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Is it right to get a breast aug. with 500cc implants without a lift, when I am already a DD cup with saggy breasts?
My personal opinion:
Large implants do not replace the need for a breast lift. Your concerns are right!
Because breast implants by definition make the breasts larger, there is a risk of worsening the sagging over time when they are used in breasts that are already large. I believe this often applies to smaller breasts too. Trying to correct sagging with implants is not usually a good idea. One exception is breasts that have deflated after breast feeding, but this would apply when the skin envelope is loose, not true sagging.
Adding 500 cc breast implants to DD size breasts, whether saggy or not, in my opinion, is a huge mistake. This is especially true since you "do not want to be huge." Even with a lift, the sagging will recur. Also, I have never seen a woman happy for very long with that large a breast. My advice to you, with saggy DD breasts, if you want large breasts, just do a lift. If you do decide to add the implant, you will need a lift no matter how large the implant.
If your nipples are below your inframammary fold, it is generally accepted that a breast lift will be needed to provide a satisfactory appearance. Augmenting saggy, large breasts will only create larger, saggy breasts (the rock in the sock look). You should discuss this further with your surgeon and if he/she is not an ASAPS member or Board Certified in Plastic Surgery, I would suggest you get a second opinion.
It depends on what you want your final result to be. 500cc implants added to sagging DD breasts will leave you with slightly less sagging DDD or E cup breasts. However, if you are looking to be the same size or slightly smaller but firmer and more projecting, you may want to consider a lift (mastopexy) or small reduction instead. No implants are necessary for this approach. Talk it over with an experienced board-certified plastic surgeon.