Breast Implants and Lift for DD Breasts?

I am 24 years old and my breasts are 36DD. I visited a PS and he suggested a lift and no augmentation but cannot guarantee how long I will be happy with it. He's thinking within a year I will be unhappy with my result. Although he cannot predict every case. I think I will lack the fullness that I truly want. I like the appearance of implants and the fullness they give. He also stated that it is an oxymoron to reduce them smaller and then put implants in. I really think that would make me happy.

Doctor Answers 10

Breast Reduction with Placement of Implants

Hi there-

While at first blush it may seem like it doesn't make sense to reduce a woman's breasts and then place implants, I can tell you that in my Orlando Plastic Surgery and Skin Care Center, we have a great many happy patients who have had this combination of procedures.

By reducing the volume of the patient's natural breast tissue and placing an implant, the patient is able to achieve BOTH her desired size AND shape.

Orlando Plastic Surgeon
4.8 out of 5 stars 159 reviews

Breast reduction followed by augmentation

In the past, no one would have considered reducing breasts that were large down to a size where they needed to be augmented.  The process just didn't make any sense.  Now that patients are sometimes looking for a very full "fake" look, this combination has come into the discussion.  It can be done but still seems somewhat contradictory to me personally. 

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Breast Implants and Lift for DD Breasts

Breast Implants and Lift for DD Breasts: Your surgeon is correct but so are you. IF you want larger breasts and are willing to accept the increased potential for future sagging with larger lifted breasts, then proceed with the implants.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 82 reviews

Breast lift and augmentation

It seems based upon your description that you have enough breast tissue to do a lift. Why don't you see how that looks first before considering adding an implant?

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Reduce naturally large breast and add implants to produce artificially large breasts?

I  am not really sure why the surgeon would be certain that you will be unhappy with your result.  It sounds like you have enough breast volume to produce large enough after your lift that will provide you with perky breasts.

I would suggest that you consult with several other plastic surgeons before you have a reduction and implants which does not make sense to me.

Good Luck.

The Breast YoYo Procedure - Reduction and Implants.

The adage that the customer is ALWAYS right should NOT apply in Plastic Surgery simply because a lot of patients do NOT really grasp the long term consequences of their wishes.

From your statement : "my breasts are 36DD. I visited a PS and he suggested a lift and no augmentation ...I think I will lack the fullness that I truly want. I like the appearance of implants and the fullness they give. He also stated that it is an oxymoron to reduce them smaller and then put implants in. I really think that would make me happy" it is obvious that you do not appreciate how the breast will react to a reduction followed by an augmentation nor of the long term consequences.

A few truths:
- Skin is a lousy construction material. It always gives, stretches and sags.
- Perky breasts NEVER stay perky, like everything else they loose the eternal battle with gravity and gradually head south.
- The heavier the breasts are (such as your DD), the faster the drooping process
- The more we load the breasts (placing large implants) or weaken the suspensory ligaments of Cooper holding the breasts to the chest wall (by breast augmentation ESPECIALLY over the muscle) the faster the sagging
- The simplest operation, the more predictable the outcome and the lesser the chance of something going wrong

It makes NO SENSE to remove a piece of living breast, replace it with an implant and scar tissue to get TEMPORARY upper pole fullness in large breasts which will now sag faster when the only goal was FULLNESS.

Think it over carefully. Once done the results are going to be irreversible.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 109 reviews

Vertical breast lift will give you perky breasts without breast implants.


1) It all depends on how the breast lift is done. Most of the time, the lift is accomplished by tightening the skin envelope, but skin stretches, and sagging comes back.

2) The best lift is a vertical breat lift (Lejour or Hall-Findlay operation). Here, the breast tissue itself is shaped and lifted INTERNALLY, without relying on pulling the skin at all, and you get long term upper fullness and a lollipop scar. This leaves your breasts the same size.

3) We also occasionally do an operation called the "plus/minus" operation, where a breast reduction and breast implants are done together. This is what you have in mind, and it is not a bad idea. But most women do best with a good vertical breast lift alone.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Breast implants in the DD breast

Breast size is a matter of preference and if you do like the appearance of implants and the fullness they provide it is very reasonable to combine a subglandular implant with your breast lift. We do not reduce a breast to 'allow' the placement of the breast implant. The natural breast tissue gives the best cover and helps to blend the implant in with the breast contour. The subglandular placement will permit the implant and breast tissue to flow together. A submuscular implant in a large breast will tend to be held in place and not settle into the breast as well. I think your surgeon is right, complete your breast lift with the implant of a moderate size and you should have the look you want.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Why do breast augmentation on large breasts

Your breasts are already large, so I would not place breast implants. It will be hard enough to lift all that breast tisse without adding the extra mass of implants. A proper lift involves actual remodelling of the breast tissue and suspending it higher on the chest, not just tightening the skin.

Realistically, you can only lift large breasts to a certain point and then gravity takes over, so your surgeon is being honest in not guaranteeing results. Placing breast implants with the mastopexy will only make it more difficult to reach your goals. I suggest that you have a mastopexy now and have implants placed at a second procedure if you need more fullness.

Bruce E. Genter, MD, FACS
Abington Plastic Surgeon
4.3 out of 5 stars 16 reviews

Combination breast surgery

 The breasts you desire has a certain size and shape. If you cannot achieve that with a single procedure (i.e. augmentation, lift, reduction), you might require a combination or alter your expectations. Some patients do indeed need to have a reduction-augmentation-mastopexy to rearrange the volume of breast and its shape.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 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.