5’7, 167lbs, 500-550cc, can I get a BA and BL in one procedure? (Photos)

Question

I desire BL and BA(500cc- 550cc) in 1 which should get me to a D/DD. I am a current 36/38 flat D and fullness at the top get a natural look. I consulted a physician who stated I would require BL first due to nipple positioning then BA but would see my in person for that final decision. 5’7 167 LBS Prior surgery : Gastric sleeve 2015 (lost 85lbs) and left fibercystic lump removal 2005. I’ve been told during breast bisopy that my tissue is dense. What would you recommend?

Vasileios Vasilakis, MD, FACS · Answer

Thank you for the question. BL and BA can be safely performed at the same time. I wish you the best of luck. Vasileios Vasilakis, MD. Double board-certified, fellowship-trained plastic surgeon, Houston. TX.

Michele A. Shermak, MD · Answer

Hello!
There are definitely surgeons who prefer to break this combination out into 2 procedures which is believed to optimize healing and predictability of the outcome, particularly if one starts with the breastlift and then augments. Having said that, the reality is most plastic surgeons do this combination at one time because generally the results are great and the convenience of one surgery over 2 is so much more optimal. 
The implant will add the upper cleavage and the lift will better position the breasts and reduce and freshen the nipple areolar complex. You have a great plan.
Be sure to see a board certified plastic surgeon! Best of luck to you!

Zoran Potparic, MD · Answer

You seem to be good candidate for breast lift and implant augmentation. Extensive lift, as yours, will make you to loose about 1/2 to 1 full cup size; addition of 500 ml implant will provide 2-2,5 cup sizes up. Hope it helps. Good luck.

Gary M. Horndeski, MD · Answer

At size 36/38, each 200 cc of implant corresponds to 1 cup size change. Since you are wanting to go up cup size I do not recommend implants. I recommend a lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Gerald Minniti, MD, FACS · Answer

Let go of bra cup sizes. What you really want is an  appearance in the mirror when you see yourself. This is why pre-surgical sizers work so well. To get the best result though, you’ll need some of your own breast tissue reduced, and that estimated amount should be added to whatever size sizer is chosen to get the final implant volume.

Ronald J. Edelson, MD · Answer

I also would do this in two stages. If you try in one stage you won't  get a good result and the risks are greater.  Then you will end up needing a second operation anyway. Two stage is best way in your case because the nipples need to be moved really far. Tough to do when using even a small implant

Scott W. Vann, MD, FACS · Answer

I do almost all my breast lift/augmentations as a single procedure. The ones that I do in two procedures are the severe ptosis patients like you that require a massive amount of skin removed to do the lift. Especially true in massive weight loss patients. There are just too many "moving parts" to have good success with one procedure. After your lift is healed it will also be much easier for you to try on implant sizers to help pick your perfect implants.  I think your surgeon is giving you good advise. Good luck.

Finny George, MD · Answer

Hi, thank you for sharing your question. While doing both of these procedures in one is possible, given the distance of nipple repositioning required, a two-stage procedure is safest. This is to avoid loss of the nipple. Once your discuss the safety profile of each option with your surgeon, he/she will guide you to your best choice. I hope this helps.

Daniel Barrett, MD · Answer

Dear barbie00001,
generally speaking, it is possible to combine breast lift and implants. My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. 
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

You would do well with a breast lift, but 500-550 cc implants will be too large and heavy and you may resag.  An examination is needed to see if the augmentation could be done at the same time as the lift.