Concerned About Getting Good Post Op Shape After Breast Reduction and Lift.

I am 43 and a 34 DDD/F with sagging after baby and wt. loss. I have consulted w/ 3 surgeons about a breast reduction/lift. I have been disappointed with post op photos as the breasts often look flat on top and too droopy. I dont want to have to get implants to get a nice shape. Only one of the surgeons had fantastic "after" photos. Is this a result of technique or the patient? How can I know if the surgeon's technique will likely promote that upper pole fullness? what ?'s should I ask?

Doctor Answers (7)

Upper pole fullness with a breast reduction.

+2

Different breast reduction techniques will lead to different results in the postoperative shape to the breasts. Certainly patient anatomy plays a large part in the overall results. I find that techniques which suspend the breast tissue from the upper pole (such as a superior medial technique) result in more upper pole fullness, better coning of the breast, and longer lasting results. Classic techniques such as the inferior pedicle technique often lead to flattened appearing breasts and have issues with bottoming out over time. Questions to ask are how many reductions a surgeon has performed, what type of reduction are they comfortable performing, and whether or not they are board certified by the American Board of Plastic Surgery.


Boca Raton Plastic Surgeon
5.0 out of 5 stars 12 reviews

Large sagging breasts after childbearing

+2

Childbearing and lactation can produce marked changes in the shape of your breasts. Commonly after multiple children, the repeated stretching and engorgement of the breasts leave the skin lax and with stretch marks. The glandular tissue also involutes into a tighter mass at the bottom of the breast, thus your upper pole appears flat. Most breast reduction procedures decrease the volume (and weight) of your gland and tighten the inferior skin to place the nipple and remaining gland in a more "natural" position. It is for this reason that surgeons will suggest a small implant to help fill the upper pole on breast LIFTS. In your case (reduction) the techniques of gland suspension used for patients after massive weight loss may be a consideration.

Ricardo Izquierdo, MD
Oak Brook Plastic Surgeon
3.5 out of 5 stars 6 reviews

All surgeons are different and wil give you different results in plastic surgery

+2

The 2 main determinants of the plastic surgery result you will get are the nature of your own tissues and the skill, talent and artistry of the plastic surgeon you choose.  Named techniques or cute advertised procedures will not be more important than either of these 2 priorities.  Go back to the one with the best results and ask what they honestly think they can do for you.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 51 reviews

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Breast Reduction Results?

+1
Thank you for the question.
Although it is difficult to give you good advice without direct examination, the results of your breast reduction surgery will come down to two major determining factors.
1. The skill  and ability of your plastic surgeon.  This can be best evaluated by evaluating before-and-after pictures and meeting with patients who've had similar procedures performed.
2. The current condition of your breasts  and skin quality/elasticity will play a major role in the final outcome of the breast reduction procedure.
Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 781 reviews

Each patient is different

+1

A very important determinant of what result you obtain will be what your breast look like beforehand. the public

is often mislead that regardless of what the surgeon starts with, he/she can shape your breasts into what they looked liked when you were 18 y/o and your ideal weight. there certainly is a role for technique and artistry. however, the shape of your breasts, the degree of skin tone, per cent of fatty tissue, your overall weight/height etc all play an important role in the result you will obtain. 

also if your breast are this big, i would suspect the shape is not ideal. you will definitely have an improvement in your shape and appearance but you must also keep your expectations realistic. 

 

good luck

sincerely

david berman md

David E. Berman, MD
Sterling Plastic Surgeon
5.0 out of 5 stars 23 reviews

Breast Reduction - Concerned About Getting Good Post Op Shape After Breast Reduction and Lift.

+1

 Hi blossom,

There are many factors that go into the post-operative appearance of this - and all - surgical procedures.

These include the preoperative appearance, the surgery that is done, and the way that the patient heals into his or her new shape.  For breast reductions, the factors that can be controlled are really just the surgery - the Prue-operative appearance is out of your control, as is the way you will heal.

So one part of the post-op photos you liked may be the way the patient was before hand.  In general, firmer tissue with more breast tissue and less excess skin is more likely to remain "elevated" than when there is already a lot of sagging (nothing personal).  There are trade-offs with all techniques and approaches, so I don't know that there is a single approach that you can select that will guarantee you a specific result.  Sometimes the best results after a breast lift or reduction - are actually when an implant has been inserted, either at the initial procedure or at some later date.

I'd suggest choosing the surgeon you're most comfortable with, which should be a combination of credentials, results shown, and your ease with interacting with the surgeon and his or her staff.

I hope that this helps, and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 155 reviews

Breast Reduction and Breast Shape

+1

Hello Bellasmom,

In general, upper pole fullness is a lofty but elusive goal of breast reduction surgery, and is not obtainable in the typical fatty breast, regardless of the technique.  In certain individuals with very youthful, glandular breasts, upper pole volume is more reliably obtained.  Typically this is seen in women in their adolescence.

For most women to obtain upper pole fullness however, a breast implant should also be utilized as part of the breast reduction surgery.  This will enhance the overall appearance and result of the breast reduction by giving upper pole fullness.  Utilizing an implant will also allow the surgeon to remove more of the 'sagging' tissue, which will give a better shape to the lower pole as well.

Ask your surgeon about simultaneous breast augmentation and reduction to achieve optimum shape.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 33 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.