Can I get a breast reduction then implants?

Yes, many surgeons perform this in one- or two- stages.  The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified Beverly Hills Plastic Surgeon

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.

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!

Rather than making breasts smaller then larger again with implants, it might be a better idea to have the reduction done with a GalaFLEX internal bra to maintain the shape. It transforms into living tissue over time and helps maintain upper pole fullness..

Dear Alyssa g,it is hard to tell without an examination but based on your explanation, it sounds like you might be a candidate for breast reduction. Once you are fully healed, then you might consider breast augmentation. I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

but if you were doing this cosmetically, you could do both at the same time.  Implants will make mounds perkier on top and provide volume, and the reduction re-position your nipples to a good spot and to remove the heavy, hanging tissue that ruins traditional mastopexies when starting with that.

hello there
i do alot of breast surgery in my practice, i think very large breasts should be lifted and reduced first. This allows the breast to heal i the neal position first. If you combine that with an implant it heals in a more saggy position. this surgery is one of the few times i recommend two parts.
hope this helps

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 correct that breast reduction and lift techniques may not be able to provide the same degree of upper pole fullness achievable with an implant. Some patients do get pretty good upper pole fullness with breast reduction depending on the pedicle technique, as this determines which part of the native breast tissue is preserved and which areas are reduced. It does seem a bit paradoxical to reduce a breast and then augment it but it is not that uncommon a practice for this very reason of limited upper pole projection. However, the procedures should be staged a few months apart to let the breasts settle and "bottom out" before adding an implant and tweaking the lift component for optimal positioning. 

Both breast reduction and breast lift (mastopexy) procedures are limited in their ability to add upper breast fullness. Once healed, patients who have had either procedure may be candidates for implant augmentation to add needed volume in the upper pole. Because the nipple/areola have already been positioned in a higher more youthful position, the results can be quite good aesthetically. As always, an in person examination and consultation is essential, particularly when planning for staged or multiple procedures. I would discuss your goals with a board-certified plastic surgeon in your area.