Would like areola reduction and breast increase, is fat transfer/ implants better and can I avoid breast lift? (Photo)

Hi,
thank you for your question.

Looking at your pictures I think it is possible to improve significantly the appearance of your breast with periareolar incision and breast implants. Furthermore, Fat Injection to the Breast can act as a help, but not being the sole way of enlarging the breast, especially if your goal is to go up by 300-350 cc. I would strongly recommend implants over fat injection.

Thanks for your question. Yes, based on your photos, I think you would do well with a circumareolar mastopexy (breast lift with scars only around the areola). This could be combined with an implant to increase overall volume and upper pole fullness. Fat transfer is another option but you would be unlikely to achieve as much of a volume increase with this (given your likely available donor fat), and you may require more than 1 procedure to achieve a satisfactoryy result.

The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers can be performed. Implants are not lifetime devices. 8% fail within the first year and 30% fail within six years. Fat transfers are permanent and incorporated into the body.

Best Wishes,

Gary Horndeski, M.D.

To reduce your areolae I recommend the lollipop lift along with a modest sized implant. Avoid the donut type lift they don’t work well and leave bad scars.

Your photos do not indicate that you need an areola reduction or breast lift. A board certified plastic surgeon will be able to guide you to the correct size implant. Based upon measurements of your chest wall and breast imprint width as well as knowledge of all breast implant sizes and profiles should make this process easy. Try on a profile bra with various silicone sizers your PS recommends under a tailored blouse, tank top, bikini, workout clothes, and other garments you typically wear so that you have the best idea of whether the garments fit as desired with the implant selected. Select the size that boosts your self-esteem, and fits your anatomy.

Dear Dazzling632177,
determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I appreciate your concerns, however I do not see a need for areolar reduction, unless the size bothers you. It also appears that placement of moderate plus or higher projection implants over the muscle would provide enough lift for, achieve the size you desire and avoid scars from breast lift surgery. It does not appear that you have enough excess fat to achieve appropriate augmentation by fat transfer alone. Consult with a board-certified plastic surgeon in your area to confirm my advice. Good luck.

If you want 300 to 350 cc's, you will need implants instead of fat. You could possibly have the peri-areolar lift and avoid the vertical scar.

The areolar reduction could end up acting as a "doughnut" mastopexy and give your breasts a little lift, you would want to have the surgeon use a Goretex or Prolene suture to keep the scars and your new areolas from spreading. A fat transfer to give you some upper pole fullness and general increase in size would also be a nice enhancement in addition to the doughnut mastopexy

Looking at your photos you may not need a breast lift. To be more certain you really to have an in-office consultation. Good luck!