Dear Sir/Madam, I Have Stopped Breastfeeding from 7 March 2013. Im Considering to Do Breast Lifting and Enlargement? (photo)

Based on my pictures, Dr. thinks that he first need to do a breast lift on the left breast and a breast reduction on the right to make the breasts equal. And 6 months after this operation, he can perform a breast enlargement. And this is the most confusing part for me. Why do I need to do reduction on the right breast? I was hopping to have only one surgery(lift and enlargement). Best Regards, Ola

Doctor Answers 8

Frankly, I think you are getting bad advice!

With respect to the doctor rendering an opinion, I think he is giving you bad (and possibly self-serving) advice. You have some ptosis, but both nipples are above the crease position, and skillful breast augmentation with different sized implants alone can rejuvenate your breasts beautifully, achieving much improved symmetry and a pleasing aesthetic outcome.

 You do not appear to need a lift, but exact measurements and discussion with you would be necessary to give you proper advice regarding any kind of lift at all.

Many plastic surgeons would not recommend any kind of breast lift for a woman with your anatomy, whereas others may recommend a modified lift, particularly if you ask about one. But that does not make it optimal, just possible!

Extra operations(s) and additional incisions and scars only add to the risk, unpredictability, and of course, cost. This is the self-serving part--the surgeon makes more money, but only if you "buy" this line of reasoning and go for two larger, more costly, and more scarring operations.

Reducing the right breast to equal the lesser volume of the left only increases the believability of recommending a lift (to "match" the scars) on the other side, and then adding implants. Reduce your own breast size so that the implants can match? This is daft!

Your breasts are not so asymmetrical that different implants cannot correct your mild volume discrepancy quite nicely!

Seek consultation with additional board-certified plastic surgeons in your area. I can recommend my friend Alex Verpaele MD and his associate Patrick Tonnard MD in Gent. Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

No need for reduction or lift

All you need is breast implants of different size. Unless, you want to have a smaller breasts you don't need to do reduction.

Andre Aboolian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 60 reviews

Go to spmeone else for a second opinion

I've been specializing in breast surgery for 10 yrs now so please trust me when I say that you do not need a breast reduction! I would recommed a breast augmentation alone with a larger implant on your left side. Let this settle out for at least 6 months and if you are willing to accept some mild breast asymmerty (as almost everyone has; "breasts are sisters and NOT twins") then you will likely not ever need a breast lift. This way you can avoid the scars and the extra cost of a lift, especially a two-staged procedure. Your left nipple and areola will still be lower but I think it would be better than having asymmetric scars. Whatever you do please do not allow a surgeon to talk you into a "crescent lift". It only make the areola elongated. I have had to fix a lot of these because surgeons in my area haven't figured this out yet.

Kevin Rose, MD
Provo Plastic Surgeon
4.6 out of 5 stars 11 reviews

Breast Lifting and Enlargement?

I am not sure what your size goals are, and how much tolerance you might have for a  modest amount of asymmetry. 

If the right side is OK for size, an implant on the left side, and then, based on your goal, a lift  may improve the result, and the surgeon could decide after the implant is in. If you wish the right side larger, different sized implants could be used, and again a decision in the OR about a lift on the left. I would not support the reduction and two stage idea. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

How to address uneven breasts.

Dear ola83, as you can see different doctors have different opinions.  That only means that there is more than one way to correct your problem.  I also want to add that some doctors will deliver better results than others.  Having said that I will explain the way I would correct your problem.  Based on your photos it seems to me that there is nothing wrong with your right breast and therefore there is no reason to reduce it.  I would only augment it to your desired size and then I would figure out what to do with the left side to make it match the right.  If the left is only augmented with a larger size implant then your nipples will not match therefore the left breast will need a lift.  The type of lift needed depends on the vertical discrepancy between your nipples.  For a mild discrepancy I would do a crescent lift which is less invasive.  For a larger discrepancy a formal vertical lift would do. I think you would fit the first option judging by your photos.  Correction of asymmetry is very difficult so improvement and not perfection should be expected.  Dr Brou

Juan A. Brou, MD
Oklahoma City Plastic Surgeon
4.7 out of 5 stars 36 reviews

Breast lift with augmentation

Most of us will do this operation in the same setting and would use differential size implants.  You should get a second opinion.  This is done safely as long as you are not a smoker.

N. Bill Aydin, MD
Paramus Plastic Surgeon
5.0 out of 5 stars 58 reviews

Lift with augment and keep as much of your tissue as possible

From your pictures it appears you have both a shape and a volume difference, however I can't tell if your rib cage shape may be contributing to the apparent volume difference.  That could be an important consideration when sizing you.  It also depends on how much asymmetry you are willing to accept in both shape and size.  I have always found that the more there is of your own tissue compared to implant, the more natural the result.  Therefore a reduction first would not be something I would ever suggest.  I have done a "donut" (peri-areolar) lift on one with an areolar incision on the other for patients with your findings so the scars will somewhat "match."  I have seen this stand up well over time with excellent symmetry even 10 years later.  Good luck!

Myles Goldflies, MD
Seattle Plastic Surgeon
4.3 out of 5 stars 11 reviews

If Your Breasts are Uneven and Need a Lift and Augmentation, What Should I Expect?

If your breasts are significantly different in size, a breast lift and implants may not be enough to achieve symmetry. The right breast may actually need some of your breast tissue removed and actually replaced with an implant just like the left to give you the best symmetry possible. While it seems counterintuitive to have a reduction AND a breast implant augmentation, it is because natural breast tissue may be too soft without enough density to stay up and would eventually slide downward off your breast implant. The optimal surgery may indeed be to reduce the right breast so it starts out at the same size as your left, then perform the breast augmentation. My opinion differs in that I personally would perform the lift/reduction/augmentation at the same time. That is completely my personal approach and opinion. 

This is for general educational information only and should not be construed as specific medical advice.  If you would like to establish a doctor-patient relationship, we would be delighted to set up an appointment to see you. If it is more convenient to be seen closer to your home, then you should follow-up with local doctor in your locale.

Michele Koo, MD, FACS
Saint Louis Plastic Surgeon
4.8 out of 5 stars 72 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.