Is It Possible to Get a Slight Reduction and Add a Small Implant to Get Upper Pole Fullness?
Doctor Answers (10)
Breast lift procedures improve breast shape
The combination you describe is exactly what I do for a lot of patients with breast tissue sagging below the infra-mammary fold. We do a small 'inferior' breast reduction, a vertical breast lift and a small submuscular implant. This combo yields a great result that will last for years.
Breast reduction augmentation
At first this might sound contradictory, adding an implant to somebody who is large already. But you can't make that "fake" look by a lift alone. So, you can reduce/lift the breast so it holds up better over time and add the upper pole fullness from a large HP implant.
This is easier said than done though and has lots of potential complications. Finally, depending on how big an implant you need, it may need to be staged by 4 months between or so to let the lift/reduction heal before magnifying it. A reduction/lift tightens and an implant stretches you so they may not be wise to do at the same time if the stretch will be extreme.
Breast implants after breast reduction
In order to go from a DD-cup to a small D or a C-cup the reduction would not be a slight one, though it is possible to have a breast reduction or lift, and add a breast implant for upper fullness. It may be wise to begin with a breast lift and reduction, and add an implant later if you still feel that you need the extra fullness.
Best of luck,
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Options for superior fullness at time of a breast reduction.
There are breast reduction procedures that can improve superior fullness of the breasts. Vertical breast reductions can utilize the superior breast tissue and allow for a rounder, fuller breasts. Poor skin elasticity such as is seen with patients with numerous stretch marks can limit post-operative superior breast fullness because of lack of support. After the procedure, if your breasts don't have enough superior fullness, it is possible to augment them later. This should be done as a delayed procedure, if it is needed at all, for precision and safety.
Breast lift with implants?
Thank you for the good question.
I think what you are describing is an excellent operation for many patients who want more volume superiorly and less loose skin/tissue inferiorly.
This is not, however an answer agreed-upon by all plastic surgeons. There are good plastic surgeons who will insist on doing the procedures separately and there are good plastic surgeons who can produce excellent outcomes in a single stage.
The combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increase with breast augmentation / mastopexy surgery done at the same time.
In my opinion, the decision to do the operation in a single or two staged fashion becomes a judgment call made by a surgeon after direct examination of the patient. For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).
Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks are greater with a 1 stage procedure and the patient does have a higher likelihood of needing revisionary surgery.
I hope this helps.
Reduction and an implant
It is certainly possible to provide a good projection by combining a reduction/lift and a small implant. You will of course accept the risks of both procedures, but a skillful operator can provide you with the look that you want.
Breast lift, small reduction, small implants?
Be careful what you ask for!
You can certainly have enough tissue removed so that you can add Implants and go from a DD to full C or small D, but if you want a full, high, round look and hope to achieve this with implants, you could end up with more than a "look" you like! You could end up with capsular contracture, which is what causes the "look" of high, tight, and round.
What you may NOT realize is that you also get breasts that "feel" like croquet balls in your vest pockets, inability to hug anyone without them feeling the hardness of your breasts, inability to sleep or lay on your chest (unless you dig holes in the beach sand), etc. My point is this: you have adequate tissue to not "need" implants. Why not simply get a full breast lift that yields the size and nipple position you desire, and accept the eventual dropping and settling as your incisions heal? You will at least have soft, natural breasts that are the size you like, perkier than your present degree of droop, and retain the ability to hug, sleep on your chest, read on the beach on your tummy, and never have to consider re-operation to deal with capsular contracture, malposition, or size change!
Trust me on this--this is the best "free" advice you'll ever receive, and those who "give you what you want" may not be your best friend! Don't get me wrong; breast implants are great for those who need them, and I really don't have a high percentage of patients with problems or regrets. But do you really want to take (even small) chances with that choice, and have to pay extra to boot?
Breast implants for upper pole fullness with reduction
Dear Kokomo ,
To achieve your goals, I would suggest a mastopexy utilizing a superior medial pedicle technique with excision of inferior breast tissue and placement of an implant
Implants with mastopexy are reasonable choice for the smaller breast
Implants with mastopexy are reasonable with smaller ptotic breasts with upper pole flatness. While this tehnique can be used with large breasts, the heavy weight of a large breast makes a recurrent deformity or "waterfall" deformity from descent of the breast tissue over the implant a potential long-term problem. In the large breast with flat upper pole, I recommend a superior pedicle breast reduction similar to that of the vertical mammaplasty as described by Lejour. Depending on your breast size and shape desires options to consider include that of a small implant versus a superior pedicel reduction mammaplasty.