Which procedure will help me obtain a natural look I can be confident about? (Photo)

I am 19 years old and have had a baby / breast fed . I need to make my areoles smaller and I feel like a lift without implants would benefit me but I am very open to suggestions of whatever would help my look to improve

Doctor Answers 11

Natural and confident

Ideally your breast aesthetics could be quite improved with a lollipop lift plus implants to fill out the upper portion of your breasts. 


I would recommend a Wise pattern mastopexy.  This will allow you to reduce your areolas and lift your nipples with the best breast shape.  You could do an implant as well but you have sufficient breast tissue for a nice result without implants. 

Breast Lift +/- Implants

From your pictures, it appears you would be a great candidate for a breast lift.  This would reshape your breasts and nipple size.  This will make your breasts smaller though.  A lift always dies.  If you are ok with that, then that is the direction to go.  If you want some improved shape and fullness, then an implant may be needed at some point.  I hope this helps.

Which procedure will help me obtain a natural look I can be confident about?

Thank you for the question and picture.
Based on your photograph, it is most likely that you will benefit from breast lifting plus/minus breast augmentation surgery.  
You will do best by seeking consultation with well experienced board certified plastic surgeons. Ask to see lots of examples of their work and communicate your goals clearly.
Generally speaking, patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. In other words, the combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately.
Furthermore, the potential need for revisionary surgery is increased with breast augmentation / mastopexy surgery done at the same time. This revisionary rate may be as high (or higher) than 20%.
Personally, I find that the breast augmentation/lifting procedure to be one of the most challenging of the breast operations I perform, even compared to somewhat complex revisionary breast surgery. On the one hand, when performing breast augmentation/lifting surgery we are increasing the breast size with breast implants; on the other hand, we are reducing the breast “envelope” in order to achieve the breast lift. These two “forces” must be balanced as perfectly as possible in order to achieve the desired results. Removing too much skin/ breast tissue is problematic; removing too little breast skin/tissue can also be problematic. Remember also that patients presenting for breast lifting surgery and general have lost some skin elasticity/thickness making potential incision line healing problems and/or recurrent drooping/sagging important concerns to communicate.
To achieve a surgical result where the breast implant and breast tissue “come together” and behave like a single breast is one of my goals but can be difficult to achieve. Essentially, we are trying to create a breast implant/breast tissue interface that feels and behaves as naturally ( as a single unit) as possible. Generally speaking, making sure that the breast implant has some sub muscular and some sub glandular component ( dual plane) and tailoring the overlying skin/subcutaneous tissue/breast tissue as precisely as possible over the underlying breast implant is key.
Despite these efforts, breast implants are after all a foreign body that don't necessarily stay where we wish they would; therefore, breast implant related problems such as positioning ( too high, too low, lateral displacement etc.) can occur and may be a reason for returning to the operating room for revisionary breast surgery. I use a “tailor tacking” technique that allows a determination of what breast implant should be used to SAFELY produce the results the patient is looking for. This technique involves use of a temporary sizer and temporary “closure” of the overlying breast skin over the sizer. The use of the tailor tacking technique is very helpful. Breast lifting involves removal of skin ( and tightening of the breast skin envelope) while breast augmentation involves expansion of the breast skin envelope. These 2 forces are counteracting each other. Again, despite these efforts, breast implant and/or tissue/skin complications may arise causing minor or significant complications.
Generally speaking, it is difficult to achieve the “perfect” result with breast augmentation/lifting surgery, despite best efforts. Patients should be aware of the complexity of this combination procedure, achieve REALISTIC EXPECTATIONS prior to proceeding, and understand that additional surgery ( along with the additional recovery time, stress, expenses etc) may be necessary in the short or long-term. Patients should understand that the results of the procedure will not necessarily match aesthetically the results of patients who have undergone breast augmentation surgery only.
For example, some patients who wish to maintain long-term superior pole volume/"roundness" or "implanted look" may find that this result is not achieved after the initial breast augmentation/lifting operation.
An additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness). It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation. The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery, Including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia, lateral displacement etc).
Potential risks associated with breast augmentation/lifting surgery include infection, bleeding, incision line healing problems, loss/change of nipple/areola complex sensation, and blood flow related issues to causing skin or tissue necrosis. Poor scarring, pigment changes, areola/nipple asymmetry etc. are also potential problems. Again, patients may experience implant related problems such as encapsulation, leakage, displacement problems ( too high, bottoming out, lateral displacement, asymmetric positioning etc.), rippling/palpability of breast implants etc. Patients may also be dissatisfied with breast size, shape, and/or how the breast implants and overlying breast tissues “interface” with one another. Occasionally, a breast implant may even have to be removed and the patient will generally be “implant free” for several months at least. Obviously, this situation can be quite physically, emotionally, and psychosocially stressful to the patient involved.
Given the complexity of the combination breast augmentation/lifting operation and the greater risk of revisionary breast surgery needed, there are good plastic surgeons who will insist on doing the procedures separately. For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure in one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).
Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks are greater with a 1 stage procedure and the patient does have a higher likelihood of needing revisionary surgery.
Having discussed some of the downsides and potential risks/complications associated with breast augmentation/lifting surgery, most patients (If properly selected and who are doing the operations at the right time of their lives psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry.
I hope that this summary of SOME of the issues surrounding breast augmentation/lifting surgery is helpful to you and other women considering this procedure in the future.
The attached link may also be helpful. Best wishes.

Breast Lift Options

A mastopexy or breast lift operation is designed to improve the shape and position of the breast without reducing their size. It is used for breasts which sag or droop (ptosis). Sagging of the breasts may occur with normal development for some women, or as part of the aging process. Pregnancy, breast-feeding and weight loss are other conditions which increase breast ptosis. Some patients will have a better shape to their breast such as increased superior fullness if an implant is used at the time of mastopexy. The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height.

I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring. Now you just need to search out local surgeons and schedule consultations to find their surgical options in helping your achieve your desired results. Good luck!

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Which procedure will help me obtain a natural look I can be confident about?

Areola reduction breast liuft and submuscular breast implants may be your best option. The breast gland atrophies after having children. A lift alone will improve shape but the breast tissue remains soft and "jiggly" after lift alone. Please read below:

Breast lift after pregnancy

Thank you for your question and photos. Based upon the photography and your comments a breast lift using the standard anchor type mastopexy would benefit you the most. This procedure will lift your breasts give you better symmetry and reduce your areola size.  it's important to have several board-certified plastic surgery consultations before you make a final decision. You can add implants to the procedure if you are desiring a larger and fuller cup size.As always it is best to be healthy before hand.  No smoking, eat healthy,  and to make sure all of your medical conditions if any,  are currently under control. The only bit of warning I would add is that you are only 19 years old and it is quite possible that you might have additional children in the future. If so that too will cause more sagging and stretching of your breast tissue. This might require a secondary revision or corrective type procedure down the road. Implants do last a long time but they are not forever. Again given your age sometime down the road it could be several decades from now you might need to have the implants replaced.Best to you

Bennett Yang, MD
Rockville Plastic Surgeon
4.9 out of 5 stars 10 reviews

Which procedure will help me obtain a natural look I can be confident about?

Hello dear, thanks for your question and provided information as well..
The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but  also help bras and swimsuits fit more comfortably and attractively. By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast, Actually the perkiness on a person or another, depends on patients skin and breast tissue, hugs!

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 333 reviews

Which procedure will help me obtain a natural look I can be confident about?

Thank you for your question.  Based on your photo which shows breast ptosis (sagging), you would benefit from a breast lift (mastopexy) which would lift your breasts, make them perkier and tighter, reduce the areola size and improve symmetry.  If you're happy with your current volume, you can stop there.  If you want more volume, especially for upper pole fullness, you may add implants.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck!

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 14 reviews

Full breast lift with implants

Thank you for your question and photo.  It appears that you would benefit most from a full breast lift with implants.  This will lift your breasts as well as give them an improved shape and volume.

All the best,

Dr. Results
Miami, FL

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