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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 31

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.

Omaha Plastic Surgeon
5.0 out of 5 stars 53 reviews

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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 7 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 7 reviews

Breast Reduction

Considering all the different approaches to your ultimate desired result I think the most sensible thing to do is just have a breast reduction with the goal in mind of having natural appearing smaller breasts with a C cup. All breast reductions include a lift as part of the reduction surgery

Fred Suess, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 6 reviews

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

To achieve what you are seeking, it is best to break down the surgery into stages. The first stage may be a combination of breast reduction and breast lift (most likely a vertical incision). After 6 to 12 months post this stage, you can assess if you want/need implants.

The cost of a combined Breast Lift and Reduction like other plastic surgery varies considerably across the country and even in the same area. South Florida tends to have lower fees then more expensive areas such as New York or Los Angeles. We charge starting at $5000 + MD Anesthesia related costs for a combined breast reduction and breast lift. Since you can get quality work at lower costs, patients will travel from throughout the state, the country, and internationally to have surgery in South Florida.

To ensure that you are receiving quality work at the most cost effective prices, consult with board certified plastic surgeons that own their own nationally accredited facilities. The quality must be maintained at the highest level to maintain accreditation. The surgeons also have incentive to hire and train quality staff (to ensure that surgery is efficient and enjoyable), to ensure comfortable and private facilities (to encourage referral), and to eliminate waste (to ensure that these facilities can compete effectively).

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 21 reviews

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.

Breast Reduction... To Implant or Not To Implant, That Is The Question

Greast question. There are obviously alot of opinions. There is no specific right or wrong procedure. There are different opinions with each procedure having different risks and results. You will have to be the judge. You should look at multiple before and after photos of the different procedures and see which results you like best, including shape, scars, etc. Then choose a qualified surgeon who you feel confident can produce the results you seek.
In my opinion, you would get a very lovely, natural C cup by a breast reduction alone. A breast reduction encompasses both a reduction in breast tissue and skin, along with a breast lift. Rather than discard some of the breast tissue, in can be used for your own natural augmentation. With this "auto-augmentation", breast tissue that would normally be discarded, is rotated high up onto your chest above the nipple, producing fullness from your own tissues. This will avoid the additional expense and the need to deal with potential breast implant complications as well as avoiding the need to replace in the future. There is also additional risks to the blood circulation of breast tissues when performing breast reduction surgery and breast implants at the same time. 

Breast reduction and implants

A breast reduction with implants is useful in women who have very saggy tissue, especially in women with excessive weight loss.  However, most women do well with just a breast reduction, and do not need implants. Having implants may lead to future surgery. Breast implants can always be added later should you desire more fullness.  Many times it is safer to your breast tissue to just do the breast reduction, and save the augmentation with implants for a second surgery.  What little I do see of your photos, you appear to have fairly good skin. I would suggest meeting with a plastic surgeon, and discuss your options.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.0 out of 5 stars 5 reviews

Breast reduction and breast Implants - OT Auto Augmentation mastopexy

Auto augmentation mastopexy is a surgery that repositions your own breast tissue into a more pleasing and comfortable position.  Auto-augmentation mastopexy makes the breasts only as much bigger as there is lower pole breast tissue available to move into the upper pole.  The lower pole tissue that is moved up is fixed in place with sutures to the pectoral fascia, so it is not possible for the relocated tissue to ‘drop’.  

Breast implants add volume (and weight) to the breasts while auto-augmentation really does not.  Additionally, implants augment the entire breast, while auto-augmentation augments the upper pole only.  So for many reasons auto-augmentation results tend to be less prone to recurrence of droopiness.

Other advantages of auto-augmentation mastopexy:

                #1 - Zero need for implant surveillance and possible replacement


Zero risk of capsular contracture

                Zero risk of implant migration / malposition

                Zero risk of visible fold/ripples

                Zero risk of implant infection

Auto-augmentation mastopexy is absolutely the procedure of choice for a patient who wants a breast lift, who will not have adequate upper pole fullness without an implant or auto-augmentation, and who is happy with the amount of breast issue that she is starting with.  If a patient wants a lift AND fuller breasts (i.e. increase in true cup size), then an implant is required.

It is important to understand that there is no plastic surgery procedure for which the results do not change over time.  Skin is elastic and stretchy and so is breast tissue, and that ‘stretchiness’  increases with age.  The elasticity of skin and soft tissue is genetically determined, and it therefore varies widely from patient to patient.  So it is impossible to predict for any one patient how long it will be, if ever, before they feel they need a secondary mastopexy – which in most cases is just a touch-up procedure and not nearly as extensive as the original mastopexy.  Certainly if a patient has breast stretchmarks and thin breast skin from multiple pregnancies, then that patient is more likely to need a secondary mastopexy at an earlier date than a patient with thicker skin and better skin and breast tissue tone.




Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 48 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.