Seeking a "perky" more rounded look - what procedure would you recommend? (Photos)

Question

I would like for my breast to be more round and up. I ike to wear dresses without a bra and would love some professional opinion feedback as to which procdeures would be best for long term success. Thanks!

Paul M. Parker, MD, FACS · Answer

You appear to be a good candidate for a breast reduction along with a vertical mastopexy and consideration given to auto-augmentation. This is where the central breast tissue in the lower portion of the breast is transferred to the mid and upper portion of the breast with sutures instead of removing it entirely. This along with the vertical mastopexy (otherwise called a "lollipop lift") should give you more projection and a round, perky breast. Find a board certified plastic surgeon near you that does a lot breast reductions/ lollipop lifts with auto-augmentation to discuss these options. Good luck!

Ira H. Rex III, MD · Answer

You probably only have two realistic options.  One is a breast lift and the other is a lift with a small implant for upper pole fullness.  With either operation, sometimes a small amount of lateral breast tissue is removed to help shape that area.  You may also have liposuction of the armpit area.  This is often just part of the surgery.  It is not a bad idea to start with a breast lift and may be consider a small implant down the line.  One thing to know is that breast tissue tends to keep sagging over the years.  You have to consider that you may need further surgery after a number of years.

Daniel Barrett, MD · Answer

Dear Marisol0929,

my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Leila Kasrai, MD, FRCSC · Answer

For rounder, perkier breasts, a breast lift may be suitable. This reshapes the breasts and removes just a bit of tissue, so you’ll be about the same size as you are now. If you’d like significantly rounder breasts that look more “bolted on”, then you can consider breast augmentation performed at the same time.

Jonathan Heistein, MD · Answer

Hi.  You could achieve a very perky result with a breast lift.  Autoaugmentation can be done with it to enhance the volume and roundness at the top.  This is done with your own tissue so there would not be an increase in your size.  If you want to be larger and more rounded, then a small implant can also give you a more round look at the top.  Talk to your surgeon about what you can expect with each approach.  Best of luck!

Brandon Elnekaveh, MD · Answer

Hi and thanks for your question! To get a more rounded appearance, I would recommend a breast lift with an autoaugmentation, and liposuction on the sides of the chest and armpit area. A good alternative would be a lift with an implant to really keep that fullness superiorly. Choosing a more cohesive implant that keeps its shape better can help- consider Motiva round implants if you choose to go that route. Best of luck!

Donovan Rosas, MD · Answer

Reduction and lift are similar (if not identical) procedures done for different reasons. A lift primarily lifts and the breast will tend to get smaller as a consequence. A reduction primarily reduces but will lift as a consequence. In summary, the 2 are inseparable.

The operation typically involves formation of a pedicle or a protected area of breast tissue containing the nipple and areola. This area will preserve blood supply to the new smaller breast. Anything outside of this protected area can be removed to reduce the size without compromising the breast blood supply. An anchor scar is standard.

Based on your photos, you would appear to be a reasonable candidate for a reduction. This will lift and reshape the breast mound and downsize you (which may have the side effect of symptomatic relief). An implant may deliver greater upper pole fullness if that is something you desire.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Franklin D. Richards, MD · Answer

From your photos you seem to have very good volume to your breasts. A standard breast lift (mastopexy) should do a very nice job. A mastopexy technique that uses your lower breast tissues for auto-augmentation will give you a great superior pole fulness. If you want more volume, then a breast lift with an implant will work well. I would recommend a Mentor Boost or Motiva implant. These implants will give you better upper pole firmness.

George Marosan, MD · Answer

Thank you for your question and photos. To get a more rounded look, you would need a breast reduction/lift with auto-augmentation of the upper poles of the breasts. The lateral chest wall and excess armpit fat needs to be contoured with liposuction. The breast asymmetry can be improved as well. I do these surgeries in our accredited office surgical suite under deep intravenous sedation. See a board-certified plastic surgeon for an in-person consultation/evaluation. Good luck.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. I have been in practice for over 30 years and breast surgery is a large portion of my practice. I have performed surgery on thousands of cases similar to yours wanting to be smaller with more upper pole fullness. I have developed with a technique termed "reductive augmentation" which I published in 2017. It involves perform a breast augmentation, removal of inferior pole breast tissue, and a mastopexy/lift. You should be able to have an excellent result and beautiful breasts. Best wishes to you.

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