Can you have a breast reduction and auto augmentation done at the same time?

Question

I'm getting a breast reduction Done. My breast size 36 DDD to an F. Is possible to have auto augmentation at the Same time to have an fuller upper pole and a nice shape? How much does it cost?

Richard H. Tholen, MD, FACS · Answer

Perhaps I do not understand bra sizing, but I thought that DDD breasts are SMALLER than F cup breasts! If your breasts are too large and saggy, then breast reduction (by whatever degree you and your surgeon decide on) will place your remaining breast tissue in a higher, tighter skin brassiere, just like a bra does to your existing breasts. So, your first step is to decide if your present breasts are too large or  too small. If they are too large, removing tissue to add tissue makes absolutely no sense, since every breast lift (or breast reduction with too much sagging) places either the existing saggy tissue (or a somewhat smaller reduced volume of tissue) in a higher, tighter skin brassiere with improved upper pole fullness and shape. You don't "transplant" to a higher position to get upper pole fullness--you leave the attached tissue (for keeping blood supply and tissues alive) in a higher position. Sure, I understand that you don't want to sag again, but that is a function of your skin tone (or lack thereof). Auto augmentation has no place in the scenario you ask about. Honest.The problems is that patients (and some doctors) sometimes have been led to believe (incorrectly, in my humble opinion) that implants replacing breast tissue somehow "magically" gives better upper pole fullness, or doesn't re-sag when the skin again stretches. I read about this more and more here and elsewhere, but it makes it no more true.If your breasts are exactly the right size, but too saggy, then breast 
lift (removing only about one ounce of skin per breast) will give you 
the same volume in a higher, tighter skin brassiere. This is no 
different than removing breast tissue (plus skin), and then adding back 
the same volume of tissue removed in the form of breast implants. That 
is, if your implants don't develop malposition, symmastia, capsular 
contracture (firmness and pain), or other implant-related problem!You
 see, fill volume is fill volume, whether it be implant or breast 
tissue--if you have plenty of the latter, just skip the cost and 
potential problems of breast implants (however minimal they are, they 
are still greater than your own tissue).However, I do understand
 your question, as there are a few (misguided, IMHO) plastic surgeons 
who apparently feel that breast implants give women more upper pole 
fullness and perhaps sag less than a woman's own breast tissue. It's the skin that stretches and sags, NOT the breast volume!Still,
 volume is volume, and if careful surgery yields a soft, mobile, non 
capsular-contracted implant placement on both sides, then a reduction 
plus implants is no different (except possible slightly LESS natural) 
than a breast lift alone with your own tissue in the place of implants. Let's try an example here--let's say you have an old stretched trampoline in your backyard, and then someone throws a bowling ball in the center. It sags, right? Think of the stretched springs and the stretched elastic fabric of the trampoline as the skin containing your breast volume. Now, let's go back to the trampoline--switch the bowling ball for a large rock of the same weight. Will that "help" the springs or fabric to be less saggy? Of course not, and the same goes for implant vs. tissue, or even more so for your question: existing breast tissue for auto-augmented tissue. Plus, if you're thinking fat grafting (like BBL), around 50% of the fat will die. leaving lumps, scar tissue, and less ability to detect breast cancer! None of this is good.It's
 another thing entirely if you want to be uplifted and larger--that WILL
 take a lift plus implants--but if your present size is good, there is 
no advantage to removing more breast tissue than necessary to do the 
breast lift and then adding larger implants--this only makes the edge or
 ripples or palpability of the implants more likely!If what you 
mean by "a fuller upper pole and nice shape" is the high, round, 
Baywatch coconut "look," there is nothing wrong with that look, it's 
just that too many women want the look without realizing that this is 
not the product of a good push-up bra but rather a poorly-done 
augmentation with capsular contracture, which is unnaturally hard, like 
croquet balls in your vest pockets! Truly, not good!SO if your 
surgeon is "pushing" this concept, I'd suggest finding a different 
plastic surgeon who does not depend on CC with implants, or removal of tissue and auto-augmentation to give his/her patients the 
look they desire. If this is simply a misunderstanding on your part, I 
hope I've explained this adequately! Best wishes! Dr. Tholen

Hilton Becker, MD · Answer

A breast reduction reduces the size of the breast, however  the volume is reduced from the lower pole of the breast often leaving the upper pole without fullness. The addition of internal mash support helps elevate the remaining breast tissue into the upper pole giving fullness ,hence the term auto augmentation

Paul M. Parker, MD, FACS - Account Suspended · Answer

An autoaugmentation can be done at the same time as a breast reduction or breast lift. It will add fullness and shape to the upper pole of your breasts. Discuss this option with your operating surgeon to see if this is appropriate for you. You indicate you are a DDD cup but there must be a typo in terms of your intended size.

Can you have a breast reduction and auto augmentation done at the same time?

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Can you have a breast reduction and auto augmentation done at the same time?

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