Does a Breast Lift Always Result in Dramatically Smaller Breasts?

I went in for an uplift on my size 36 g breast and have come out a 36 D, i am traumatised by the whole operation and very upset at being so small.

I knew he would have to reduce them but not by 3 cup sizes, is this normal? do they have to always make your breast much smaller to achieve this?

Doctor Answers 52

Breast Lift Changes Bra Cup Size

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Cup sizing is based not just on volume, but also the width of the breast.

With mastopexy (breast lift), the breast is not simply lifted to a better position on the chest; the breast is reshaped.  The droopy breast is often flattened and widened, rather than full and round ("perky").

In recreating the more perky shape of the breast during breast lift, the base of the breast (the width from breast bone to side of the ribcage) is tightened, making the breast less wide.

The amount of tissue (skin only) that is removed during a breast lift may amount to no more than a tablespoon, yet will probably reduce the cup size by about 1/2-a-bra-cup, because the breast is less wide! In other words, there is no significant change in volume, but the size in a bra goes down because the shape is different.

Denver Plastic Surgeon
4.7 out of 5 stars 45 reviews

A breast lift alone should not alter breast size

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A breast lift alone should not alter breast size. The skin removed from a breast during a breast lift has very little mass. Perhaps you had a breast reduction, a lift combined with a reduction in the size of the breast. It is also possible that the size was not actually reduced, but the lift caused the breast shape to change and for you to feel more comfortable in a different size bra.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

I would be interested to learn why you had a breast...

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I would be interested to learn why you had a breast reduction (it does not sound like you had a breast 'lift' or mastopexy) in the first place?

Certainly with size 'G' breasts, you might have had neck and back pain, posture problems or hygeine issues. If this was the case, have these troublesome symptoms resolved? If they have, then you achieved one of the important goals of the procedure, and that something to be happy about!

As far as the breast size reduction, you insurance carrier might have 'demanded' that a certain minimum amount of tissue be removed during your breast reduction. This is a common demand by third party payors. At times, it's challenging to safely remove the amount of breast tissue that the insurance company requires, but in other cases, it's not a problem. Your surgeon cannot remove all of the tissue that is available to be removed, since the blood supply to the remaining breast skin and nipple must be preserved.

If your insurance company paid for your breast reduction, that may explain why your surgeon removed the amount of tissue that he/she did.

Frankly, a 36D size, if that is what you truly are, is not 'so small', but size is in the eye of the beholder, correct?

It's my feeling that third party payors set the 'required' amount of breast tissue to be removed on the 'high' side, thus preventing a subset of patients that really need the procedure but fall under the resection requirement, from getting the procedure. Insurance companies don't want to pay for surgery and they do not have your health in mind when they authorize or decline to pay for a procedure.

The sooner the public comes to grip with this fact, the sooner appropriate reforms will be made in our ridiculous health care delivery system.

Breast lift does reduce bra size

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although the amount of skin removed with a breast lift is not much, the bra size usually goes down by one size after a breast lift. therefore, it might be able to compensate for this by adding breast volume with a breast implant.

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

It sounds as though you had a communication gap with...

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It sounds as though you had a communication gap with your doctor. A G cup patient would, in almost any surgeon's eye, need a "breast reduction" to improve symptoms and make the breasts a better size match for the rest of your body. A reduction essentially always includes a lift.

A lift alone, however, doesn't require your breasts to become much smaller if all of your breast tissue is preserved and just the skin envelope is reshaped and reduced.

On the other hand, if you just lift a patient with huge breasts and don't reduce them some, gravity will take over again and you will need the surgery repeated.

Breast Lift - Does it mean a reduction in Breast Size?

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A breast lift does not need to mean smaller breasts. Sometimes women with larger breast want their breasts lifted and minimized. Others are pleased with a lift that they report makes them feel lighter by having the breasts lifted to a more comfortable and aestheticly pleasing position.

Other women may lack upper pole fullness and use existing breast tissue to create an auto-augmnetation mastopexy to create the illusion of fuller breasts without an implant. 

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Breast lifts are on the same spectrum as breast reduction

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Ms. Mosson: A breast lift is a small breast reduction, in the fact that the surgeon usually remodels the breast by excising excess skin and breast tissue, as well as repositioning the nipple-areolar complex to a more favorable position.  The "uplift" portion relies on the preservation of the nipple-areolar complex' blood supply and there are at least 4-5 pedicles or  techniques which can be employed.  Frequently, a surgeon will resect a portion of breast tissue, which (s)/he believes will enhance the end result, but this is usually a small amount and would have been discussed with the patient pre-op. 

A breast reduction is a "trade-off": a patient accepts scars for a better shape.  Collectively both the surgeon and patient aspire to have longevity in the results.  That being said, it's virtually impossible to guarantee that a "G" cup would remain "high and tight", so there is an element of compromise.  Discuss your concerns with your surgeon and be confident that the relative size reduction is somewhat of an optical illusion.  As the reshaped skin brassiere relaxes, you may find that the volume isn't so small.  Good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Breast lift should not significantly alter breast size

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In general, the breasts do not have to be made smaller when undergoing a breast lift. The only thing that has to be removed is the loose skin and maybe a small amount (a few grams) of breast tissue to allow proper molding of the tissue. This should not change your cup size significantly. On the other hand, a breast reduction can be performed at the same time as a breast lift if desired.

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

Breast lift and bra size

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A breast lift is different from a breast reduction, and does not necessarily involve removal of breast tissue. A pure lift removes excess skin and repositions the nipple and breast tissue within the new smaller skin envelope. A breast reduction will lift the breast as part of the reduction.

Based on your comment, it sounds like some degree of reduction was planned as part of your lift. It is possible your surgeon removed only a small amount of breast tissue along with the excess breast skin, and the remaining breast tissue is now sitting more compactly in a tighter and lifted skin envelope, making your bra size smaller. Even without much breast tissue removed, the lift can make a breast appear smaller visually.

I hope you feel comfortable enough with your plastic surgeon to ask him or her about your situation directly. It may help you understand your outcome better, and will let your surgeon know how you feel. If you want more breast volume at this point, breast implants may be an option.

Best of luck!

Anita Patel, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 12 reviews

The simple answer to you question is that all breast...

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The simple answer to you question is that all breast lifts do not require a reduction in the size of the breast. But it sounds like you may have had some miscommunication with your surgeon.

Part of the process for getting good surgical results with this procedure is not only matching the breast lift to the patient's body proportions but also to listen to the patient and get a real sense of what they are looking for. Some women are very clear that they do not want to change the size of their breasts, simply the shape, while other wants both improvement in shape as well as reduction in size. This communication throughout your consultation is key to getting the results you desire.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 155 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.