Lift with Fat Graft, or Lift with Implants? (photo)

I have tuberous breasts that are widely spaced [5 inches apart] and have meet with two consultants. The first MD suggested I go with a vertical breast lift and a fat graft to plump up the area and enhance cleavage. The second suggested I avoid fat grafting completely and go for a doughnut lift with moderate profile implants. My ultimate goal is lifted, fuller breasts that are much closer together. Which path is more likely to achieve this? I'm 20 years old, have never given birth or breastfed.

Doctor Answers 10

Yes, a lift is needed to address the condition of tuberous breasts.

Thank you for your question and the photo.

Yes, a lift is needed to address the condition of tuberous breasts.

For volume and a wider breast base, you can go with fat grafting if you only expect a slight increase in volume. If you want a larger increase in volume, then breast implants will likely be necessary for a good and predictable result.

Keep in mind, however, that you are young and implants do not last forever. It is almost certain that at least once or twice in your life you will need to have one or both implants changed.

The choice is up to you and the board-certified plastic surgeon that you choose.

Be informed.

Best wishes.

Nashville Plastic Surgeon
5.0 out of 5 stars 182 reviews

Is a Breast Lift with fat graft better than implants?

Often #BreastLift candidates experience more satisfying results by combining a #BreastLift with #implants to restore superior fullness. In some cases, harvesting one's own fat and transfering it to their breast can be an alternative to implants for qualfying candidates. The options best for you will be discussed during your one-on-one consultation.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 107 reviews

Lift with Fat Graft, or Lift with Implants?

A periareolar lift will not be satisfactory with the amount of lifting needed. I would favor implants, but if you size increase goal is modest, might consider fat grafts. None of these will bring your breasts as close together as you or your surgeon would like.  All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

For tuberous breasts you need a vertical lift and implants

They are both half right and half wrong.  You need a vertical lift with implants.  The donut lift will not correct your degree of sagging.  A fat graft will leave you disappointed.  If you want your breasts close together, with a decent cleavage, there is no substitute for implants.  The tubeous breast deformity tends to be well-treated with a combination of a vertical lift and implants.  You should look at plenty of before and after photos provided by your surgeon.  This is a difficult situation and you need an experienced surgeon.  I have attached a link to the portion of my website that describes breast lifts in combination with implants.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.7 out of 5 stars 56 reviews

The Ultimate Breast Lift is designed to customize the ideal breast

Dear Ria,


Thank you for your question and photos. There is a new technique that uses engineering principles and reconstructive techniques to design the ideal breast for any type of sagging problem. It reshapes your breast and lifts/moves your breast in a permanent position to provide longevity to the lift-unlike current techniques. The UBL is not a cookie cutter technique like the others. It is not like any other technique. It does not require a vertical scar. The vertical scar weakens the lift by placing an incision at the point of maximum tension. This is an inherently faulty design requiring revision in a few years. Incisions are hidden around the areola and the natural inframammary crease. Breasts are given a round, perky and natural appearance.

Hope this helps.

Kind regards,

Dr. H


Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 222 reviews

Breast lift and breast implants

Based on your posted photo your goal of lifted fuller breasts that are closer together is not achievable. There currently are no reliable surgical techniques for improving cleavage (moving the base of the breasts closer together towards the midline). You will need surgery on the breasts to adjust the positioning of the tissue within the breast skin envelope and surgery on the skin itself to adjust the position of the nipples as well as most likely an implant. Your case is a difficult one and you need to have full frank face to face discussions with prospective surgeons before proceeding.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 1 review

Tuberous Breast Surgery and Cleavage

Your breast anatomy poses a difficult challenge in achieving an ideal result. You most definitely need a lift with implants and there would be some differences of opinion aboout what type of lift and type and size of the breast implants. But one reality that you will have to accept is that cleavage from any type of breast procedure is not going to be obtainable. Your breasts are too widely spaced apart and fat grafting is not going to achieve cleavage no matter what other breast procedures you do. It is going to be difficult enough to end up with uplifted fuller breasts that have reasonable symmetry and good scars.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Lift and implants for tuberous breasts

Fat grafting would not help because it would be much like dropping a ball in a sock.  Your goal is to;


1. Improve shape of breast mound

2. increase width of your breast base

3. decrease areola size and reposition higher


Initially, I was inclined to consider the donut lift, but the amount of excess skin removal you need from the area around the areola would do better with a vertical lift and be more stable long-term.  A moderate size implant would be best.

Ramin Behmand, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 39 reviews

Implants and lift

Without an exam it is difficult to say, but based solely on your photographs, you probably will need implants with a lift. This may be accomplished with a vertical. I perform a lot of circumareola lifts, but I am not sure that you are a candidate without examining you.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Correction of tuberous breasts

With what I can see in the photo, you would need a lift and implants to correct your breast tuberosity.  The exact lift would have to be determined by a qualified surgeon examining you.  A fat graft would not be indicated because it would not be able to correct your cleavage gap.  In addition, there is still debate in the scientific community about whether or not we should be injecting significant amounts of fat into breasts due to the unknown long-term effects (such as increased cancer risks). 

I have  before/after photos of a woman with tuberous breasts that I corrected with a donut mastopexy and implants if you are interested (case #2007).  Please feel free to call me if you have any other questions or concerns.

Victor Ferrari, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 36 reviews

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.