Breast Augmentation for a Fuller Upper Pole?

I naturally have quite large breasts, around a 32DD, but feel like I do not have enough cleavage. My breasts sit considerably low, and even with a push up bra still look very flat. I am unable to wear strapless tops because if I do not wear a bra my top will fall completely off. I understand natural breasts are not going to have as much fullness throughout the breast as ones with implants do, but I am wondering if this would qualify me for surgery or not. If so, what would be the best option?

Doctor Answers 11

Mini Ultimate Breast Lift to increase upper pole fullness

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There is a new technique called The Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage.  If you are already a 32 DD, you certainly do not need implants.  Aligning the areola and breast tissue over the bony prominence of the chest wall maximizes anterior projection without the need of implants. 


Best Wishes,


Gary Horndeski, M.D.

Lift or augmentation?

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If you can be happy with results from a lift (your surgeon should be able to show you photos of just how much upper pole fullness you can expect), it is always preferred over using implants that bring a list of risks with them.  But if you want exaggerated fullness on top and want to stay about the same cup size, you will have to consider a reduction with an implant understanding that your native breast tissue volume will be diminished considerably.

Breast augmentation or a lift?

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It sounds like from your description that you have large breasts that may be amenable to a lift.  An augmentation will just give you more volume.

Breast Augmentation with Lift for a Fuller Upper Pole

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The intentional result of a Breast Lift (#Mastopexy) is to improve the shape and position of the breast without reducing their size. It is used especially for breasts which sag or droop (#ptosis).
I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.
In regards to implants alone, this is usually said to be mistake by patients reflecting back at the decision. Most breasts will look larger and more droopy with solely implants. They will sag more and sooner, due to the sudden and excess weight. At times it's possible for a “Snoopy” breast or double bubble to develop as a result.
Additionally, an implant with lift may be useful to re-position the nipples which may have been affected by ptosis or drooping.
Each implant has their benefits. The #implant shell of #saline implants is ordered in a specified size which can be filled to a minimum or maximum fill amount, allowing the some flexibility with sizing during surgery. Saline tends to be a little less natural feeling than silicone, but it can also create a more dramatic upper breast appearance, which some women prefer. The Ideal Implant™ was recently FDA approved and was created for women who are not comfortable having silicone implants in their body. The unique structure of the Ideal Implant allows for a similar look and natural feel as silicone with the safety of saline.
More women tend to choose silicone breast implants due to the natural feel and appearance. #Silicone implants are now made of a cohesive gel which are anti-leak even when cut. Look and feel like natural breasts due to the cohesive silicone gel material. New generation silicone gel implants are far superior than those used in the past and have a proven track record of safety. Silicone implants have gone through more testing than any other medical device and are the preferred choice for over the muscle implant placement.
Other factors which contribute to the outcome are size, shape, and profile. Your procedures should be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. I suggest you view before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Increasing upper pole breast fullness

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Certainly no one can give you specific recommendations without a face-to-face consultation and examination. But in general, significant increase in upper chest fullness can only be reliably achieved with implants although in select situation, and with full awareness  of potential risks, some surgeons may feel that fat grafts may be helpful. In a situation as yours where your breasts are already quite large, a surgeon should analyse the size, shape, form, and relative distribution of volume of your breasts. Coupled with visualization of a specific goal, some combination of lift, implants, and even reduction may be required so as not to over-augment the breast.

Robin T. W. Yuan, M.D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Breast lift and implants is needed

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By your description, likely a combination of lifting and implants is indicated to achieve more upper fullness, lift and cleavage.

David J. Levens, MD
Coral Springs Plastic Surgeon
5.0 out of 5 stars 78 reviews

Breast Augmentation for a Fuller Upper Pole?

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Too many possibilities to discuss that could be narrowed down were you to add photos to your posting. Please consider. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon


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A breast lift will help with position, but does not ever achieve the best upper pole fullness. Implants are of no help unless you were to reduce the breasts first. 

DD Breasts Always Go South. Gravity Always Wins.

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Have you ever seen a DD breast stay high, whether natural, augmented, or lifted?  It can't happen.  All skin will ultimately stretch under the weight of the breasts.  Adding more volume only gives a temporary improvement, and they will fall even more with time.  A lift can always help, but with that amount of weight the skin will stretch again. Remember, a lift tightens only from the removal of skin, not from the restoration of elasticity in skin.  So the skin that remains after the lift is the same skin that already gave way to the weight, and the same effect will happen.  Obviously if there is a significant degree of drooping there will be significant long term improvement.  But from your description it sounds as if you don't quite have the upper fill you want.  That is not permanently maintainable.  As a general rule, such patients are well advised to consider accepting the imperfection as we do not yet have a reliable and enduring treatment.

Very large breasts might benefit from mastopexy rather than breast augmentation to address infra clavicular lack of fullness.

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If you have doubled the breasts are not certain why you want a breast augmentation. Perhaps a mastopexy is the best way to redistribute the volume of your breasts to something more suitable.

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.