Breast reduction and implant - is this typically done in two stages?

with all due respect, it does not make sense to get implants if you already have large breasts. I recommend that you do a breast lift with an auto-augmentation which will give you upper pole fullness and a breast implant like look without an implant. Sometimes I add a little fat as well for fullness in the desired areas but if you want to avoid an implant, it is possible.

Hi BMR! If you are satisfied with the volume of your breasts, then you would be a candidate for a mastopexy (lift) using your own tissue (auto-augmentation). The best way for you to determine this is whether or not you are happy with the size of your breasts in a supportive, pushup-type bra. If so, it is possible to acheive upper pole fullness with only a tissue rearrangement without the need for an implant. I utilize an absorbable surgical mesh in my mastopexies and reductions to create an internal support bra and minimize the aging or sag of the breast over time. If you feel in a bra like you need more volume to reach your goals, then a mastopexy with implant augmentation is the way to go. These can be done at the same time. I encourge you to consult with a board-certified plastic surgeon that specializes in surgery of the breast and body to discuss your goals and meet your aesthetic expectations. Best of luck!

Thanks for your question! If you really want to be more implant than breast tissue, I would suggest staging the surgeries. If you are okay with being fuller and just adding a moderate or lower profile implant, then I think that can be done in one stage. Some wish pics would be helpful! Good luck!

Due to your large breast size, gravity is making the breasts sag. Adding an implant may exacerbate the sagging over time. A lift alone will help boost the upper pole volume, but you will still need support in the form of a bra to enhance cleavage. Placement of implants can enhance upper pole volume, and are a good option for individuals with deflated breasts. This is not your situation. Due to the fact you do have some excess fat, you could have a lift, followed by fat grafting to the upper pole of the breast. This would avoid the risks of breast implants (capsular contracture), and enhancing the exact area where you want projection, but not adding significantly to the overall volume of the breast. Find a board certified plastic surgeon who is familiar with fat grafting in large volume.

I agree with you. If you do not want the fullness I would avoid implants. They have their own set of issues including capsular contracture, asymmetry, and need for surveillance. I believe you would be very happy with a breast lift alone.

If you are already a 34 D then you do not need implants. 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.

Best Wishes,

Gary Horndeski, M.D.

The major issue I see is asymmetry of your breasts with the right significantly larger that the left. The left side has normal shape and proportion in relation to your body. Depending on your expectations and concerns, it may be a good plan to start with a right breast lift/reduction to obtain maximum symmetry. Then, IF desired, proceed with augmentation, but you may be happy with the lift alone. Thank you.

A breast lift with an implant is one of the more challenging operations plastic surgeons can be faced with.

That's because a breast lift and reduction Both aim to lift the breast upward so that it is more perky whereas a breast implant tends to pull the breast in the opposite direction, downward

I think you could have a nice result with good fullness at the top what's a breast lift or small reduction.

A small implant to provide you more fulness and better shape at the top is also an option.Much of this depends on the consistency Of your breast tissue and the elasticity of your breast skin

Thank you for your question and photos. You do have bottom heavy asymmetrical breasts with poor upper pole fullness. You will need a breast lift to make your breasts symmetrical. The breast has an upper pole "foot plate", which is about the junction of your lateral chest muscle and lateral breast (indented). To lift this foot plate and give you upper pole fullness, an implant will be needed. This is a +/- operation, removing volume inferiorly and increasing volume superiorly to give you better shaped breasts. This can be done at the same time or in two stages. This type of surgery has about a 20% reoperation rate if done in one stage. I would do the lift first and the augmentation later if you choose to have a two staged operation (better control of outcome). I use the Vectra 3D to simulate this operation and give you a realistic three dimensional photo. See a board certified plastic surgeon experienced in all aspects of breast surgery. Good luck.

You may want to consider a breast lift with auto augmentation. This approach uses your own tissue to give upper pole fullness without an implant. This is not fat grating. A lift is performed at the same time. I've included a video that I hope you find helpful.