32F. Natural breasts. Consulting for reduction/lift. Desire 32C-D Perky, more comfortable breasts with out heaviness. (Photo)

I appreciate your question.I would recommend a breast lift with some minimal tissue removal laterally to give you a more rounded look.you could always consider an implant at a second stage but don't think its necessary when you already have too much volumeThe best way to assess and give true advice would be an in-person exam.Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.best of luck!Dr Schwartz

Hello,There is no getting around the fact that natural breast tissue will NEVER fill the upper pole, regardless of the technique to lift or reduce the breast. Breast lifts and reductions only do a few things reliably well; from most significant or durable to least:1. Move nipple position2. Increase breast projection3. Lift the lower portion of breast4. Create upper pole fullnessIt's a fantasy many surgeons have that preserving breast tissue during the lift will help create upper pole fullness. It just doesn't happen. Similarly, the more tissue is left behind, the more your breast will likely dropout with time. My approach is to use an implant simultaneously to the lift and reduction, preferably an anatomical, form stable device for the most reliable upper pole fullness.  The size of the implant is determined by your anatomy, your goal of reduction, and the amount of breast tissue that is planned to be excised.  It is all done in a single surgery, and it's just as safe as a reduction or a lift alone in the hands of expert cosmetic breast surgeons.Best of luck!

For your frame a reduction/lift from a 32F to a 32D is removal of 250-300 grams of breast tissue/breast. I'm not sure why implants were recommended when you state, "No fake balls, no flap jacks, boxy boobs!! On your photo, on the right breast I see a wise pattern drawn on, consistent with an anchor type breast lift. I personally like the vertical lift, since it shapes, rounds and keeps the breast projection better than an anchor lift. The only reason a small implant would be considered if you want more superior fullness, but then a lot more lower pole breast tissue needs to be removed to give you a C-D cup. Upper pole fullness can also be achieved with a vertical lift and auto-augmentation with breast tissue or fat grafting of the superior poles at the time of the reduction/lift. Although implants will not affect your activity level, but if they are placed submuscularly, you will end up with some implant animation with muscle activity.

Thank you for your question and photo.  Given your surgical goals, it appears that you have adequate breast volume to undergo a breast reduction/lift alone.  If you were to have saggy breasts without adequate volume, I would suggest that you consider getting at least small implants.All the best,Dr. ResultsMiami, FL

is what I would be advising if you were sitting in my office.  But I would also show you what you could anticipate as you viewed yourself in the mirror and you would then decide if an implant was needed.  With that information, my patients can easily decide on what they think will work best for them.  I always try to avoid anchor scars as much as possible too but that means my revision rate is high for smoothing the bottoms of the vertical scars with lollipop reductions/mastopexies.

Based on your photo and description, I think you would be a good candidate for a breast reduction.  This also involves a lift and will reduce the size of your breasts, which is what it sounds like you want.  It will not, however, create much fullness in the upper part of your breasts, which is possibly why the other surgeons suggested implants.  If smaller breasts and less heaviness in your chest are what you desire, you would probably be very happy with a breast reduction.

Thank you for the question. Based on your description and pictures, you may be an excellent candidate for breast reduction surgery. This operation tends to be one of the most patient pleasing operations we perform. “Typical” patients who present for breast reduction surgery are women who have disproportionately large breasts, causing problems such as neck/back/shoulder discomfort, postural changes, bra strap grooving, skin irritation/rashes under the breasts, and/or difficulty with activities of daily living and/or exercise etc. There may be both physical as well as psychosocial “stress” caused by the disproportionately large breasts.Reducing breast tissue mass and elevating the breasts on the chest wall tend to improve or alleviate many of the symptoms associated with the disproportionately large breasts.Patients considering breast reduction surgery should also consider the potential downsides (risks/complications) associated with the procedure as well. Poor scarring, for example may be associated with the procedure. Additional surgery may be necessary in the short or longer term for a multitude of reasons. Ultimately, careful selection of your plastic surgeon will be the most important decision you make.To this end, I would suggest you visit a few surgeons whose practices concentrate on aesthetic surgery. Ask to see lots of examples of their work and preferably speak/see patients who have had similar procedures done.Once you have chosen your plastic surgeon carefully, it will be important for you to communicate her goals carefully as well. In my practice, I asked patients to use as many “visual aids”, such as goal photographs, during the communication process. Avoid the use of subjective terms; for example, "C or D perky” such terms can be confusing, since they may mean different things to different people. Once you have communicated your goals, your chosen plastic surgeon will be able to provide you with a more precise plan, including specific technique to be utilized.I hope this, and the attached link (dedicated to breast reduction surgery concerns), helps. Best wishes.

From your pictures, it appears to me that a reduction Mammoplasty would result in a nicely contoured C-D cup size projecting breasts

I have no idea why two consultants recommended implants when what you asked for is a lift and reduction. You have plenty of volume. But when you lift and reduce a natural breast you retain a natural look.That means more fullness in the lower breast and less in the upper breast without a bra. It takes a bra to get upper fullness. If that is acceptable to you, find an artistic surgeon who does lots of that type of surgery and you will have a great result.