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Possible to Have Complete Breast Reduction and Implants?

I'm 5'3, 120 lbs, 27-year-old with 34D breasts. They are very uncomfortable. My lower back always hurts (while sleeping, sitting, etc). Is it possible to have a complete breast reduction and then insert breast implants? Or would they keep growing afterwards and look worse? Also, is it better to do this after I have children? My breasts have gone from 34B to 34D in the last 5 years and I'm scared they will just keep growing.

Doctor Answers (12)

Breast Reduction Plus Breast Implants - WHY?

+1

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

                Also:

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. 


Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 40 reviews

Breast Reduction - Possible to Have Complete Breast Reduction and Implants?

+1

Ironically, you may be happiest with exactly the procedure you're describing - a breast lift (which is the same as a small reduction) and the insertion of a small breast implant to maintain superior pole fullness.  First, it's possible that you have a lot of extra skin (nothing personal, of course) and so when you get the lift/reduction you'll be smaller than you think.  Secondly, unless you have a lot of breast tissue you'll get superior pole fullness better with an implant than any other way.  You may want to stage the procedure (ie, have the lift/reduction done now and then wait 6-12 months to see if you still want an implant - this is being recommended by several surgeons around the country) or you can combine the procedures, with the understanding that that makes it a little more complicated (you're doing a lot at one time).  Either way, see a PS with this exact request and see what he or she says; you might find someone in complete agreement with you.

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 150 reviews

Breast Reduction and Breast Implants?

+1

Thank you for the question.

Although it sounds counterintuitive, breast implants may be helpful to achieve superior pole fullness that cannot be achieved and/or maintained after breast  reduction or breast lifting surgery. Based on your description,  you may be better off undergoing the breast reduction first followed by bresst augmentation several months later.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 720 reviews

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Breast Reduction Questions Answered

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Traditional breast reduction will make your breasts smaller, narrow and lift your breasts.   If you do not have breast tissue in the upper part of your chest wall, you will not have the major cleavage seen with breast implants.   If that is the appearance that you wish, then a larger reduction could be performed and implants could then be placed to give you more upper pole fullness.   You will have to consider that you will need to maintain the implants over your lifetime as they generally last only 10 to 15 years.   Additionally breast implants can have rippling and firmness known as capsule contracture.    Breast reduction can be done at any age and many 20 to 30 year old women elect to have it performed.   I don't recommend it if you are planning to get pregnant within the next year or so as pregnancy will have an effect on most women's breasts.   Usually most breasts stop growing dramatically in your 20's as long as you maintain your weight.   

Carlin Vickery, MD
New York Plastic Surgeon
5.0 out of 5 stars 4 reviews

Breast reduction and implants?

+1

You can certainly have a breast reduction to reduce the overall volume of the breasts and you certainly would not need an implant to do that.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Breast reduction and implants

+1

If you are a full D cup, and you want to be smaller, there is no sense in putting in implants at the time of a breast reduction, especially if you are considering having children. You can get an absolutely beautiful breasts with a reduction, as this surgery will not only make your breast smaller, but it will lift them too. Of course, your results will vary depending on the surgeon and the technique, but since you have not had children yet, I would not necessarily recommend doing a "complete breast reduction" then placing implants at the same time.

If you are considering having children and perhaps breast feeding, then a reduction alone would be your best bet. Then, when you are done childbearing, you can re-evaluate your breasts, and determine if you want them lifted, reduced more, or augmented with implants because many women loose breast volume after childbirth.

I would recommend having a consultation with a couple of Board Certified Plastic Surgeons to be examined and go over your options in detail. Good Luck!

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 85 reviews

Breast reduction with implants

+1

Performing a breast reduction would decrease the volume of breast tissue as well as lift the breast and nipple. If you are having significant shoulder pain and discomfort from the large pendulous breasts, then a reduction would be beneficial.

The reason breast implants are sometimes used at the same surgery is to give shape to the upper pole of the breast. A small implant is used and size is determined by the plastic surgeon and you. Generally a small implant is sufficient.

After having children, the breast shape may flatten and stretch even greater. Many moms have the "mommy makeover" after having children to lift and shape the breasts and flatten the tummy.

Andrew Turk, MD
Naples Plastic Surgeon
4.5 out of 5 stars 17 reviews

Breast implants can be placed after reduction

+1

You question is a 'what if' type. If I did a full reduction, could I place a implant? Yes, But the implant would be less than 250 - 300 cc's. Otherwise if a larger implant is needed than 2 operations are recommended about 4 months apart.

Now from your history that you so kindly gave in your question, I would first recommend no surgery if you are considering children or pregnancy. Second, ALL breast reductions leave scars. So you must consider these issues prior to having any breast surgery. There are more issues to be discussed but I feel an in person consultation with your local boarded Plastic Surgeon can address them. Best of Luck!

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

Breast reduction: with or without implants, before or after pregnancy

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AT this point in time implants would only complicate the matter. I believe it comes down to your priorities. If I read your question correctly, it is my impression that you find the weight of your breasts distressing. Therefore I would proceed with a reduction only. Allow for pregnancy, if and when it occurs and then reassess your situation and desires. Please realize that any breast reduction may compromise your ability to nurse.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

Breast surgery

+1

If you are planning to have children in the next few years, your breast size, shape and tone will most likely change, and surgery after having children will give the best long-term result. A complete breast reduction with implant placement is not a good option for cosmetic result. A breast lift with minimal reduction, with or without a small implant is probably your best option.

D. Scott Rotatori, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 10 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.