I am going to get a reduction. Best results for full and firmness.

Hello I am going to be 30 soon and after breast feeding 2 children I went from a 36 c to at times an h. I now am a 38ddd sometimes larger and want to get a reduction to reduce pain and regain perkeyness. Will simply getting a reduction help achieve this alone or will lifts and implasts be considered. I will be going for a full consult in the future but I'm looking for advice before the consult.

Doctor Answers 5

I am going to get a reduction. Best results for full and firmness.

Thank you for the question. Based on your description, you may be an excellent candidate for breast reduction surgery. This operation tends to be one of the most patient pleasing operations we perform. 

“Typical” patients who present for breast reduction surgery are women who have disproportionately large breasts, causing problems such as neck/back/shoulder discomfort, postural changes, bra strap grooving, skin irritation/rashes under the breasts, and/or difficulty with activities of daily living and/or exercise etc. There may be both physical as well as psychosocial “stress” caused by the disproportionately large breasts. Reducing breast tissue mass and elevating the breasts on the chest wall tend to improve or alleviate many of the symptoms associated with the disproportionately large breasts.

Patients considering breast reduction surgery should also consider the potential downsides (risks/complications) associated with the procedure as well. Poor scarring, for example may be associated with the procedure. Additional surgery may be necessary in the short or longer term for a multitude of reasons.

When the time is right, I suggest that you seek consultation with well experienced plastic surgeons who can demonstrate significant experience achieving the types of outcomes you would be pleased with. Ultimately, careful selection of your plastic surgeon will be the most important decision you make. To this end, I would suggest you visit a few surgeons whose practices concentrate on aesthetic surgery. ***Ask to see lots of examples of their work and preferably speak/see patients who have had similar procedures done.    I hope this, and the attached link (dedicated to breast reduction surgery concerns), helps. Best wishes.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Breast reduction. Best results for fullness and firmness

Good question. In my opinion, conventional breast reduction techniques do not provide long term upper pole fullness/perkiness. Poor results are also compounded by poor fatty breast tissue that does not and cannot hold its shape. It is imperative that women realize that being overweight will affect their results. Breasts are made up of fatty tissue and breast parenchyma (firm tissue). The more fatty tissue you have, the more undesirable your results will be. Conventional methods do not take this into account. Conventional methods (Wise pattern or vertical scar techniques) rely solely on the skin envelope to reshape and provide stability for the newly shaped breast. Clearly, this is not enough. The Horndeski Method breast reduction actually reshapes and anchors the newly shaped breast internally to the chest muscles taking the weight off the skin envelope. There is a series of internal straps that act as a "living bra" to help maintain shape and position long term. The internal bra also relieves pain associated with pendulous breasts. The vertical incision component has also been completely eliminated in order to provide a stronger skin envelope. The vertical incision placed at the lower pole is a faulty design simply because this is where most of the weight of the breast eventually lies. It makes sense to keep this section intact in order to provide supportive strength (not to mention better aesthetic sense). I suggest you visit the breast reduction forum on this site to see long term results and follow women who mostly have complications at the T junction from the conventional methods. Give me a call if you would like for me to explain this in more detail. I hope this helps. Best wishes and kind regards,

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews


Based on your breast size, you should have plenty of breast tissue to reposition higher on the chest without needing an implant.  So, for safety purposes and longevity of your reduction, go with the reduction/lift first and let it settle.  If you decide later that you want more fullness, you can go with either a small implant or even fat grafting at a later date (although I doubt you'll want it).

Cain R. Linville, MD
Houston Plastic Surgeon
5.0 out of 5 stars 32 reviews

Breast Reduction

Thank you for your question.
Often just a breast reduction is required to give a nice size and shape to the breast with perkiness.  However, in some instances, the upper pole can still be a little flattened after surgery (and either a small implant, or fat grafting, would help in that case).  I would discuss the look you want with your surgeon, and they will come up with a good plan for you.

Dr. Dan Krochmal
MAE Plastic Surgery
Northbrook, IL

Daniel Krochmal, MD
Chicago General Surgeon
5.0 out of 5 stars 23 reviews

Reduction vs lift with implants

So, a reduction and a lift are essentially the same thing, it is a matter of semantics and how much breast tissue if actually removed as the goal of the procedure. To reduce pain, a reduction is clearly indicated. Breasts after reduction can be perky but sometimes still lack upper pole(superior breast) fullness that patients desire, only then would an implant be considered. Go see your consult and clearly decide what your goals are for the surgery, a properly trained plastic surgeon will be able to assist you in this matter.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.