The surgery you are referring to is an addition / subtraction, where an implant is added for upper breast fullness and tissue is removed from the lower breast to reduce drooping and heaviness. This an uncommon procedure that I usually reserve for patients who have loose, droopy skin, and not enough of their own breast tissue to achieve their desired result. Any woman that is large enough to need a breast reduction (especially if they are having neck, back or shoulder pain) should be wary about adding an implant as this will increase the breast weight and add other implant maintenance and complications that would otherwise be avoided. For patients of mine that need a breast reduction but want more upper breast fullness, I use fat grafting as my first line option. This technique allows me to borrow fat from areas where it is not needed and reinject it to selectively add fullness to the upper breast without adding much extra weight to the central and lower breast. Because this technique uses only the patient's own tissues, there is less maintenance over time. This technique is much more common for me to use in patients seeking a lift without a reduction, but could potentially be applied in your situation as well.
Breast reduction and implant
Breast reductions and breast lifts do not give the upper fullness to the breast that most patients are looking for. In order to achieve this look an implant is need to fill the upper pole of the breast, while the low, excessive breast tissues below the inframammary fold are removed. Attempts to push this low tissue into the upper breast and have it stay are not successful. If it fell once, it will fall again.While the concept is counter-intuitive, if you analyze it in the above stated fashion, it makes sense.Good luck!
Why would anybody do a breast reduction and then put an implant?
Yes, that is an available procedure but rarely used. It is performed for patients whose breasts are so heavy and long, with the greatest proportion of the breast falling below the fold, that the tissue cannot be well shaped and supported by the breast reduction/lift process.
Reduction and implant at the same time
Thanks for your question and I agree this is quite counter intuitive. Most people who fall into this very small category have very large pendulous breasts. Their elasticity of their very large skin envelope is typically poor. As a result they usually have more skin excess than gland excess. Reshaping these breasts is hard because the density of the gland is not very good. An implant can be used in some cases to try and provide a nicer shape and particularly some upper pole fullness. Best of Luck!
Implants and breast reduction
There are three basic components to a breast reduction.
- Re-position of the nipple to a higher location
- Removal of excess tissue
- Tightening of excess skin
Many patients seeking a breast reduction have lost most of the volume from the superior aspect of their chest - that is the breasts have emptied at the top. A breast reduction will not restore this fullness. So for some women who want to be smaller but also want the smaller breast to be fuller and not empty we may place an implant.