Can I Have A Breast Reduction, Augmentation, And Areola Reduction In The Same Surgery?

Two years ago, in Oct of 09 I had a breast reduction. I was 120 lbs.,a sz 32i & was taken down to a full c. I am now, 2 yrs later, a 36G.When I had the reduction I had them lifted, as they were very heavy and had no upper volume. I did not receive the desired results, and now my aerola is the sz of a baseball, and i have no top volume. I want smaller breasts, full c, an areola reduction, and implants to achieve the top fullness and space between. Can this be done all @ the same time to cut costs

Doctor Answers 14

Can A Breast Reduction, Breast Lift And Breast Augmentation All Be Done At The Same Time?

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The answer to your question is yes.  Reduction, lift and augmentation all done simultaneously is a common cosmetic surgical combination.  All breast reductions include a breast lift, and therefore this combination basically goes without saying.  The addition of an implant usually in the subpectoral space will give upper quadrant fullness along with the lift reduction. 

There are any number of ways to accomplish this combination.  Very often, I complete the lift reduction bilaterally but do not completely close the lateral incision.  At an earlier stage in the surgery, I cut the pectoralis muscle off the 5th rib and create the subpectoral pocket.  Then at the last moment, I put saline sizers in to determine what size implant will match both the requested size and also the patients breast aesthetics.  Then as a final maneuver, place the chosen implants along with a JP drain and close the last of the mastopexy incision.

An alternate way of doing the augmentation at the same time is to place the implants in through the armpits in the partial subpectoral space once the breast reduction/lift has been completed. 

All that being said, no matter what the technique, a combination of the three surgeries is an excellent way of forming the desired breasts all at one sitting.  With specific reference to your situation with a previous lift/reduction, a free nipple graft very often takes the worry out of where the potential blood supply to the nipple is coming from. 

This surgery needs to be done by a Board Certified plastic surgeon with a great deal of experience in breast lift/reductions and breast surgery revisions.


Secondary surgery following breast reduction

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Yes you can combine these surgeries, and it can work well; but I would make sure that your wieght is fairly stable; and that you work closely with your plastic surgeon regarding these goals.  This is a revision surgery, therefore a little more difficult and several more things are going on: taking away additional tissue, yet needing a certain amount of tissue to accomadate the implants. Your surgeon will also like to know as much as possible about the previous surgery as possible.  You might consider just a revision breast reduction with the areola reduction and alleviate the addition of the implants, as there are ways to achieve some reasonable upper pole fullness with your existing breast tissue.  If this does not work out you could always have the implants later on. Good luck

Jerry Lugger, MD
Southlake Plastic Surgeon

Revision of breast reduction, with a lift and implants, can be one procedure.

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  Implants can be placed after breast reduction to add volume and upper pole fullness (fullness and roundness to the upper part of the breasts). In addition, further lifting and, in your case, areolar reduction can be performed at the same procedure. Ideally, we would review your old operative report to determine which reduction technique was used, but this is usually not obtainable if the prior surgery was years prior. There are considerations regarding blood flow to the nipple that must be evaluated prior to surgery.

I would suggest that you review photographs of other patients who have had augmentation after reduction.

Thanks for your question.

Steven Goldman, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 168 reviews

Can I Have A Breast Reduction, Augmentation, And Areola Reduction In The Same Surgery?

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To reply to the question I believe all three steps can be done at one operation. But the risks increase because of the initial reduction for N/A and skin necrosis, fat necrosis. These and other items need to be discussed in detail with your chosen surgeon. 

Breast reduction and augementation and nipple reduction

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Dear Ms/Mrs. Gomez,

Without a detalied exam it is very difficult to give you an excact answer.  The use of implants can be used to give you better cleavage as a re-reduction would decrease the size of your breasts and give you a nicer shape but would not produce the given projection that you want.  However, you must have realistic expectations and understand that with time, even with the implants in place, the projection will decrease and the upper pole fullness will decrease.

Ernesto Hayn, MD
West Palm Beach Plastic Surgeon

Breast Reduction and Breast Implants at the same time........

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Yes, Breast Reduction can be done with Breast Implants at the same time.  This done to remove the excess Breast tissue that is drooping and stretching your skin and placing an Implant under the muscle to provide more fullness superiorly.  The implant is supported by your muscle and therefore doesn't really add any weight to your breast skin and therefore isn't likely to ever cause additional drooping.  It works very nicely!  

Daniel P. Markmann, MD
Baltimore Plastic Surgeon

Breast Reduction, Augmentation and Areolar Reduction at the Same Surgery

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This is a very common request for most women with larger breasts.  They tend to have breast volume, but it is located at the lower aspect of the breast, not above where most women would prefer. The solution is a removal of the excess lower breast tissue, the placement of an implant to provide the volume in the upper aspect of the breast and the reduction in the size of the areola.  All this combines to provide a shapelier and more youthful breast.  The volume can be maintained or reduced, but now it is located in the more desirable locations on the breast.

The key is understanding the amount of change you are desiring/anticipating and also if this possible depending upon your anatomy.  An in-person consultation with a board certified plastic surgeon will help determine the final answer.

Best of luck,

Vincent Marin, MD, FACS

San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 52 reviews

Breast reduction and breast lift

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In order to properly respond to your post more information is required. You basically state you have recurrent large breasts with drooping and stretched areola after a breast reduction 2 years previously. The required information is your height, current weight, specific surgical technique used at the previous reduction surgery, photos (before, after and current) and whether you did not receive the desired result from day one after surgery.

Given your starting weight of 120 pounds I suspect your large breasts were due to increased sensitivity to female hormones rather than obesity. In such cases there is always the risk of recurrent large breasts especially in younger patients whose tissues are more actively growing. If the large breasts are related more to weight gain recurrence after reduction surgery is less likely as long as the weight is stable. If your previous reduction employed a minimal scar/incision approach the tension of skin closure was placed mostly around the areola. Therefore when the breast re-enlarged the areola stretched more than they otherwise would have.

The question is what do you do now and the answer depends on the information required that is not included in your post. Depending on the skin pattern of excision at your previous surgery your surgical options may be limited affecting your ability to achieve the desired result. Your skin is likely to be damaged by the repeated stretching so there is no guarantee that your skin envelope will hold a breast implant in position to maintain upper breast fullness. The breast is held in position on the chest wall by ligaments called Cooper's ligaments. When these ligaments are all stretched out there is no way to replace them. We cannot shorten or tighten them. Sutures cannot take their place because with exposure to gravity over time the sutures pullout. That is why historically primarily tightening of the skin envelope was used to lift breasts. Also, no such ligaments exist to keep breast implants in position which is why larger implants always move downward over time unless placed under the muscle

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Please send pictures

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Breast reduction and aerola reduction can be done at the same time. It would not make sense to remove your natural breast tissue and replace it with implant that will cause more sagging. Please send your pictures for further evaluation.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 154 reviews

Breast reduction

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I do not think that if you have a lot of breat tissue that you would need an implant to create a fuller look. But, you have to be realistic with the results. Breasts do not sit up against your chin after surgery. They all fall down a bit.

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