Breast Reduction or Lift with Implant for more youthful, perky and full breasts? (photos)

Your breasts exhibit a natural 'rock in sock' shape, that is to say heavy breast (most likely glandular) tissue hanging in a stretched out skin envelope. The best approach to lifting this breast type is through precise skin removal in conjunction with breast tissue reduction; this both achieves a lift of the breast mound and nipple, and reduces breast tissue mass. The end result is, as you might expect, a smaller, tighter breast. For those like you who want a lift AND want more fullness, a breast implant would be necessary and appropriate in addition to the aforementioned lift and reduciton.

To get the treatment and result that you want I would encourage a moment spent on defining and understanding the terminology. In the big picture, the things you can do to modify breast size and shape are: reduction (smaller, lifted), mastopexy (lifted, about same size), and augmentation (or mammoplasty, ie bigger). You can also combine two of these: augmentation+mastopexy, either at the same time or in different operations. Another point: all reductions include a lift but not all lifts include a reduction. Another rule of thumb: reduction and implant don't mix. The implant is used to augment, or increase, size. The reduction is a procedure to decrease size. So these are generally not talked about together. Most patients with your anatomy and thoughts between these approaches end up wanting a breast lift, or mastopexy, and that might be what you want to discuss. But having the above terminology down should help that conversation so that you get the right treatment for your goals.

At size 34 H, you do not need implants. You do need a breast lift and the technique I recommend is 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. The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief and long term stability. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.

Best Wishes,

Gary Horndeski, M.D.

I do a lot of augmentation and lift procedures together including one this morning. However, I do not think you should have this done in one stage. I think it would be unwise and unsafe. I would start with a massive breast reduction and then let your tissues settle for a few months. Then if you wish, add an implant and revise the soft tissues if need be at the second stage. Good luck.

Dear LaughLines2006 thank you for your question.
Upon looking at your photos I think you are a candidate for breast reduction and lifting. An implant may give some upper pole fullness but overall a great effect can be achieved by reshaping the gland and skin, achieving perkier and youthful-looking breasts.
As you mentioned scars will need to be long since the technique you require involves an inverted-T scar, but it usually heals nicely and can be concealed inside the bra or bikini.

Hi, thank you for sharing your question. You are a great candidate for a breast reduction. Many patients that undergo the procedure can be left with upper pole deficiency. If your preference is for fullness, projection and a youthful appearance, an implant can be helpful to fix that problem. I hope this helps.

You are a good candidate for a breast lift. Unfortunately there are certain to be scars. As far as an implant I don't think you will need one. Just do the lift first and if you want an implant for upper fullness have it placed at a second procedure.

Dear LaughLines2006,
my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I would recommend a breast reduction to reduce your heavy breasts and lift. You may do very well without adding implants which will add volume and weight.

There is no need to add an implant to a large breast that is sagging. Reduction surgery with autologous augmentation (using your own tissue to create fuller look) will give you contouring definition, fuller upper pole and a long lasting result without the need to have implants replaced or any of the complication risks related to implants