BA-- is lift needed? I'm also getting fat grafting from inner thighs to bring breasts closer together/make cleavage. (photos)

Hello, thank you for your question. Fat transfer to the breasts can only increase the size by 1/2-1 cup size at most. If you are looking for something a bit larger, consider breast implants. Speak to your plastic surgeon about your concerns.

Fat transfers will not bring your breasts closer together and increase cleavage. The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Dear momof3131619,
determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thanks so much for reaching out. By the looks of your pictures, I don’t think you need a lift, especially if you choose a large enough implant. That being said, I don’t think the implant needs to be more than 300 cc to achieve that. I think it will be vital that a dual plane be used in this case in order to achieve property, draping of the breast while avoiding a lift.

Based on these, very limiting, photos, you seem to be a candidate for breast augmentation with implants; it may not be necessery to do a fat grafting if you decide to select larger implants. That is something that sould be discussed with your surgeon in details, before undergoing surgery. If possible, second opinion consult with another board certified plastic surgeon should be considered. Good luck.

Just based on your photos, you need a lift. The last photo you show as your wish photo, shows a lady whose implants are bottoming out from being too large and heavy for her tissue. Please do not go too large.

1) don't think you need a lift
2) not sure what fat grafts would add
3) it would be hard to get you to a D without wrecking your breasts with an oversized and overly wide implant. Based on how narrow you are, would shoot.for a C as more realistic using an implant in low 300 range or slightly larger with an extra projecting type device normally reserved for breast cancer reconstruction

I used to always worry about telling a patient they needed a lift because I knew they didn't want a scar but now after being a plastic surgeon for quite a while I never hesitate to tell a patient they need a lift because the results are so superior with a lift if your breasts are droopy before surgery.

Otherwise patients are not happy after their surgery and then the surgeon says "well, if we did a lift it would look better but you didn't want the scar".

I don't blame patients, I just tell them you need a lift and if they don't want a lift I decline to do the surgery because I don't want to get into a situation where I know a lift was needed but they didn't want a scar and now they don't like their breasts. Accept the scar and get the best looking breast you can and that's it.

Typically if the nipple is above the breast fold with the arms held naturally at sides a lift is not needed. If the nipple is below it generally is. If it's at the crease you could go either way. An in person evaluation is best, but based on the submitted photos you may be able to forego a lift and opt for augmentation alone. I encourage you to discuss your concerns with your surgeon.

Thank you for your photos. If you are going from an A to a D and adding fat grafting as well, then you would not need a lift based off your current photos. The extra volume from the implant combined with the fat will be plenty in filling up your breast skin envelope and naturally lifting your nipples to the correct position. Hope thsi helps!

Johnson C. Lee, MD
Double Board-Certified Plastic Surgeon