How Much Cup Size Do You Lose with a Breast Lift?

It sounds like you are thinking the right thoughts.  Don't believe a plastic surgeon who says he can restore your upper pole fullness using a lift without implants.  If you want upper pole fullness, you need implants (breast tissue is too malleable to stay perky).  Period.  But you also need an aggressive lift using the vertical technique and greatly reducing the amount of tissue in the lower poles.  A lift alone reduces your cup size; if it does not, then it won't be effective.  You need to reduce breast tissue to have an effective lift.  The vertical technique is most effective, provides better shape, and less scarring.  Look at plenty of before and after photos for yourself.  Avoid disappointment by knowing the facts.

Though a breast lift is not designed to alter the size of your breasts, many patients find that their breasts look and feel a bit smaller after the surgery. You can expect to lose an insignificant amount because of the tightening and lifting involved in the lift, but this depends on how your surgeon approaches the procedure and the specific composition of your skin/breast. You will not lose a significant amount of your size.

One of the most important
decisions facing patients who undergo breast lift surgery is the ultimate size
of their breasts.Most patients are
striving for harmony, balance, and proportion with the surrounding anatomic
structures.Typically they want a
natural look with some fullness in the upper breast area.Most patients tend to speak in terms of cup size.Unfortunately, cup size isn’t always helpful
because cup size means different things to different people.This has the potential to create communication
problems.In theory, breast size doesn’t decrease following breast
lift surgery.Despite this, many
patients request breast implants to increase upper breast fullness following
this procedure.If you’re considering breast lift surgery and are
concerned about the ultimate size and aesthetics of your breast, it’s important
to consult a board certified plastic surgeon with experience in this area.This surgeon should be able to formulate a
treatment plan that not only addresses your anatomic findings but achieves your
aesthetic goals as well.

Breast Lift Size Change

A mastopexy or breast lift operation is designed to improve the shape and position of the breasts without diminishing their size. After the procedure, the previously droopy breast should be more full and round (perky), rather than flat and wide. In theory, since there is no breast tissue removed, the volume should remain the same. However, the breast may seem to decrease because the shape of the breast has changed as the volume is more centered than drooping so the illusion is it looks smaller despite the same volume.

There are different ways of achieving a breast lift. A breast lift by itself without placement of an implant will decrease your breast volume. Although it is hard to determine how much your breast will decrease in size, according to my experience, there will be about a 2 - 3 cup size change. This is why many patients opt to have a breast lift with augmentation at the same time to restore the volume of the breast. By placing an implant, your breast volume will be restored and the lift will create harmony between the nipple and the breast implant.

Some patients hesitate about having an implant placed to augment and restore the volume. Another option that I offer my patients is a breast lift with autoaugmentation. This technique involves taking all the breast tissue that is at the bottom of your breast and moving it with its own blood supply to the top of your breast to increase the fullness of the breast. This technique will restore the natural breast fullness while at the same time will avoid a substantial decrease in breast volume. Your breasts will be smaller but not as small as a breast with a traditional breast lift technique.

I use this technique routinely in patients who have lost weight and face a significant decrease in volume and excess of breast skin.  The main thing to worry about a breast lift, regardless of the technique to be used,  is to maintain the upper pole’s fullness. It is extremely common that, if attention is not paid to detail and the internal breast tissue suspended, you will sag early in the postoperative period and will have suboptimal results.

I think that you are asking 2 questions that need to be answered separately - do you want to decrease the size of your breasts to a D, or would you rather stay at about a DDD cup size?  Would you be opposed to being bigger?  A mastopexy or breast lift alone will not decrease your cup size by that much unless you also have breast tissue removed.   The other question to address is how important upper pole or upper breast fullness is to you.  Without an implant, the upper part of your breast will not stay full and round over time, as breast tissue has a natural tendency to drop - particularly after large weight loss.   If it is very important for you to have fullness on top, you need to consider an implant.  Then your plastic surgeon will need to decide if you need breast tissue to be removed in order to accomodate in increase in size that an implant gives. Breast lifts with implants are more complicated procedures than either one alone, so make sure that you are treated by a qualified plastic surgeon who has experience with combined procedures.  Some surgeons stage the procedures, which is a perfectly acceptable way to approach this.