Breast fat transfer with or without breast lift? (Photo)

Dear Tweaker,
based on your photo, it looks like you might need breast lift. My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

I would recommend a mastopexy to maximally lift, tighten and shape the breasts. This will result in a proportionate "C" cup. If you desire more volume, then yes, you can have fat transfer, but most are happy after the lift. Thank you.

I highly recommend a lift. You should see an American Board of Plastic Surgery certified surgeon in person for an examination and evaluation.

Deciding whether to undergo a breast lift along with a fat transfer is a personal choice that depends on your individual goals, anatomy, and preferences. Here are some factors to consider:
1. Breast volume and shape: Fat transfer can restore lost volume and improve breast shape by adding natural-looking fullness. However, if your breasts have significant sagging or ptosis due to breastfeeding, a breast lift may be necessary to reposition the breasts higher on the chest and create a more youthful contour.
2. Skin elasticity: A breast lift is often recommended when there is excess skin or sagging tissue that cannot be addressed solely with fat transfer. If your skin has lost elasticity and you have noticeable drooping, a breast lift can help tighten and firm the breasts for a more lifted appearance.
3. Scarring concerns: Breast lift surgery typically involves incisions around the areola, vertically down to the breast crease, and sometimes horizontally along the crease. While scarring is inevitable with breast lift surgery, most patients find that the benefits of improved breast shape and contour outweigh the presence of scars. However, if you have concerns about scarring, discuss your preferences and expectations with your surgeon to explore options for minimizing scarring and achieving the best possible outcome.
4. Consultation with a plastic surgeon: Schedule a consultation with a plastic surgeon who specializes in breast surgery to discuss your goals and concerns. During the consultation, your surgeon can evaluate your breast anatomy, skin quality, and degree of sagging to recommend the most appropriate treatment plan for achieving your desired results. They can also provide personalized advice on whether a combination of fat transfer and breast lift or fat transfer alone would be most beneficial for you.
Ultimately, the decision to undergo a breast lift along with a fat transfer depends on your individual circumstances and aesthetic goals. By consulting with a qualified plastic surgeon and discussing your options in detail, you can make an informed decision that aligns with your preferences and helps you achieve the look you desire.

Your breasts are too low on the chest wall. You will need a breast lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

If you were getting implants, you would need a breast lift to look good, or at least normal. With fat, it will simply make your breasts larger, and unfortunately proportionately saggier, which is not necessarily a bad thing. The reason there is a difference is that fat integrates into the breast tissue and implants push breast tissue away from the chest wall. If your breast tissue was located directly over the implant, then there can be a beautiful result. But if the breast tissue sits lower on the chest wall than the implant, as in breast ptosis or sagging, then you get a lump above a persistently saggy breast (waterfall deformity); something that is neither aesthetic or normal. Your choice with fat, either with or without lift. With an implant, you need the lift to look good. You can still go without the lift, but it will look abnormal.

You definitely need a breast lift . I’m it sure if you need more volume in terms of an implant or fat transfer. I would suggest a small implant

Your photo shows that your nipple position is a bit low, and you do have a fold of breast skin, more on the left than right. Your areola diameter could be decreased if you desired it.

If these issues are a bother to you, and you are willing to accept a visible scar, then a breast lift may be a good option for you.

While fat grafting alone can address volume loss after breast feeding, it is more difficult to address breast asymmetry. A breast lift would allow for correction of asymmetric nipple positioning, elevation of the nipples to be centered over the breast, and addressing volume differences that exist at baseline. I believe it is often best practice to inject similar volumes of fat on each breast to maximize the chance of having similar retention between the two sides. In order to do this, the starting volume has to be the same for both breasts. A lift would allow for a small amount of breast tissue removal from the larger side to ensure that the starting point is the same.
Sean M Fisher MD

Fat alone will just give you bigger and still sagging breasts. I suggest doing the lift first. You might like what you see. Then if you want a little more volume, consider fat. If you want more than a cup size, then go with implants.