Can I get a breast reduction then implants?

Based on your complaints, you are a good candidate for breast reduction surgery. This surgery will help to reshape your breast and you will be able to move comfortably as your proporion will improve. To start the process, you should contact a Board Certified Surgeon. I wish you all the best.

Your question is excellent, and a frequent one in patients with large and saggy breasts.  I think what you are getting at is the frequent need for some fullness in the upper portion of the breast following breast reduction and some breast lift operations.  Depending on the shape and composition of your breast, you may be a candidate for what we call "auto-augmentaion", where some of your breast "excess" is moved up to provide fullness in the upper pole of the breast.  If your tissue cannot support this on its own, we often use a small implant to improve upper pole fullness in patients that fit your description.  Either way, a single surgery should fix your issues.  I recommend seeing an experienced Board Certified Plastic Surgeon who can evaluate your breasts and tailor an operation to your particular goals. Best wishes, Dr. L

You are absolutely correct in your assessment of breast lift/reduction techniques often not giving long-term upper pole fullness and this is the most common reason why women in my practice rarely undergo a lift procedure alone rather than a lift with implants (in addition to the desire for more volume in many cases).  It is important to understand that the technique for reduction and lifting is often the same or very similar and a lift can be done with or without volume reduction but a reduction is virtually never done without a lift as well.  However, adding implants does have its own set of downsides including long-term implant maintenance issues such as malposition, rupture, or capsular contracture (firm scar tissue forming around the implants).  There are some alternative techniques such as the way the lift is done and possibly adding a material such a stattice (acellular dermal matrix) to act as an internal bra to produce more long-term upper pole fullness using only your own beast tissue, of which it sounds as though you have plenty.  Even if you do chose to proceed with a reduction and an implant, I still believe these two procedures can easily be combined to try to avoid a two-stage procedure, which is more costly and requires two separate recovery periods (to include light activity as well as time off work).  The technique would simply be a modification of a lift with an augmentation (and as I mentioned a lift and reduction are done through very similar techniques), 2 procedures which are routinely done together, at least in my practice.  You may have to consult with several plastic surgeons to fully understand all of your options and also find someone who understands what you are looking for in your final result and feels that it can be safely and effectively delivered in one vs two surgeries.  Best of luck!