BR or BL: which type should I choose to get the best shape? Age 33, no kids. (Photo)

Question

Very concerned about scarring but much more concerned about breast shape. I have very soft nipples and I have seen pictures of women with breasts similar to mine whose BR look odd in the way the breast hangs, the nipple part appears very flat. Can anyone advise on whether this is to do with what the breasts look like before hand, or the surgery? I am 5'4'' and weigh 180lbs, but plan to lose 50lbs before surgery. Having lost weight before, I know my breasts will not reduce in size that much. Thx

S. Larry Schlesinger, MD, FACS · Answer

All breast reductions have breast lifts as a portion of the procedure.  Thank you very much for your pictures and your excellent question.  Because of the volume of your breasts and your height, if you were my patient, I would recommend a breast reduction.  Because of the position of your nipples with respect to the fold at the bottom of your breast, I believe the scars for a breast reduction or breast lift would be very similar. At this point, I recommend you get an in person evaluation from a Board Certified plastic surgeon experienced in breast surgery.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your pictures. You are going to need a breast lift but a small reduction will be needed to achieve the appropriate shape. You must remember with breast lift and small reduction your breast will get somewhat smaller. This may be fine with you or you may want to retain your volume or increase your volume. If this is the case then implants need to be added to the treatment plan.

Thomas Trevisani, MD · Answer

Based on your photos-- you are good candidate for Breast Lift. If you want to decrease your volume - then Breast Reduction is recommended. Seek an in person consultation with a Board Certified Plastic Surgeon

Jose Perez-Gurri, MD, FACS · Answer

You would benefit from a small breast reduction and breast lift. If after you lose the weight you find lacking enough volume from the glandular tissue, then it's possible that you may need implants. Wait to lose the weight prior to making any decisions.Always seek out the opinion of a surgeon certified by the American Board of Plastic Surgery with years of experience in cosmetic breast surgery. Furthermore request to see before and after photos of previous patients by that doctor....not a clinic or surgery center. Do your homework......research and verify the doctor's credentials. Have they had problems with the Board of Medicine, disciplinary or otherwise. Any law suits? How about the center, clinic or facility? Are they accredited by a national organization or do they just have State approval. Understand that at the current time, there are three nationally recognized organizations responsible for the highest levels of patient safety, AAAASF, AAACH and JCHO. You owe it to yourself to position yourself for the best possible results but under the most stringent safety regulations, If you have kids, even more so.How about anesthesia? Will you have a medical doctor certified by the American Board of Anesthesiology or a certified nurse anesthetist (CRNA)? Understand that there is no substitute for research. Cosmetic surgery, no matter how simple it may be to the patients, are invasive procedures and as such carry certain risks and complications. Good luck

Allen Gabriel, MD, FACS · Answer

If shape is your number 1 priority then I would recommend to
wait until you have lost all of your weight, as this will help you determine
what size you want to be.Knowing your
breast size doesn’t change, your overall body will change with weight loss and
this can affect your overall body silhouette.Some breast tissue will have to be removed even if you decide to have a
lift to improve the long-term shape. The
question will be how much breast tissue should be removed once you have lost
your weight. I would recommend you wait
and seek out a board certified plastic surgeon in your area for detailed
evaluation and make sure you ask all of the questions that you would like to
have answered.

John J. Edney, MD · Answer

You  would benefit with a breast lift.  If however you wanted to be smaller along with being lifted you would require some degree of breast reduction.  Normally the scarring is similar for both.  If you loose 50 pounds and experience noticeable change in the volume of the breasts you may want to undergo breast lift only.  It is very important for U

Brian J. Lee, MD · Answer

The decision for breast reduction versus breast lift hinges on your desire for size. If you like the volume you have and not the shape, a lift will suffice. If you would like to be smaller, then a reduction is indicated. By dissecting the tissue and leaving more volume superiorly and anchoring the tissue in a higher position will help maintain a fuller breast after the surgery.I would recommend you wait until you are closer to your goal weight before proceding as breast tissue tends to be replaced by fatty tissue as you age and this is more susceptible to volume loss compared to your previous weight losses.

Darryl J. Blinski, MD · Answer

The way I explain these options is the following. A Breast Reduction/Lift removes more glandular/fatty tissue while lifting. Vs a Breast Lift/Reduction only lifts the breasts by skin removal and minimal tissue excision. In your care I would opt for Lift/Reduction...

Jeffrey Zwiren, MD · Answer

Depending upon your desire for breast size you could have a small breast reduction with a breast lift.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures. You are going about things correctly; achieve your long-term stable weight prior to proceeding with elective breast surgery. Then, select your plastic surgeon carefully. Ask to see lots of examples of his/her will work achieving the types of outcomes you would be pleased with.  Then, communicate your goals carefully when it comes to breast size/shape. Achieving realistic expectations and understanding the downsides/ trade-offs associated with breast reduction/lifting surgery will also be important. Best wishes as you achieve your goals.

BR or BL: which type should I choose to get the best shape? Age 33, no kids. (Photo)

Answers (10)

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