Can You Have Implants After a Breast Reduction and Lift?

My breast are heavy and have been so since my early teens. I plan to have a redution with a lift. But I never see any before/afters that I like. The breasts just don't look full to me. And will the implant cause the back pain/fatigue that I always have?

Doctor Answers 17

Fat Transfer instead of Implant with Breast Reduction

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Yes this is possible and may be recommended if you wish to be more full on top. A small implant can still give you overall smaller less heavy but still full breasts. However there are other ways to accomplish this at the time of your Breast Lift/Breast reduction. If you have been considering a Breast Lift, Reduction or improving your appearance after breast augmentation but are not comfortable with introducing artificial material into your body, you may want to look into the benefits of breast augmentation with fat transfer. An alternative to breast implants is fat transfer also known as fat grafting or lipoinjection. This technique allows women the option of enhancing the appearance of their breasts without the potential problems of saline or silicone implants such as hardness, rippling or rupture.
Who is a candidate?
  • Any woman who is healthy
  • Women with sufficient body fat for the procedure
  • Women considering breast augmentation who wish to be one cup size larger or less
  • Women who have had breast augmentation or reconstruction but who lack fullness or have contour concerns. Fat transfer can further enhance and reshape your breasts while smoothing out visible or palpable edges of breast implants. This will disguise implant rippling and wrinkling.
  • Women with normal mammography
See the below links for more details: 

Breast reduction/lift (mastopexy) with augmentation

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Based on the severity and complexity of the case, a breast lift/reduction may be done to help improve the shape and size of the breasts followed by an augmentation as well to provide fullness and volume. It doesn't necessarily have to be a large implant. A smaller implant can provide roundness and fullness while still looking natural and not affectting the weight and heaviness which causes back and shoulder pain. The procedures may be done at one time or may be done at seperate stages. I recommend consulting with a board certified plastic surgeon to discuss the best and safest possible options for your particular case. It is important that you emphazise the look you want to achieve to your surgeon. Finding photos of what you would like to look like can help your surgeon determine whehter implants would be benficial for you. Good luck!

Implants with Breast Reduction and Lift

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The quick answer to this is yes you can do all three procedures: lift, reduction, and augmentation.

I have had occasion to do this at the same procedure and occasionally many years later (more common with subsequent weight loss). In all of these instances, the patients did not complain about the same syptoms they had when they were larger breasted.

I agree with you, in that it would seem natural that patients would report recurrent back pain but this does not seem to occur.

I will be very interested to hear what the other plastic surgeons who answer this have to say but it is very unusual for patients, even with big implants (larger than 400) to complain about back pain. This does not mean that they do not experience relief when they eventually have the implants removed but generally they seem motivated to tolerate the weight and volume.

I agree with you also in that the use of the implant is one of the best methods to ensure upper breast fullness after reduction and lift.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Breast implants with reduction is counterproductive

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When performing a breast reduction, a lift is performed. Depending upon the technique used, a full breast shape can be created. I would refrain from adding an implant if I am performing a breat reduction. I think it is counterproductive.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Placing implants with at the time of a breast reduction is illogical.

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Breast reduction is a functional operation that removes weight generating symptoms in the shoulder, back, and neck.  A reduction always includes a breast lift which makes them look more youthful.  It makes no sense to remove natural breast tissue and replace it with an artificial substance.

How many before and afters have you seen?

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probably not enough.  Newer breast reduction techniques use the breast tissue you currently have and reshape it into an aesthetically pleasing shape.  If you are symptomatic from your breast size, then you should have enough tissue to avoid the need for an implant.  Good luck!

Breast implants compliment a breast lift well

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Breast lift and breast reduction can share many things in common. In both the nipple is lifted and the breast shaped through a short scar pattern refered to by some of my patients as a "lollipop" incision, or around the nipple and down to the breast fold.

Differences lie in how the volume of the breast is altered. If you are happy with your current breast size reduction is not called for and the gland of the breast can be shaped within the lift pattern. Sometimes in lift or mastopexy there is insufficient volume, particluarly in the upper portion of the breast and this is where the addition of an implant for fullness or projection and upper fill produces a very nice result. There is no need to wait or consider a second operation if the current breast size or anticipated shape will not measure up to your expectation.

If reduction of breast size is needed there should be no reason to consider an implant, and breast lift is the "bonus" of a well executed breast reduction. Take your time and make sure you address corrrect what bothers you.

Best of luck.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Breast implants and breast lift or breast reduction

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Breast implants do provide fullness to the central and upper pole of the breast. if a patient is left with inadequate breast volume after a breast reduction or mastopexy they might need to have breast implants. You can potentially develop neck and/or back pain if you have very heavy breasts (either from very large implants or from large and heavy breast tissue).

Sean Younai, MD, FACS
Beverly Hills Plastic Surgeon
4.4 out of 5 stars 51 reviews

You can usually get excellent shape without implants

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To massagemamma,

Hi! If the breast reduction is done correctly, you can get wonderful shape with upper fullness. The trick is to shape the breast FROM THE INSIDE with deep stitches. This is the vertical mammaplasty operation that leaves you with just a "lollipop" scar.

If the surgeon relies on pulling the skin together, you will not get good shape, specially in the long term.

You don't neeed implants.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Be specific about what you want

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Patients with large breasts usually have a combination of complaints regarding symptoms relating to size or weight (i.e. finding clothes that fit, back and neck pain, heaviness in chest, etc) and those relating to cosmetic appearance (i.e. shape, sagginess vs. perkiness, size.etc). It is possible and sometimes necessary or advantageous to undergo a reduction, lift, and augmentation either simultaneously or in two separate operations.

A good surgeon can customize your procedures to give you close to what you are looking for. Some reduction give more or less fullness in different areas of the breast (i.e. superior, medial,lateral, central, or inferior) while some will need help with an implant.

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

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.