Recommended Procedure to Achieve Significantly Smaller Breast and Areola's with Minimal Scarring? (photo)

I'm 22 years old with sub muscular 360CC Natrelle Saline-Filled Implants. I underwent a breast aug. & a donut mastopexy 4 months postpartum my 1st pregnancy in August 2010. I'm 31 weeks in my second pregnancy and a 36DDD (I'd like to be a small b, think size of lemons). How soon postpartum can I remove the implants? I don't plan on breastfeeding, and I experience physical discomfort daily. I live in Dothan, Al, are there any dr.'s n the panhandle area you recommend. I'd like smaller areola's as to

Doctor Answers 9

Recommended Breast Reduction Procedure

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Its usually best to allow the effects of pregnancy subside before peforming surgery on any of the areas of the body that are significantly altered by the hormonal effects. This includes avoiding operating on breasts soon after parturition. The possibilty of having idiopathic or secondary galactorrhea(milk production) after undergoing breast surgery has been reported in the surgical literature and therefore I recommend a waiting period of around three(3) months before undergoing the procedure(s). Probably will require a mastopexy.

Explant and Mini Ultimate Breast Lift

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After reviewing your photographs, it is apparent that your breasts were very ptotic without any upper pole fullness.  You then underwent implantation that was centered under the areolas, which positioned the breasts low on your chest wall.  The additional pregnancy added more weight and further descent.  I would recommend waiting 3 to 6 months after your pregnancy to undergo implant removal and simultaneous lift.  Using only a circumareola approach it is possible to adjust your areola size, remove your implants, elevate your breast tissue higher on the chest wall, reshape your breast to increase upper pole fullness and move them more medial to increase cleavage.  This technique transfers the weight of your breast to the underlying muscle, which relieves pain.  This can all be done in one operation and without the ugly vertical scars of the lollipop or boat anchor shaped incisions.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Removal of Implants During Pregnancy

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   Although you have daily pain, you will deliver in a few weeks, and your breasts and weight will likely change dramatically postpartum.  You may end up removing implants that you will want in the future.  I would wait a few months after pregnancy or after the cessation of breastfeeding before considering further surgery.  Kenneth Hughes, MD Los Angeles, CA

Recommended Procedure to Achieve Significantly Smaller Breast and Areola's with Minimal Scarrin

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Best to wait 5 months after delivery for FULL breast involution than decide on an operative plan. To early to seek opinions in my estimation. Good luck. 

Implant removal

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Hi Kayla,

     If you want the implants out and you are currently having discomfort, you could actually get them removed now.  This procedure could be done easily and quickly under local anesthesia which is absolutely safe to do for both you and the baby.    I would hold off on undergoing any kind of lift or areola reduction until six months post partum.

Good luck,

Ary Krau MD FACS

Ary Krau, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 357 reviews

Smaller breasts and areolas after pregnancy. Timing is everything.

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  • As you approach the end of your pregnancy, you breasts are full and symptomatic and your desire for implant removal is understandable. Breast size and shape is a moving target while you are actively building a family. You should sit down with a board certified plastic surgeon with an established cosmetic breast surgery reputation and discuss your options.  
  • The amount of remaining breast tissue and the amount of ptosis changes with each successive pregnancy. You could remove the implants after 4-6 months when the breasts have returned to a less biologically active state (since you will not be nursing).  You are then faced with longer breasts needing tailoring; this means surgical scars.
  • Future pregnancies can and will continue to effect the appearance of your breasts. This is true if you have surgery now or defer the surgery until after you feel you are done having children. You and your surgeon must discuss the issues of surgery timing, as well.

Best Regards,

Douglas J. Raskin, MD
Colorado Springs Plastic Surgeon
4.9 out of 5 stars 69 reviews

Breast Lifting Surgery after Pregnancy?

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Thank you for the question and pictures.

I would suggest that you wait until you will have completed having pregnancies and achieved a long-term stable weight prior to undergoing any further breast surgery.

At that point, seek consultation with well experienced board certified plastic surgeons. It is very likely that you will benefit from breast lifting;  exactly what type of breast lift ( and the resulting scars) will depend on your physical examination at that point.  Your plastic surgeon will evaluate the position of your breasts on your chest wall, the quality of  breast skin elasticity, and should discuss your goals clearly.

 You may find the attached link, discussing breast lifting options, helpful to you as you do your research.

 Best wishes.

Breast revision

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While you are pregnant and all bets are off. You will have to let things settle down and your weight to go back to normal.  My guess is you will have to wait about 6 months or so.  A smaller implant with a lift may be necessary.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Recommended Procedure to Achieve Significantly Smaller Breast and Areola's with Minimal Scarring

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It is hard to guess right now as to what will be best after the pregancy induced changes in your breast are gone. I would allow at least three months, but the decision would be made by you and your surgeon as the time approaches.Since these are saline, it may be a consideration to deflat the implants after delivery and see how much the breasts will shrink.

Chances are to get you to the size you want you will need a mastopexy with more than the current peri-areolar incision. If your surgeon will deflate the implants, the removal and lift as needed can be planned for one stage without as much guesswork. 

Thanks for your question, all the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.