Which Breast Surgery Will Give Me Perkier, Fuller Breasts?

Before I had my first child, my breasts were a small B-cup. I got pregnant, then all of a sudden my boobs jumped to double D's. I was extremely excited to have huge full boobs without surgery, but soon after I had my baby, they seemed to just deflate like balloons. What would be the best breast surgery to make them higher and fuller? I always heard if you get implants they make them more lifted but I'm not sure.

Doctor Answers 30

The Operation is Tailored to the Patient

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Rejuvenation of a woman's breasts after having children is a very common scenario for plastic surgeons. While most women who are seeking cosmetic breast surgery would like their breasts to be full and sitting nicely on the chest, this goal will require different approaches based on the individual's inherent anatomy. There are usually 3 key issues that need to be addressed by your surgeon, and your input in this process is really important:

1) volume or size of the breast: the surgeon needs to know what your goal size is, and based on your input, he or she can tell you whether or not this is a reasonable goal given your breast anatomy and your overall body frame

2) amount and quality of your breast skin: this will help determine if the skin will tolerate a particular sized implant or if some skin needs to be removed

3) position of the nipple: in some women, even after children and breast feeding, the nipple position is still ok; but in other women, the nipple may need to be elevated (lifted)

With these principles in mind, the surgeon will be able to offer you either an augmentation alone, a breast lift, or a combination of the two. He will be able to review with you the pluses and minuses of each option, and put together a plan that meets your goals. Needless to say, this takes a fair amount of skill and experience, so it is very important that you seek out a Board Certified Plastic Surgeon in your area if you are considering breast rejuvenation.

Best of luck,

Dr. S

Seattle Plastic Surgeon
4.9 out of 5 stars 155 reviews

Getting bigger, perkier breasts

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Getting bigger breasts and getting perkier breasts may require different procedures, especially if you have had kids.  Often after having children, breasts have excess laxity.  Excess laxity is often best corrected by a breast lift, while breast augmentation is performed to increase breast size.  Getting an excessively big implant to help correct some of the excess breast laxity is usually not a wise decision as the two procedures are designed to accomplish different things.  So have a careful and throurough discussion with your plastic surgeon about your breasts and your goals and make sure to get the right procedure or set or procedures.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Sorting out implants and lifts

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The issues you describe are common in plastic surgery practices. There are basically 3 types of patients that come in for breast restoration after childbirth.

1. The first variety have well shaped breasts with the nipple areola well above the crease below the breast. These people have usually always been small and gravity and looseness have not affected them much. They can have a simple breast augmentation to get to their desired end point working with their surgeon to achieve the look they want.

2. The second type of patient has enough size in their bra when it gathers up the loose tissue. They are not looking to be larger. They can often be served by a breast lift without an implant.

3. The third and most common group are those who want an increase in size or volume (therefore needing an implant) and also need an elevation of the nipple areola to place them on the front of the breast mound (therefore needing a lift). There are several kinds of lifts that can be done and the amount of scarring required depends on how far up one needs to move the nipple to get to a youthful position.

Remember that implants DON'T lift the breast. I have yet to meet the patient who would be happy with their result if they had implants alone but needed a lift and didn't get one. I have pictures of patients who had that done by other doctors and not once have I met a patient who looked at those pictures and said they would be happy with that look just to avoid the scars.

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Mommie Makeover for your breasts

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The scenario that you describe effects millions of women across America annually and is one reason for the marketing phenomenon known today as "Mommie makeovers". Typically, correction of the condition that you describe requires both a breast lift and augmentation using implants. However, since you were excited about your "huge full boobs" during pregnancy, you might be a candidate for a large augmentation, which might correct your sagging without the "lift" part of the operation. If you are planning to have more children you may want to wait on any surgery at this time. Surgery may affect your ability to breast feed and the results of surgery may be affected by future pregnancies. Consultation with your board certified plastic surgeon will identify your needs and alternatives more specifically.

Good luck.

Perkiness is in the eye of the beholder

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Perkiness is not an anatomical definition. What makes a breast look perky or saggy is deterined by a number of factors (i.e. location of nipple, amount of breast tissue below the inframammary fold, the degree of fullness or emptiness above the nipple, firmness of the breast tissue and skin, etc.)

What you shoud do is explain exactly what sort of breast you would like to your plastic surgeon, both in terms of volume and shape. Depending on what you have to begin with, you might need just a lift of sorts (there are many variations), just an implant (and there are many types) or a combination fo lift and implant. Be prepared to compromise. If you canachieve the look you want in a bra, you might just need a lift that tightens the skin. If you feel empty or loose in a bra, you probably need an augmentation.

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

Implants + a possible lift

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The best option to give you higher fullness is to get high profile saline implants. Whether or not you need a lift will be completely dependent on your current breast tissue. Without looking at where you are now and where you want to be, it is impossible to tell exactly what size implants or if a lift is necessary.

But for starters, Saline will give you a rounder and higher profile than Silicone. Plus, you can choose to do a low, moderate or high profile of Saline as well. A high profile saline implant is going to give you full, rounded breast that sits higher than a Silicone implant will.

The best thing to do is talk with a plastic surgeon who has bras that you can try that simulate different sizes of implants. This will allow you and the doctor to see what you are thinking, rather than just trying to describe the results that you want.

Breast augmentation surgery.

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It is very common in pregnancy that you will go up a cup size or two. Depending on several factors (like weight gain, weight loss, response to hormones, breast feeding), some women's breast will sag or droop significantly after. In order to restore lost fullness to the upper part of the breast, an augmentation is the only thing that will restore that volume. If you have a lot of sagging however, you will need (or at least you should consider having a breast lift at the same time of your augmentation). Implants by themselve will not lift a sagging breast, they just make them bigger, but they remain somewhat saggy. So it really depends where your breast sit on your chest. If you are borderline, then an augmentation is usually suffcient without a lift.

Breast lift fixes moderate to severe sagging

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Saggy breasts are a common complaint of women who’ve had children. Your breasts swell during pregnancy, then deflate as the need for breast milk production is no longer required. This process can be rapid, and sagging results. If you are significantly saggy, then a breast lift would be best to reshape your breasts to make them perkier. Mild to moderate sagging can be fixed with high profile implants.

Ronald Levine, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 25 reviews

Breast lift or the right implants

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With a significant increase than decrease of size, your breasts are probably affected by lax tissues that were unable to snap back to the smaller contour. As a result, a breast lift may be the best option for you. However, you may find that an implant with a smaller base width to make your breasts project more forward from your chest wall and body can be sufficient, making a breast lift unnecessary. Consider the Allergan Inspira TruForm 2 implant. 

Breast Enhancement Surgery

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If someone uses the word perky they almost always need a lift which can be a lollipop or a wise pattern or anchor pattern plus an implant for volume

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.