Breast Lift or Breast Reduction Surgery for 21 Year Old?

The Ultimate Breast Lift/Reduction was developed using engineering principles to elevate and support the breast other than just skin. This new technique reshapes a woman's own tissue to form an internal bra that is then attached permanently to the chest muscles. Standard techniques rely on skin to be the only means of support for the newly formed mound. And as every woman knows-this is simply not enough! With the Ultimate Breast Lift, the forces of gravity are opposed. Breasts are lifted higher than other lifts achieving upper pole fullness without the need of an implant. An added benefit of this new technique is that the vertical scar is NOT needed. The final result is a firm, perky, natural appearing breast with minimal scars. It's worth looking into.

Best wishes,

Dr. Horndeski

Yes, your description makes me think you would likely benefit from a breast lift/reduction.  A reduction is also a lift.  It turns out that a lift is also a reduction (it reduces the lower pole of your breasts).  They are really the same operation.  In a breast "reduction" we usually just take out more breast tissue.  The optimal technique is the vertical technique.  The inverted-T technique produces an unflattering boxy shape and excessive scars, although it is still in use.  The "donut" technique that removes tissue around the areola is not very effective in treating sagging. 

 I would recommend that you look at photos of results from different surgeons before proceeding.  There is quite a bit of variation in results, less than for breast augmentation, and you will see fewer examples of breast lifts posted online than augmentations.  If you are satisfied with the results you see, that is a good sign and you may feel more confident about the surgeon you select.  I've attached the relevant section of my own website.

Hello! Thank you for your question! The mastopexy, breast lift, procedure raises the breast, which ultimately provides a more youthful and perky breasts. This is done by removing the extra loose skin and rearranging the surrounding breast tissue in order to reshape and support the newly formed breast. At the same time, the nipple-areolar complex (NAC) is raised to the ideal position above the fold beneath your breast (the inframammary fold) as well as being placed at the most projecting portion. Oftentimes with age or following pregnancy, the NAC becomes widened and enlarged. This may be reduced in size during the breast lift procedure. A breast reduction has basically the same principles, except that the goal is to make the breast smaller. Regardless, the overall result will be to remove excess skin and tissue while also raising the nipple-areolar complex to an appropriate, aesthetic position on the breast. Ultimately giving a fuller and more youthful, yet smaller, breasts.It is common for the breast to lose its firmness and uplifted appearance over time, which is also accentuated with age, pregnancy/breast feeding, weight gain/loss, and gravity. This results in breast ptosis, or sagging of the breast, with a “deflated” appearance. Women seek the mastopexy procedure to regain the previous youthful appearance of her breasts and women report increased confidence, self-esteem, and femininity once achieving this desired shape and fullness. Breast lifts may or may not be performed with implants – the implant would add increased size but also greater fullness in the upper pole of the breasts which creates more cleavage. Hope that this helps! Best wishes!

If you want children and expect to have them soon, then I recommend you wait as pregnancy can reverse the effects of your surgery. If you're not sure, then you can consider a breast lift and reduction performed at the same time. This would give you breasts a perkier shape and reduce them in size if necessary. The reduction is optional.

A breast reduction and a breast lift are the same except with a reduction you are making the breasts smaller. Having children may affect your surgery long term but this is a decision you and your PS should make. You should be able to breast feed but no guarantee. 

The first question, is at what age would you have children. If it is in the immediate future, it will be best to defer surgery until you have completed your pregnancies. There is no question that pregnancy is one of the great referral sources to my office. However, if the pregnancies in the future surgery may be indicated.
A breast reduction always involves some type of breast lift. Often, most procedures are combination of both. It is difficult to evaluate and give a good answer without seeing your breasts. I'm sure the surgeon will be able to help you reach your decision.

Many times I do the procedure you are talking about for the problem you are describing by doing a breast lift with a very small amount of tissue reduction. The reduction is not to reduce the aide of the breast but to improve the shape. By removing some tissue I can get the breast to have a prettier rounder shape with less fullness in the outside part of the breast.

If you are happy with the size of your breasts in a bra, then a lift alone may be all you need.
However, if you feel that they are too large, even with a bra, then a reduction and lift may be more appropriate. I do not think you are too young, and you can not diet and excercise your breasts to change the current shape.

Dear VirgoBlue88,
It is difficult to determine what you may need without pictures. Pictures help me view the breast tissue in its relationship with the crease and the nipple's relationship to the crease to name a few. Based on your description and without the history of back pain, neck pain, rashes beneath the breast which go along more with heavy saggy breast that would need reduction it sounds like a breast lift would benefit you.
The only other point I will mention is that when a patient has a lift it makes the breast smaller and some patients desire more fullness of the upper portion of the breast so implant placement at the same time may be necessary. Whether or not you should wait until after you have children is a decision you will ultimately have to make based on how much your appearance bothers you and your willingness to accept the possible complications of the procedure(s).
Visit with some plastic surgeons in your area and get a good evaluation on which options are best for you.
Good Luck!
Dr. ES

Pregnancy by itself even without nursing can cause quite prominent sagging of the breasts. It sounds as if you really need a lift more than a reduction but it truly depends on your timing. If you plan on having children in the near future (less than five years) I would probably do the procedure afterwards.