Breast lift without implants. Am I going to lose 1 or 2 cup sizes? (Photo)

I appreciate your question.

I perform a liposuction breast lift that removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast I then remove the skin to tighten the breast and create a better shape with nice cleavage. Since I perform this less invasively the recovery time is faster. The size would depend on the proportion with your body versus going for a cup size. It works very well if there are asymmetries. I can also use the removed fat as a natural breast augmentation by grafting the fat back into the breast to create more projection or into the top to create more cleavage. This procedure can also be combined with an implant if needed or wanted.  It should not affect nipple sensation, mammograms, cancer risk or breast-feeding. If you gain or lose weight, the transferred fat can do the same.

The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic plastic surgery.  

Best of luck!    

Dr. Schwartz 

Board Certified Plastic Surgeon

#RealSelf100Surgeon 

#RealSelfCORESurgeon

Hi Julmas3,

Determining whether you need simply a breast implant versus a breast lift or both can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position.

Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just breast augmentation depending on the size of the implant the patient wants. I often use an implant when I perform a breast lift because it provides more upper breast fullness after the lift. Also, price range for breast lift is around 10k to 15k depending on whether you need a lollipop or a donut mastopexy.

Another important consideration to make would be the breast implant type and sizing selection. In fact, this is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient.

When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.

Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.

Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.

You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals for both BBL and breast augmentation.

Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, Am. Society of Plastic Surgery

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another. See the below link on some suggestions on finding the most qualified Plastic Surgeon for a  Breast Augmentation

With a non-implant breast lift, the minimum that needs to be removed is about 30g (one ounce) of skin per breast, even with a full, Wise-pattern (anchor) lift. This leaves your present breast size intact, just in a higher, tighter (and one ounce smaller) skin brassiere. If one breast is larger, and the smaller breast is still of adequate size to fulfill the patient's final size goals, then the larger breast can have skin and tissue removed to match the opposite side (where only skin is removed).If both breasts are larger than desired, skin and tissue can be removed from both breasts to give not only the higher, tighter (perkier) skin brassiere, but also smaller breasts of the desired size. This would be called an elective, cosmetic breast reduction (which includes a lift because it involves the same skin pattern).If enough skin and tissue can be removed to qualify for insurance company guidelines, this would be considered a breast reduction (and again, a lift is part of the procedure since the same incisional pattern is used).I do recognize that there are other skin incisional patterns (lollipop, circumvertical, periareolar, donut) for performing breast lifts, but these have differing ability to actually "lift" breasts. The usual goal is to reduce incisions and the attendant permanent scars, as well as cost (time of surgery), but fewer incisions equal not only fewer scars or cost, but also ability to actually "lift." Always remember that less is indeed always less. Techniques that are marketed to reduce "ugly" scars always have the limitations required by the loss of the incisions that are eliminated. Less is less--no magic, no physics, and no engineering marvels can overcome the need to remove skin via incisions as this is what allows the surgeon to shape the remaining skin into the desired shape.Now, one last comment.How about those surgeons who tell you that they "must" remove tissue and "replace" it with implants in order to promote "shape retention," "upper pole fullness," " or "longer-lasting" results? IMHO, this is bogus BS, and it does not take a medical degree to understand that terminology! Breast implants are designed to replicate breast tissue, so why would you remove one to add back something designed to feel and act the same? Implants are soft, pliable, and even round ones have a teardrop shape when the patient is standing. So how does that improve a breast lift that retains breast tissue to "fill" the skin brassiere and that same upper pole?Correct--it doesn't!Now, I'm not calling those surgeons who say or do this unethical or ill-informed . . . but I am saying that their training or thought process is lacking (unless, of course, capsular contracture is part of the process). A few may indeed be "trained that way" and simply do what they have been trained to do without giving this much thought. And, it does bring in a larger check! But if a surgeon knows it is not necessary, yet promotes it anyway just because it sells a couple of implants and takes a bit longer in the operating room (generating more revenue), then this indeed is unethical. Let's hope board-certified plastic surgeons are more ethical than that!So, I hope that answers your question, because it was stimulated, I would assume, by someone "informing you" that your perfectly adequately-sized breasts (that need only to have an ounce of skin removed to perform a beautiful breast lift) will "lose a cup or two" of breast size and must therefore "require" implants. I would try to simulate a sneeze like Iceman in Top Gun and simply say "H****S***!"Properly performed, a breast lift on breasts whose size you like requires only an ounce (30g) of skin removed per breast. NO MORE is required (another 15 g per breast if they are super droopy and deflated with lots of "extra" skin), but if your surgeon CHOOSES to tell you more MUST be removed, you can choose to go to someone else who simply removes the skin necessary to reshape and lift your breasts. ALL of the patients in the photo gallery you can access by clicking on the web reference link below have had breast lift ONLY--not one implant in the bunch! Best wishes! Dr. Tholen

Thank you for you question and photo,         The Bellesoma Method is a current technique to lift and/or reduce breasts without using implants or the ugly vertical scars.  The incisions are hidden around the areola and in the inframammary crease. The vertical incision has been completely eliminated. The areola incision heals almost invisibly due to the fact that there is hardly any tension on the closure. With this particular technique, ducts are preserved along with nerve supply maintaining nipple sensation and the ability to breast feed. Because the breast is reshaped internally and is secured to your chest muscles, upper pole fullness is possible without an implant. Attached is a patient who underwent The Bellesoma Method. Please note that her tissue was used to create upper pole fullness and cleavage without any foreign materials (mesh, implants, etc).  It is a proprietary technique that only surgeons that have been trained by me can perform. I hope this helps. Best wishes and kind regards, Dr. Gary Horndeski

Hello and thank you for your question. Based on your photograph, you are a
great candidate for a breast lift.  Your breast size will remain the same.  This can be designed to result in an
improved shape and contour of your breasts while minimizing scar
appearance.  Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and evaluate their results.  The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Based on your pictures, you appear to have enough breast tissue to still maintain nice fullness and volume with a lift alone.  A lift does appear to make patients look smaller, but the more actual breast tissue you have, the more fullness and shape you will retain.  The best thing to do is to come for a consultation and see what will work best for you.  I hope this helps.

Hello dear!!
Thanks you for your question. It is my pleasure to help you with your concerns.
You can be your own best version, and you can definitely achieve amazing results with plastic surgery in order to improve your breasts. For you, I recommend both procedures combine: an anchor incision breast lift with tissue and areola reduction, for perkier, youthful breasts. No implants are needed.
I suggest you to make an appointment with a board certified plastic surgeon for a good evaluation and to talk about your goals.
I hope this is helpful.  Good luck :)

Thank you for your question. When you undergo a breast lift, you usually do lose a bit of size, simply because excess skin and tissue are removed, and your breasts are reshaped. However, from your pictures, it appears that the size will not be seriously impacted. My best advice would be to schedule a consultation with a specialist plastic surgeon. They can examine you in person and provide you with options for achieving the optimal results from your surgery. Good luck!
- Damon Thomas, FRACS

Hi, thanks for sharing your concern and photos with us!
Looking at your photos I might say that you´ll be a great candidate to get a breast lift without implants because you have enough tissue to reshape and lift it.
Before all this, of course, you need to get a complete medical evaluation and laboratory exams to check everything is fine, please also look for a board certified plastic surgeon that helps to get what you are looking for, remember that your safety, always, must be first.

Good luck and have a great day!

Dr. JPG