Considering a breast lift and fat transfer - what can I do to achieve a perkier and round look? (photos)

Question

I am a mom of two and each pregnancy, my breasts went from a B to a full double D. They are currently a C, but I feel most of it is loose skin and they are just lifeless and flat. I'm debating on augmentation or fat transfer. I'm happy being a C, but just want them perkier and round again! I am always very self conscious in certain clothes because of the loose skin on my breasts. Wondering thoughts on what direction to go!

Lane Smith, MD · Answer

Fat transfer to the breasts can give you perkier, fuller breasts. In order to have fat transfer to the breast you would need 5-20lbs depending on desired fullness, of excess fat that it doesn’t appear you have. Augmentation using silicone or saline implants would probably be a better fit for you. If you would like to be seen here at Smith Plastic Surgery to go over options in more detail, feel free to reach out to my office for a consultation.

Daniel Barrett, MD · Answer

Dear jpursel,
based on your photos, it looks like you would benefit from breast lift. 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. 
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Jeffrey Lisiecki, MD · Answer

There are a couple of great options for reshaping your breasts.  A lift is part of the equation, to help lift your nipple/areola and reshape your breast tissue to be tighter and rounder.  As for more perkiness and fullness in the upper breast, implants or fat transfer (or a combination of both) are all great options.  Implants give the most predictable increase in fullness and give great shape and structure to the breast (often also with some fat transfer to the upper and inner breast).  If you'd like to avoid an implant and stay about the same size, then fat transfer is a good option as well.  For patients like you, I often recommend a lift with a small to medium sized implant and some fat transfer to the upper and inner breasts.

Cristina Dracea, MD, FACS · Answer

Having a breast lift will get your breasts to be perkier and round again as you desire. However, you'll still probably lack upper pole fullness, meaning fullness at the top part of the breasts. So, a small implant or fat grafting are good options for that as you are thinking. From the pictures you posted, you look thin so you might not have a lot of fat to give for grafting (even though I can't be completely sure without evaluating the abdomen or thighs). Also, not all of the fat grafted will take (aka survive) so might need several procedures to get you the desired fullness. The fat that does take will become a part of you, meaning the volume will decrease if you loose weight or increase if you gain weight. A small implant maintains it's size and shape, but there are also some implant associated issues that can occur down the line which is a whole other discussion. In your case, I think you should definitely first be evaluated by a plastic surgeon to see if you're even a candidate for fat grafting, because if you are not, then an implant would be your only option.

Yily De Los Santos, MD · Answer

Thank you for your question and pictures. In your case I suggest getting a Breast Lift with implants. Breast Lift will help you getting rid of the excess skin and lifting your breasts and the augmentation with a right size implants will help you with the round shape and "perkier" look.

George Marosan, MD · Answer

Thank you for your question and photos. Based on these photos, you are a great candidate for a breast lift and augmentation with an implant ( "to achieve a perkier and round look"). Fat grafting will not give you that result and based on these photos, you do not have enough fat to give you the desired results you are looking for.
See a board certified plastic surgeon for an in person consultation/evaluation. During my consultation, I use the Vectra 3D to simulate the surgery and give a visual feed back of what a patient can expect. Good luck.

Gary M. Horndeski, MD · Answer

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. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Matt Novak, MD · Answer

The decision between breast augmentation and fat transfer depends on your individual preferences, body type, and the specific results you're looking to achieve. Both procedures can help improve breast shape and fullness, but they have different considerations:
1. **Breast Augmentation with Implants:** - **Size and Shape Control:** Breast augmentation with implants allows you to choose the exact size and shape you desire. If you want to restore fullness, perkiness, and roundness to your breasts, implants can be customized to achieve those goals. - **Implant Type:** You can choose between saline and silicone implants, each with its own characteristics. - **Longevity:** Implants have a long-lasting effect, and their results are generally more predictable than fat transfer. - **Surgery:** This procedure involves the insertion of implants through incisions, typically under the breast crease or around the areola.
2. **Fat Transfer to the Breasts (Breast Fat Grafting):** - **Natural Tissue:** Fat transfer uses your body's own fat to enhance the breasts, which can provide a natural look and feel. - **Limited Size Increase:** Fat transfer may not provide as significant a size increase as implants. It's better suited for those looking for a more modest enhancement. - **Potential Multiple Procedures:** Multiple fat transfer sessions may be required to achieve the desired results. - **Liposuction:** Fat is harvested from other areas of your body (e.g., abdomen, thighs) through liposuction, which can offer body contouring benefits.
Considering your desire for perkier, rounder breasts and your concerns about loose skin, breast augmentation with implants may be a more suitable option. Implants can provide the volume and shape you're looking for, and they can also help fill out loose skin.
To make an informed decision, I recommend scheduling a consultation with an aesthetic plastic surgeons. During these consultations, you can discuss your goals and preferences, undergo a thorough evaluation, and receive personalized recommendations based on your unique anatomy and aesthetic objectives. Your surgeon can help you choose the most appropriate procedure and implant size to achieve the results you desire while addressing your concerns about loose skin.

Connie Hiers, MD, FACS · Answer

Go with the lift to get perky. If you want to be larger, then add implants. You do not appear to be a good candidate for a fat transfer for you don't appear to have much donor fat. Implants, not fat, will give the round look.

Mats Hagstrom, MD (license on probation) · Answer

To get the best outcome, do you need implant augmentation with a mastopexy(breast lift).
You could also do a breast lift with fat transfer, though personally, I do those procedures as separate operations or as staged procedures.Implants will give a far better aesthetic outcome with forward, projection and substantially better increase volume in the upper half of your breast. Fat transfer is very subtle compared to what implants can accomplish, and does not create the same in the upper half of the breast.
Fat transfer may be a decent option for those women who will not accept having implants. If you’re open to having implants, then I suggest using implants because they give far better results.
I suggest having multiple in person, consultations with local board-certified plastic surgeons in your community. You’ll probably find that most plastic surgeons. Towards using implants, especially those who lack fat, transfer skill and experience. 
The number of plastic surgeons who mastered Liposuction and fat transfer procedures, are in a small minority. If you are considering fat transfer as a viable option, then you’ll need to find a provider whi have sufficient skill and experience and can deliver consistent quality results using Liposuction and fat transfer.
During each consultation, asked each provider to open up their portfolio and show you their entire collection of before, and after pictures of the previous patient who had similar body characteristics to your own. For fat transfer results recognize that early results can look very impressive at final results take 3 to 6 months to be a representative. Always confirm that the timeframe of when after pictures were taken when looking at fat transfer results. Never assume the after pictures were taken as long-term outcomes when results are final.
An experienced provider should have no difficulty showing you the before and after pictures of at least 50 previous patient. 
Being shown a handful of preselected images, representing the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider.
Continue scheduling consultations until you feel confident you found the right provider for your needs.
Results very quiet, dramatically, depending who you choose as your provider especially for procedures, like Liposuction and fat transfer.
Recognize that fat transfer always includes having to procedures at the same time. Fat transfer always requires having liposuction a harvest the fat. It’s not uncommon for patients to seek fat transfer only to end up having problems because of the Liposuction, because they did not properly vet providers regarding skilled for both procedures.Best,
Mats Hagstrom, MD

Considering a breast lift and fat transfer - what can I do to achieve a perkier and round look? (photos)

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