What do perky C cups really look like? (photo)

A vertical breast lift or reduction would be a reasonable option
just based upon your photos. Find an expert in breast surgery who has
great reviews and great before and after photos.Kenneth Hughes, MDLos Angeles, CA

Thank you for your question and photo.Allow me to give you my opinion on what a perky breast should look like...A youthful breast is not about size. What makes a female breast beautiful is a high position on the chest, skin tightness, symmetry, round shape, firmness, areolas that are proportionate to the size of the breast and the least amount of scars possible.In your case, I would not give you a highly visible vertical scar, nor would I reduce the size of your breasts. Your breasts are causing back and neck pain because the weight of the breast is on your skin envelope pulling and aggravating your sensory nerves. There is a new technique called the Ultimate Breast Lift that does not require a vertical scar and that anchors your breast on to your chest muscle to provide long term results and relieve back/neck pain. So, you see a reduction is not necessary to alleviate the pain. Your chest muscles will carry the weight for you. Your areolas will be reduced and your breasts will be reshaped and repositioned higher on the chest wall. Should you insist on a reduction, it can be achieved with the same technique.Best wishes,Gary Horndeski M.D.

Hello,If you want your breasts smaller, you could have them reduced safely. Given the degree of sag, your areolar width, and your desire for being small (and I assume tight), a formal type of anchor incision breast reduction would give you the best result. Any answers you get from this website does not replace an in-person consultation with a plastic surgeon who is expert in all forms of cosmetic breast surgery. Risks, benefits, and alternatives will be discussed with you so that you can make the most informed decision possible. Best of luck!

A breast lift would address your concerns in regard the shape, position and areola size. A breast reduction could do all this also, but would also make your breasts smaller. The question is, do you feel your breast are too big or just too low and saggy. I usually ask my patients how do they feel about their breast size when they are up in a good supportive bra. If you feel they are about right size then, maybe only a lift. If you feel your breast are way too big up in the bra then you probably need a true reduction. Most of the patients I have had with your appearance have picked in between with a lift with small reduction.  That way I try to get exactly what they want. Discuss all this with your plastic surgeon.

If you want a volume reduction, then get a reduction.A lift will not relieve the symptoms you describe. In looking at your photo it certainly would be reasonable to have only a lift, but the surgery is about making you happy.As for the technique, a lollipop incision only describes the incision - not the technique. I prefer the Lejour technique to the Hall-findlay technique because of durability, shape and ease of scar healing.All lift and reduction techniques will make the nipple areolar complex smaller. I give my patients three choices for areolar diameter - 38mm, 42mm and 45mm. A simple rule of thumb is that larger nipples and breast volumes get larger areolar diameters.If you would like more information on breast lifts, please read my book " Cosmetic Breast Surgery - a complete guide from A to double D".

Thanks for your question. The difference between a breast lift with a circumvertical approach vs a reduction only includes the removal of breast tissue mostly from the lateral and inferior breast, and both would have the same incisions and skin removal from your breast and could incorporate reduction of your areola. You would really just need to decide if your current breast size in a good support bra is something you are happy with vs too big. You could have a nice perky result either way. You would have better skin excision with a final anchor pattern scar, but a perkier look with the vertical approach and either lift or reduction. if your surgeon has extensive experience with vertical lift/reduction procedures, she can achieve great results and a perky breast with small areolas. The inferior pedicle breast reduction is very reliable, but often produces a flatter breast shape with limited projection. You should seek opinions from other board certified plastic surgeons before deciding.

as your planned lift is not, you are in the driver's seat and should be able to dictate to your surgeon what you want done with your surgeon either agreeing to this or refusing to do what you want.  There is nothing unreasonable about having a limited reduction along with your lift determined by how much tissue you want removed with your procedures.  And make sure you are not billed for both procedures.  Perky can be  helped with the auto-augmentation technique where tissue from the lower pole is skinned and then elevated and secured under the upper pole.  Anyway, if your surgeon isn't listening to you (and some don't) find another surgeon who can better appreciate your goals and desires.  Make sure some of your tissue is elevated to fill out the upper poles as a reduction alone does not do that.

It has been my experience, that although only skin and minimal to no breast tissue is removed with a breast lift, patients tend to think their breasts look a little bit smaller post-op once all of the swelling has subsided. With the breast lift, the breast tissue is reshaped to be more perky and youthful and the areola reduced in size. If you want your breasts to be significantly smaller, the breast lift alone without a reduction would not achieve that goal. From your photos it looks as though you will have a beautiful result with a breast lift alone, but if you are certain you want very small breasts, you should talk with your plastic surgeon again about a reduction/lift. Ultimately, this is a decision that you and your surgeon will have to make together.

Generally speaking, any time you have a lift, you lose a cup size. Breasts sag due to discrepancy between the skin envelope and the breast core. From the posted pictures, with a lift only, you will most likely end up with an average "C" cup or smaller. Lift will also address the size of your areolas. Best to have a consultation in person for proper evaluation and advice. 

I think you would be wise to get another 1 or 2 consultations. It doesn't sound like the last doctor listened to you. Also, you have a lot of skin to get rid of to get a significant lift, let alone reduction, and the anchor scar is much better at getting off all the excess skin. In any case an areola reductin can be done at the same time.