. If you are happy with your breast size in a bra but unhappy woith the way they look out of a bra than most likely you only need a lift and no implant. On the other hand, if you are unhappy with the appearance of your breast out of a bra and want more fullness, then you will need to add at least a small implant. I generally recommend restraint when adding an implant. This is because adding an implant and tightening the breast work against themselves. The larger you make the breast, by adding an implant, the less tight you can make it. Most women, especially after children, want a tighter, perkier breast, not just a bigger a breast. I do not agree with doctors who suggest that “implants lift the breast”. This is really just an illusion and works in only certain breasts. If the breast does not have good support and you add a large implant to fill out the whole breast, it is likely that you will end up with a larger saggy breast. If not immediately, than soon down the road. It is true that when adding an implant to a lift operation the scars can usually be less. But this is a trade off that needs to be explained well at the time of your consultation. The most important thing is to understand what it will take to get you to your goal. Then you can decide whether it’s worth it. Check out my website at www.cosmeticsurgerybaltimore.com for more info and photos.