A frequent question I get all the time from patients is if I think a breast augmentation alone will give them the result they are looking for. I think in most cases, they want to hear that you can get a breast augmentation alone and your breasts would look full and perky and perfect and you would not need a lift.
Most of the time, it just isn’t that simple. Things like childbirth or changes in weight can drastically affect the breast shape causing ptosis (drooping of the breast skin and tissue from its natural position). The goal with breast augmentation is to put the implants in a position where the natural breast tissue and nipple are most projected over the implant. When you have ptosis that means that your natural breast tissue is sitting too low (Fig 2a). If you place the implant in the proper position to give you fullness and cleavage at the top of the breast, the natural tissue will hang over and below it and look distorted (this is called a waterfall deformity (fig 2b)). If you place the implant very low so that it is in line with the rest of your breast tissue, the implants will appear low and not give you the upper fullness you desire.
These descriptions are all based on what your breasts will look like when you stand in front of the mirror naked. However, if your breasts look fairly good now if you put them in a bikini, you can probably conclude, that your augmented breasts will also likely look good in a bikini because the bra will hold all the tissue up and in the proper position.
I have had patients that I explain this to and most go with the option of getting the lift with the implants, as this provides the best possible outcome for fullness of the breasts both in and out of clothing. However, there are some that still decide to proceed with breast augmentation alone without a lift. They do not mind that their breasts will look different and have a waterfall deformity when they look in the mirror naked. They are happy with their result in clothing or in a bikini, which is what their main goal was to achieve. So it just depends on what would make you happy, and what result you couldn’t possibly be satisfied.