Breast Lift Alternative for Large Breasts?

I am 5'6" approximately 168 pounds, my breasts are large (about 36 DD), they are fairly full, but due to the heaviness, I have ptosis. I am not interested in a breast reduction.

Originally, I had wanted a Breast lift but am uncomfortable with the amount of scarring. (Anchor incision, especially since my stomach will be scarred up after my Tummy Tuck) A relative had suggested that Breast implants might perk me up but I don't know if that is possible or wise. Your advice is appreciated.

Doctor Answers 17

Breast Lift alternative for Large breasts

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The most commonly used technique to lift large breasts is currently based on the Wise pattern. This was developed in 1957 based on the concept of excising the skin in a pattern identical to that used by bra manufacturers of that time. Unfortunately, this results in an anchor shaped scar with cuts around the nipple, vertical and horizontal cuts. The principal of the Wise pattern is based on using the external skin envelope to hold up the breast. Women with large breasts have already overstretched their skin capacity. Using stretched skin without reducing the breasts will result in hanging breasts. For this reason, a new technique was engineered. The Ultimate Breast Lift is based on the principle of transferring the weight of the breast  (especially large breasts) to the underlying muscle. This technique uses the excess skin to make an internal 'cup' and 'straps'  similar to that of a brassiere. The straps are then attached to the underlying muscles. When a woman assumes a vertical position gravity pulls on the breast. The muscle responds by contracting - lifting the breast. This technique does not depend on skin's elasticity to pull the breast up. Women with large breasts often have neck, back, shoulder and breast pain. Pain is relieved by this technique since the weight is now transferred off the skin envelope onto the muscle. The other advantage of the Ultimate Breast Lift is that  there are NO VERTICAL INCISIONS. The disadvantage of the vertical incision is that the weight of the breast widens the scar. The Ultimate Breast Lift was specifically engineered to correct the deficiencies of the current techniques, relieves pain and provides a new alternative for patients with large breasts who need a breast lift.

Best wishes,

Dr. Horndeski

Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Breast Lifts for Large Breasts

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         In women with large breasts, breast augmentation is not a viable solution for breast sag. Under these circumstances, breast implants won’t fix breast sag, but instead will create larger saggier breasts.


         Without pictures or a physical exam, it’s hard to know what option is best for you. Patients will go to great lengths to avoid surgical incisions and in some cases this may not be in their best interest.


         In your case, correction of your problem probably isn’t possible without a breast lift. In fact, placement of an implant might accelerate your breast sag and make your problem even worse.


         It’s also important to understand that gravity is an unrelenting force and that your breast sag will only get worse with time. If you’re concerned about breast sag consultation with a board certified plastic surgeon is appropriate. 

Breast Lift Alternative for Large Breasts

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You state that you have DD breasts and with that size there is no indication for breast implants.  Implants would only make your breasts heavier and they will not lift your breasts.  I think you will need a breast lift or reduction.  There are techniques to avoid the anchor scars.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
4.8 out of 5 stars 116 reviews

Breast Lift Alternative for Larger Breasts?

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Thank you for the question.

Although it is difficult to give you good advice without direct examination,  many patients in your situation  decide to have breast reduction/lifting performed  followed by a second stage breast augmentation.  During the first stage procedure the breasts are lifted and reduced to place  them on the appropriate place on the chest wall;  I describe this as similar to creating the foundation of a building.

During the second stage procedure,  breast implants are used to  increase the breast size;  the difference is  that the breast volume is where the patient wants it to be ( for example, more superior pole fullness).

In person examination is necessary for precise advice;  a thorough discussion of patient's goals is a critical.

I hope this helps.

Breast lift

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Without an exam it is hard to say but making your breasts heavier with implants will most likely cause early relapse

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

Breast lift alternatives.

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1) You are already very big. I think breast implants are not a good idea.

2) I personally would not do a breast lift on you unless you agreed to a small reduction. Breasts this large are just too heavy and will sag again, and they will not age well.

3) The good news is that you don't need an anchor scar for a breast lift. We use a lollipop scar which fades nicely. In fact, Dr Elizabeth Hall-Findley is one of the surgeons who popularized the lollipop approach, and she is Canadian!

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

Breast Lift alternative for large breasts

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Dear Ch3ryl,

Regarding - "they are fairly full, but due to the heaviness, I have ptosis".

The appearance of the breasts is at its most basic a inverse relationship between Breast Fill and weight and the Breast skin envelope; If the skin envelope is unchanged and the fill increases, the breast become fuller (but with time, skin gives and these larger breasts droop, as is seen with virtually all women). If breast fill decreases and skin stays the same (IE not breast reduction or Breast lift hems it and takes excess skin off), the breasts droop (rock in a sock look in advanced cases). This is very similar to a sail boat on the waters. When the wind blows, the sails fill up, but when the wind goes away (no fill in the sail), the only way to get the sails flat is to roll them up.

In VERY MILD droopiness, a moderate implant MAY lift the breasts up SOMEWHAT. But, this lift is temporary and as the skin gives and relaxes, the breasts WILL progressively sag.

When the breasts "they are fairly full, but due to the heaviness, I have ptosis", ADDING to the already heavy breast with an implant will NOT work. It will merely stretch out the skin, worsen the droopiness AND compromise the blood supply to the skin envelope so when you change your mind and decide to have either a Lift OR Reduction, you may have a higher rate of potential nipple death and wound separation.

Putting in an implant in your case will not benefit you and may hurt you in my opinion.

I hope this was helpful.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Implants for a DD?? You must be kidding...

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The purpose of breast implants is to make breasts larger.

In some cases, the process of filling up an empty breast appears to perk it up, but that is not the primary purpose of a breast implant.

And there is no way ANY breast implant can lift up a DD breast.

Further, since you describe your breasts as heavy now, let me ask you: do you want them heavier?

And you also mention that you have ptosis (droopiness). If you add the weight of an implant, you will increase the amount of droopiness.

From what you describe, you are in need of a lift and not an implant.

Steven Teitelbaum, MD
Los Angeles Plastic Surgeon
4.6 out of 5 stars 49 reviews

Lift without implants

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Dear Ch3ryl

I would not recommend implants unless you wanted to be extremely large and probably droopy. I would recommend a lift and possibly even a small reduction to give you a perkier breast.

Depending on you size shape etc. I am often able to reposition your own breast tissue to auto - augment the upper portion of the breast to give you a better shape, a narrower breast and a perkier breast.

It is very unusual I use an anchor incision and many plastic surgeons like myself almost exclusively use a vertical or lollipop lift instead to cut down on the scarring. I can always give you more scars later on if you need more skin removed, but can never take away a scar no matter how good it heals.

I would suggest seeing another doctor who may be able to do the vertical mastopexy and minimize the scars.

I would not use an implant.

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There are techniques for breast lift that work better for a larger breast. I like to take a wedge of the extra tissue hanging on the bottom of the breast and use it to "auto-augment" the breast, basically tucking it up under the breast and making it look like an implant. If you have a lot of sagging, with stretch marks and nipples below the infra-mammary crease, then you will still need a "lollipop" incision, at least. If your breasts have good skin, then you may be able to have the scar just around the areola. Find a surgeon that does a lot of breast work and you may be able to find someone who does this.

Lisa Cassileth, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 16 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.