Will I Bottom Out if I Don't Have a Breast Reduction?

DD cup bordering DDD.

I am considering a breast lift and went to my first consultation today. The surgeon recommended I have a reduction, but I'm not looking to decrease the size of my breasts. He said I risk sagging within a few years and possibly bottoming out if I just get a lift without a reduction.

Is breast reduction surgery my only option? Is it possible to possibly lipo out a small amount of tissue and get a lift? How long will a lift last without a reduction for my size? Is bottoming out a serious concern?

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10 Doctor Answers | Asked by Dallas9652 in Dallas, TX

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Breast Lift vs. Breast Reduction: Maintaining breast shape and volume

A breast lift or mastopexy repositions the nipple and shapes the breast. A breast lift is a component of most breast reductions, except in the case of women with little to no "sag" in their large breasts which is uncommon and then, liposuction could be used. A breast reduction is indicated when the breast is too heavy to be lifted. In your case i would agree that you will need some amount of reduction in order to lift and shape your breast. You don't necessarily need to lose... more

Bottoming out

I disagree a little with the other authors in that the term "bottoming-out" can be applied to reductions or augmentations; in fact, in my training, bottoming out was one of the concerns in terms of judging breast reduction shapes in comparing vertical with standard techniques. But that is semantics. Basically, what you want to know is whether your lifted breasts will stay lifted, and for how long. The answer is, like most things, it depends. It depends on how much skin excess... more

Breast Lift and Recurrence of Ptosis

Thank you for the question. Recurrent ptosis (sagging) of the breasts is very likely after breast lifting surgery. The variables involved include breast size, breast skin elasticity, weight gain/loss, and pregnancies. It is best to eliminate as many of these variables as possible prior to mastopexy (breast lift) surgery. For example, if a patient is at her long-term “stable weight” and has no further pregnancies planned she has remove some of the... more

Breast lift vs reduction

I agree with other posters that the expression bottoming out is misused here. Bottoming out refers to a breast implant appearing to sit too low on the chest, which is not pleasing to the eye. In your case, I think a small reduction is warranted. Otherwise you are at higher risk for further sagging, especially if you go on to gain weight. Mastopexy alone could certainly be performed so long as you accept the risk of reoperation at a later time. The standard breast reduction entails a... more

Breast lift...will I bottom out if I don't have a reduction?

In a word, yes. Even with manipulations of the underlying tissues, breast lifts are essentially skin tightening procedures, and large heavy breasts just do not hold up as well as smaller breasts do. With your breast size and apparent weight of your breasts, a breast lift would lift your nipples to a higher position and at least initially make them not hang as far over your inframammary fold, but very soon, within months perhaps, your heavy breast will restretch and I would... more

Breast lift vs breast reduction

You can certainly have a breast lift and maintain your same size or volume. The pattern is very similiar for a breast lift vs a breast reduction. I would not be concerned about "bottoming out" if you have a short scar or vertical type of breast lift performed. A board certified plastic surgeon can explain this to you in greater detail during your consultation once you are thoroughly examined. There are many good plastic surgeons in your area, I recommend consulting with a... more

Breast lift

The larger the breasts, the more likely with a lift that they will relapse sooner than if some weight is removed. A lift certainly could be done without removing much tissue, but some usually is removed to mold it and give it a good shape;

Steven Wallach, MD

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Manhattan Plastic Surgeon

Will I Bottom Out if I Don't Have a Breast Reduction?

Technically the term "bottom out " refers to breast implants that sit too low on the chest wall relative to the lower fold/attachment of the breast (aka infra-mammary fold). You could only have this potential complication if the surgeon was also planning on putting in breast implants during you "breast lift". Nonetheless it is indeed possible to have a breast lift only in your case.

Breast reduction or a lift alone

The term you are using 'bottomed out' pertains to breast implants. What your surgeon is referring to is the risk of recurrent ptosis or droop in the breast without a reduction with the breast lift. If the breast is reduced a small amount, say a lower central wedge, the gland can be wrapped and shaped to contribute to the stability of the lift, Without, the lift will rely much on the skin envelope and the droop can recur. The second issue is the recruitment of breast tissue as... more

Breast reduction is often an important part of a breast lift procedure

Based on your photo - I would recommend a small breast reduction on both sides - it will vaslty improve your breast shaping and the longevity of the result. The issue is the sagging tissue you have below the fold beneath your breasts. This tissue is always going to sag, no matter how it is repositioned with a breast lift. Your best option is to remove is completely. You should have a nice result with an experience plastic surgeon.