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Breast Reduction, Lift and Implants to Get C Cups from DD Breasts?

I am 5'0" and right now weigh 143 lbs. My body fat % is 35. I lost quite a bit of weight two years ago, then gained some back. I definitely plan on losing weight before, but I really want to get a Breast reduction, Breast lift, then get Breast implants. Small ones of course. Is this possible? And how expensive do you think this could get? I am a 38 DD, and they sag quite a bit. They are heavy, and make it hard to work out and enjoy my life. I would like to be about a C cup. But NATURAL looking.

Doctor Answers 36

Great Plan!

It is actually more common than you think to have a breast reduction/lift, then have a breast augmentation 6 months later.  The results with this approach are great.  It allows you do do a very nice lift/reduction operation, repositioning the nipple and reshaping the breast, then allow everything to heal.  After the breast is reshaped you can get the extra upper pole fullness you want with an implant.

Implants for a DD breast not a good idea

With large (DD) breasts that are pendulous (droopy), I would recommend a small breast reduction with a vertical incision technique.  I believe this will give a satisfactory result.  If you are unhappy with the appearance of your breasts after this procedure, you can always come back and place implants in a second operation.

David Finkle, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 61 reviews

BR

Breast reduction, or reduction mammaplasty patients are among the most satisfied of all plastic surgery patients. Large breasts (macromastia) can often decrease quality of life for a woman. With breast reduction, you can have smaller breasts that sit higher on your chest wall. You will also find relief in your neck and back with the decrease in weight and more ergonomic position of your breasts.
There are several different variations of breast reduction, differing by size, and amount of incisions; procedure; and the results. The different types of reduction techniques include: The wise pattern breast lift, the anchor shaped incision, and the donut mastopexy.
1. The wise pattern breast lift involves an anchor-shaped incision around the natural contour of the breast. To most patients surprise, this scar is mostly hidden under the inferior aspect of the breast. However, the scar around the nipple/areola is visible. Most patients heal this anchor type scar very well and are satisfied with smaller areola in exchange for the scars. This surgery is used when there is a lot of excess skin that needs to be removed in order to lift the breast and give it a more aesthetic shape.
2. Often times, the anchor shaped incision can me diminished to create a lollipop or J shaped incision. This results in some excess skin at the inferior aspect of the breast near the breast crease that will flatten out over a 6 month period. Some patients are willing to tolerate this excess skin for 6 months in exchange for a smaller scar. This is a personal decision that each patient can make.
3. The donut mastopexy involves creating an incision around the areola and removing a doughnut-shaped area of skin. This surgery can be used for patients that need a smaller amount of lifting. This surgery results in a scrunched-up look to the breast skin surrounding the areola for about 6 months before it flattens out. Patients need to be understanding and tolerant of this in exchange for an areola-only scar. These patients do run the risk of areola widening as well.
Insurance may cover some of these cases when back pain, shoulder bra-notching, and rashes under the breast are present. Insurances vary though and your doctor can submit a report and photos to see if your insurance approves your procedure.
The risks of the procedure include bleeding, infection, bruising, poor scarring, pain, swelling, and changes to nipple and areola sensation, and rarely, partial or total nipple loss. The recovery time is usually a couple weeks if all goes well. In general, however, breast reduction patients are some of the most satisfied and grateful plastic surgery patients. This is truly a life-changing procedure. In my area, the cost ranges from 6700-8500. Best of luck!

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 26 reviews

Breast reduction and augmentation

A standard breast reduction (which includes a lift) should be all that you need.  I generally do not recommend placement of breast implants when you are doing the reduction because a very natural look can be achieved without them.  When you place implants, you will increase your size; if you are wanting a reduction, that defeats the purpose.  After the surgery if you are unhappy with the shape AND you are okay being 1 or 2 cup sizes larger, then you could consider an implant.

Allen M. Doezie, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 8 reviews

Reshaping Your Breasts May Not Require Implants

Modern breast reduction and lift techniques help to reshape and support the breast so that implants may not be necessary., even if you are starting with very saggy breasts.
Implants do not support the breast, so if you have enough tissue, implants are probably unnecessary.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 17 reviews

Do This in 2 stages

I am not truly opposed to the concept of a breast reduction and implants. I am just opposed to it being done at the same time. A breast reduction is different from a breast lift, where there is really just loose skin and a drooping breast.

A breast reduction requires a huge rearrangement of the breast tissue. It is too unpredictable to place an implant at the same time as a full breast reduction.

The reason I am ok with doing a reduction and THEN implants (3 months later) is because implants sit higher on the chest. NO breast lift or reduction (even if done by a really famous plastic surgeon) can actually add considerable fullness to the upper breast like an implant can do. SO if you want not only lifted and smaller breasts, lifted nipples AND fullness in the "upper pole" then you should have a TWO STAGE breast reduction and then implants.

Just my not so humble opinion.

Breast reduction

Thank you for a wonderful question.
well as you should be aware the only way to really know what type of
surgery you need is in the consultation office.
but assuming you are clear for surgery and base on what tell us and the picture you send a breast lift  would be ideal, and you have indeed enough tissue to accomplish the size you desire without the use of a implant.
but if you desire the use of a small implant (for a more projected breast) you need to understand that the size of the implant needs to be plan carefully to avoid complications.
 

Enriquillo Clime Rivera, MD
Dominican Republic Plastic Surgeon

Breast reduction accomplishes lift and volume repositioning

Based on the description given here, it sounds like you may be a better candidate for a small breast reduction/mastopexy procedure. If your skin is good quality breast tissue can typically be repositioned to a more youthful position on the chest without needing to utilize breast implants. I would certainly recommend reaching your ideal body weight prior to undergoing a breast reduction or mastopexy procedure as this can significantly alter results over time.

Rachel Streu, MD
Ann Arbor Plastic Surgeon
5.0 out of 5 stars 8 reviews

Breast Reduction, Lift and Implants to Get C Cups from DD Breasts

You have raised very good questions. 

I can not advise you specifically without performing a history and physical examination in person. 
However, in general it sounds like the goal is to achieve smaller volume (reduction), a lift and increased projection which is what I think you mean to achieve with implants. 
In these situations I recommend to my patients that they stage these procedures and start with only the reduction/lift. This procedure will use your own tissues to provide the fullness and projection desired. we then reassess after everything has settled down (6-12 months) and see if implants are really necessary. It is better to use the tissue available than to take breast tissue away only to replace that volume with implants that have their own risks.

Talk to your Plastic Surgeon and define whether you need a lift/augmenation or a reduction. 

If insurance is an option for the reduction, then the cost out of pocket will depend on your coverage but should be reasonable. 


Good luck and enjoy your results

Bram Kaufman, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 8 reviews

Breast reduction and lift and implants

All breast reductions are breast lifts. If you are having pain due to large breasts, the solution is a breast reduction. Adding an implant even after a small reduction doesn't generally make sense unless it's only done for cosmetic reasons. Consider that the weight of the breast tissue removed in a breast reduction is usually less than or similar to the weight of a breast implant. Someone with neck and shoulder pain will not have their problem solved by trading breast tissue for breast implants.
The goals of a breast reduction versus a lift with implants are completely different. There is no question that you cannot achieve "fullness at the top" without an implant, but this is a cosmetic concern, not a medical one. 

Orna Fisher, MD
Las Vegas Plastic Surgeon
4.5 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.