Do I need a breast lift or can I just get a fat transfer? (Photo)

Question

I never had large breasts and they've always been asymmetrical, but when I lost 100 lbs, they completely deflated . Do I need a breast lift or can I just fill them back up with fat ? I do not want implants . Sorry for the wonky picture, the app is not letting me upload a full photo.

Kristopher Day, MD, FACS · Answer

First off, congrats on your weight loss. I tell my patients it's nature's cruel consolation prize that for your good efforts and weight loss success you receive breast deflation in many cases. But to answer your question, you need a breast lift. This may not be what you were hoping to hear, but it is based on what is called the Regnault classification of breast ptosis, or sag. The classification system essentially says that if the nipples are almost at the level of the under-breast fold, or inframammary fold, then you may achieve an aesthetically favorable result with augmentation alone, but if they are below being just under this fold then a lift of some sort is usually required. The third stage is when the nipple-areola complex is at the lowest point on the breast mound, and this virtually always requires a lift for optimal breast rejuvenation. Also, an additional element that may not excite you...if you receive a lift procedure that creates tissue flaps, then fat grafting at the same time is not advised, because it can cause trauma to those flaps and impair healing. So some things to think about and talk with your surgeon about before surgery, which should always be designed tailored to you and your goals. Good luck on your continued journey.

Hampton A. Howell, MD · Answer

Hi.  I would recommend a breast lift and fat transfer if that is your preference for adding volume.  You might not have a lot of fat to work with, depending on your anatomy.  I would expect that you would need more than one session of fat transfers to get you a reasonable amount of additional fullness.  I would recommend consulting with a board certified plastic surgeon with good experience with breast enhancement to help you through the process.
Good luck and take care,
Dr. Howell

Leila Kasrai, MD, FRCSC · Answer

Your nipples appear to be located below your breast fold, therefore a lift would be recommended. Fat transfer would most likely be insufficient. The lift can also improve asymmetry.

Alan Gonzalez, MD, FACS · Answer

Hello @msableski thank you for your question and showing your picture. You can consider the two options, and it depends really on your breast volume. It is possible to have a breast lift and improve the shape with minimal scarring. With the weight loss, if your breast volume decreased too much, you may want to consider both procedures with a prudent time interval of three months between them. Is not convenient to do the fat transfer to breasts in the same procedure to avoid the fat to die or risk of infection. Best wishes! Alan Gonzalez MD, FACS.

Gary M. Horndeski, MD · Answer

You definitely need a breast lift and 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 if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear msableski,
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

Hilton Becker, MD · Answer

Fat grafting will improve the volume and shape of your breasts provided that you have sufficient fat to graft .In your case a mini mastopexy may be necessary.

Connie Hiers, MD, FACS · Answer

You need a lift and that should be done first. Later, you can try fat transfer or even implants, depending upon the size you wish to be.

Douglas Taranow, DO, FACOS · Answer

You would be best served with a breast lift. Please keep in mind that fat transfer to the breasts enlarge them 1/2 of a size (in the perfect setting, a full size -rare). 
Your breasts are too low and asymmetric to just add fat. 
Best wishes 
Dr. T

Darryl J. Blinski, MD · Answer

You would need a few rounds of fat transfer to refill your deflated weight loss breasts. After the 2 rounds of fat transfer then decide if you need a lifting operation.

Do I need a breast lift or can I just get a fat transfer? (Photo)

Answers (11)

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