Breast lift choices - everyone has a different opinion! Reduction, fat grafting, implants, what would be best for me? (Photos)

Question

I have always had naturally massive boobs and love them big - never experienced back issues so want to keep them big but I've lost nearly 120 lbs / 54 kg and they are pancakes now so a significant lift is a no brainer. I had an extended tummy tuck with mons lift and muscle repair in early July this year and recovery has been very easy for me with barely any pain so I'm ready to book my next procedures. I've had 4 consultations with different plastic surgeons and all are recommending different things and I'm confused as to what the best option is. 1 . Lift with slight reduction 2. Lift with Motiva round 280cc at the same time 3. Lift with fat graft to upper pole then come back for implants 4. Lift only then come back for implants

Gulcin Nujen Cardak, MD, FEBOPRAS · Answer

Hello, thank you for your questions. First of all, I’d like to say that all of these options are valid and reasonable. The key question to ask yourself is whether you would be happy with smaller breasts.If your answer is a clear no, then a breast lift with implants may be the best choice, as it will give you lifted, fuller, and perkier breasts.If you are unsure about your desired size, you can start with a breast lift alone. This option will give you a natural lift using your own tissue. If you are happy with the smaller, lifted result, then no further surgery is needed. However, if you later decide you’d prefer a fuller size, implants can be added approximately six months after the initial surgery.I hope this helps clarify your options.

Gary M. Horndeski, MD · Answer

If you are satisfied with the volume of your breasts in a bra then you do not need additional fat or implants.  You would benefit from a breast lift using The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.  Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

John LoMonaco, MD, FACS · Answer

Congrats on your weight loss !  After 25 years of working mainly with weight loss patients, I can safely say this is one of the more challenging procedures to get consistent and long-lasting results.

Lifting the breast with a vertical mammoplasty (lollipop or tennis-racket shaped scar) and rearranging your tissues to provide more fullness is the simplest operation and you never have an implant to worry about later. Problem is it doesn't give great fullness bat the top.

IN GENERAL using an implant and adding weight to a breast that has undergone weight gain/loss cycles results in sagging (or bottoming out) very soon after surgery. A small implant to provide upper pole fullness is the best option.

I prefer to do the lift and implant in one procedure.  If we get early sagging, removing and tightening the skin some more and possible using mesh is my second procedure.

Fat grafting, in my opinion and experience, is of zero help in restoring any meaningful breast fullness and can result is issues interpreting mammograms later on.

Much depends on your breast tissues and skin, so an in-person exam is best.

Finny George, MD · Answer

Hi, thank you for sharing your question. The answer to the question will depend on how much volume and projection you want as well as how much long term upper pole fullness you want. Also, whether you want the surgery in one stage or two.

Suleyman Koken, MD · Answer

From your photos, it looks like you still have a good amount of natural breast tissue. Because of this, doing a lift with an implant at the same time could carry a higher risk of developing “waterfall deformity”, where the natural tissue droops over the implant over time.
For that reason, my recommendation would be to first do a lift without an implant or reduction. This will allow the breast tissue to settle and give you a clear idea of the shape and volume after the lift. If you still want more fullness after healing (usually a few months later), an implant can be added at that stage for a safer and more predictable result.
Best,Dr. Süleyman Köken

Breast lift choices - everyone has a different opinion! Reduction, fat grafting, implants, what would be best for me? (Photos)

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Answer: Breast lift

Answer: Breast lift

Answer: Breast Uplift without Implants due to waterfall deformity risk

Answer: Breast Uplift without Implants due to waterfall deformity risk

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Breast lift choices - everyone has a different opinion! Reduction, fat grafting, implants, what would be best for me? (Photos)

Answers (7)

Answer: Breast lift

Answer: Breast lift

Answer: Breast Uplift without Implants due to waterfall deformity risk

Answer: Breast Uplift without Implants due to waterfall deformity risk

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Recommended reading

Everything you need to know about Breast Lift with Implants

Our mission is to create a world where every investment in modern beauty is Worth It.