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.