40, do I need a breast lift or could I do fat transfer to build up the volume? (Photo)

Question

I am 40 and my breasts don't look as they used to before and I am deciding the best treatment.

Carlos Marciales, MD · Answer

Hello, from the photo it is valued that your breasts are sagging and to improve their shape you need a breast lift, if you want them more fillers you will need either an implant or fat transfer

Benjamin Baker, BMBS MBA FRCS(Plast) · Answer

Hi, thanks for your question. It is not possible to make an accurate assessment based on your photograph. The best treatment to pursue will depend what you would like to achieve with surgery and the current characteristics of your breasts. A breast lift can be performed alone, or in combination with an ‘auto augmentation procedure’ which redistributes the tissues so that you are fuller in the upper pole, or with fat transfer / implants to boost volume if required. I would recommend consulting a plastic surgeon with specialist expertise in aesthetic breast surgery. Use of 3D simulation equipment may help you to make a decision and is offered as a component of our face to face consultation.

Daniel Barrett, MD · Answer

Dear Honest619,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

Your photograph is very limited. However, it does appear that your breasts are low on the chest wall. You would benefit from a lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Miguel Mota, MD · Answer

Hello and thank you for posting. Fat grafting does help with volume, but will not offer improvement as far as a lift. It will make them larger but will not improve your areola position nor will it lift any tissue above your breast fold. Most of your areola is below your breast fold. In order to correct this you would need a lift. 
A breast lift with implants is a good option if you do not want to lose volume or if you want them slightly larger.

Best of luck,
Dr. Miguel Mota

Ronald J. Edelson, MD · Answer

Your photo suggest that a lift is necessary. It’s hard to tell from the photos whether you need extra volume as well either in the form of an implant or fat transfer

Connie Hiers, MD, FACS · Answer

Although your photo does not show your whole breasts, you appear to need a lift. Adding only fat will increase you up to one cup in size, but you will still be sagging.

Hilton Becker, MD · Answer

Fat grafting is an excellent  way to increase volume to the breast if correctly done .
A breast lift will improve the shape of the breast and lift the nipples

Kenneth R. Francis, MD, FACS · Answer

Dear Honest,

Breast fat transfer is indeed an option for breast augmentation in the correct patient.  The photograph has cropped out your breasts and does not give a full and adequate assessment of them.  An in person examination would also likely be needed to properly advise you on breast fat transfer options.  Seek consultation with a certified plastic surgeon in the UK for evaluation.  Good luck!

Mats Hagstrom, MD (license on probation) · Answer

Please start with we need quality pictures to make an assessment. Take a look at our plastic surgeon to take before and after pictures of the bread to get an idea.
Fat transfer, when done by a sufficiently experienced provider can increase breast size by about 1/2 cup. The number of plastic surgeons who are good at this procedure are in the minority. Fat transfer does not change the shape of the breath and from what you describe it is the shape of your breast you don’t like.
Breast implants given far better results than the fat transfer if that is an option for you. Breast implants, unlike fat, transfer drastically change the shape of the breast, especially giving projection and volume in the upper half of the breast.
A breast lift may be appropriate as well. Of these procedures, I would be most apprehensive about provider selection for Liposuction and fat transfer. Provider selection is important for any procedure, but for Liposuction and fat transfer absolutely imperative that you choose providers who have mastered these procedures and can deliver consistent quality results.
Expect to get different opinions from different plastic surgeons. Especially regarding fat transfer. When things go wrong with breast, fat transfer, it is often a lack of Liposuction‘s skill leaving people disfigured that ends up being the bigger problem.
The following are some general recommendations for finding the right provider for your needs.
To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar body or facial characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures. 
Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results will look like in the hands of each provider.
There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. 
Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body/face to use as reference when reviewing before and after pictures. 
The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery.
Best,
Mats Hagstrom, MD

40, do I need a breast lift or could I do fat transfer to build up the volume? (Photo)

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