Will I have enough breast tissue for my lift without adding augmentation, currently a very deflated 32G? (photos)

After having 4 children and gastric sleeve I am at a great weight. I was a 34 HH, now a 32 G. The doctor and all others in the office feel I don't have enough breast tissue to have lift I will be happy with. It all skin and when it is removed there will not be enough to have full breasts. I am not looking to be a DD or bigger, I want to be natural and comfortable. I do not like the rounded upper pole look and feel it looks fake. Am I making the right decision or will I end up flat chested?

Doctor Answers 11

A breast implant is probably not necessary for a C cup in this case.

It looks as though there is plenty of soft tissue to deliver a C cup with a mastopexy only. I don't think you'll need a breast implant.

Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Breast Lift

Congratulations on your weightloss! To perk up a drooping breast, your surgeon will remove excess skin, reposition the nipple, and redrape and tighten the remaining skin to support the breast. The areola may also be reduced in size. A mastopexy (breast lift) raises droopy breasts from one to several inches and excess skin is removed. If you're sagging or asymmetrical, and are looking for perkiness, you'll need a lift--or, if you also want more volume, a lift and implants.

It is now possible with the newest technique for you to enlarge your breasts without resorting to implants! Specially prepared fat taken from another part of the body, such as the stomach or hips, is placed under the breast tissue to provide increased breast size without the need for artificial implants. The technique is called autologous fat transfers and autologous simply means "your own." And who doesn't have a little fat to spare?

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.6 out of 5 stars 10 reviews

Breast lift

I would perform a lift first and see if you are happy with the size. Implants can always be added at a second stage. Because shout beasts need to be lifted so far, I would prefer to do your procedure in two stages rather than a lift and implants at the same time.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Will I have enough breast tissue for my lift without adding augmentation

Based on your photos it appears you have enough natural breast tissue to have a very full B or a small C cup without implants. Just get the lift for now. You can always do implants later, but I bet you won't want them.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Get the breast lift, you don't need implants

Your skin elasticity is very poor from the weight gain and loss. But you look to have enough volume to get a nice improvement from a breast lift alone. Implants add most of the complications and are only needed to make you bigger and fuller or faker. They can always be done 4-6 months after the lift if you then decide you need more volume. I doubt you'll need or want them.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

You can't teach water to run uphill

In my 30+ years of experience I have used many techniques to lift the breast tissue onto the chest and try to make it stay. What I have learned is that gravity always wins. In my practice, someone with your type of breasts and weight loss would ultimately have the best result if all the tissue hanging below your breast crease is removed. I reposition the nipple and bring the remaining tissue together to form a shapely natural cone. I use a special dissolvable mesh called GalaFlex to provide an "internal bra" that will turn into your own tissue and give added strength to the breast lift. My patients have been very satisfied with their results. Please feel free to contact my office if you have any questions, I would love to see you in consultation and tell you more. And congratulations on achieving your weight loss goal! - Dr. Mills

Dan Mills, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 33 reviews

Breast volume or size after a lift without implants

I would agree with Dr. Rand's response. Neither lifts nor implants actually do anything for skin and tissue tone. Your apparent size in a lift-and-contain bra shows you about what size you would look like after a lift but without the bra. There is very little volume removed with a lift (mastopexy). It basically raises your nipple-areola and breast gland up to the proper level but doesn't give you forward projection or fill in the upper pole (although the length of the upper pole is reduced). You would look bigger because your breast is up higher even though the volume is not increased. This is similar to the effect of a bra. 
I would also agree with the responses that a lift alone is the proper procedure that I would offer and the benefits of an implant could be assessed later. 

Scott L. Replogle, MD
Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

Will I have enough breast tissue for my lift without adding augmentation, currently a very deflated 32G?

  I think that you have enough mass present so that when the skin envelope is tightened with the lift that you will have a very good result.   Find an expert with good reviews and before and after pictures.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews


Thank you for the photos.  You can always do the lift and add an implant later if you feel you do not have enough volume after the lift. Many specialists might recommend separating the procedures anyway to obtain a better result.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 61 reviews

Will I have enough breast tissue for my lift without adding augmentation, currently a very deflated 32G?

Congratulations on your weight loss.  A breast reduction / lift would likely produce a C cup or greater.  With time, the breast tissue will concentrate in the lower pole and may give an undesirable shape due to the lost elasticity of the skin.  You may want to get a touch-up mastopexy and breast augmentation at that time.  With a two stage approach, no surgical option is lost.  If you are very happy after the first lift /reduction then you are done.  If you would like an augmentation / touch-up then you can have that option in your back pocket if you need it.  

Jason Mussman, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 3 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.