A common question that is asked during a breast enhancement consultation is whether the woman needs a breast lift, breast implant or both. The answer to the question is in the anatomy of the woman and her desires.

A breast lift consultation often will start with the woman asking several questions that are on her mind. After answering these questions, more detailed questions will be asked by the plastic surgeon. Specifically, the most important questions are:

Is the woman happy with the size of her breasts?
Does the woman want her breast made smaller, larger, or remain the same size?
Is the woman content with the firmness of her breasts?
Is the woman looking for more fullness in the upper half of her breasts?
Any increase in size, firmness, or upper half fullness in the breast requires that a breast implant be placed. Keeping breasts the same size or reducing the size of the breast can be accomplished without using a breast implant, and she can have just a breast lift plastic surgery.

A breast augmentation (breast implant) consultation also starts with the woman asking her questions. After these are answered, the plastic surgeon will usually complete a history and physical exam of the woman. During the consutation, it may become apparent that the woman needs more than just a breast implant. It is usually the shape of the breasts and nipple position which requires the woman to have a breast lift in addition to the breast augmentation.

The woman who wants a breast implant and did not come in for a breast lift is often surprised that she is not a candidate for a breast implant alone. When the nipple is located below the level of the inframamary fold (IMF), the woman needs to have the nipple and gland repositioned to a higher position. This determination is usually made with the woman standing up with her arms at her sides. A woman can stand in front of a mirror, turn sideways and look at her breasts from the side. In this position, if the nipple falls below the crease of the breast (IMF), then the woman should be prepared to have a breast lift. If her nipple is at or above this level, then she may have just breast implants.