What type of procedure would improve my upper pole fullness and deflation? (Photo)

I think to truly answer your question would involve an in person consultation. While an implant will absolutely give you more upper pole fullness, it is my opinion that you would need a mastopexy procedure in addition to obtain the optimal result. This would involve resection of a small amount of skin but would help to redistribute the skin over top of Your breast and any implant that may be placed. There are also auto augmentation techniques which involves using your own excess breast tissue and redistributing it to improve projection without an implant. Again your candidacy for this procedure would involve a formal consultation to confirm that this would be best. We do the surgery very commonly in our practice. Please see the attached link for more information on the topic

The best way to increase the upper pole fullness is breast augmentation surgery. A breast lift would be performed at the same time if the breasts are deflated and sagging. That would require an assessment of the nipple position and skin quality. Based on your photographs, you need a breast lift with augmentation to get the best results.

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They then get to choose what looks right for them. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Your nipples are located below your breast fold, so a full breast lift would be recommended. Implants alone would not give you upper pole fullness since they would be centred behind your nipples, which are low on your chest.

A combined mastopexy augmentation will have the greatest effect on improving deflation, restoring upper pole fullness, reshaping the breast and optimizing nipple position. The higher the profile of the implant you choose, the more upper pole fullness you'll notice. Fat grafting is another tool that can be used to selectively customize cleavage lines where desired.

The technique I recommend is 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 or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

You need lift with implants, that’s the proper procedure to you, if you get just implants, it will look hanging and the upper pole empty, you need a lift

Dear Energetic878872,
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

You need a lift since your breast tissue is sagging, and implant can give volume. Some surgeons will use larger implants to try and avoid the lift. However, this will leave you will larger and still sagging breasts.

Implants are a great option to improve upper pole fullness. A lift may be recommended depending on the implant you select along with your surgical goals. The implants will give you volume but they will not raise the nipple position. If you are looking for a perkier look, then a lift would be recommended along with the implants. Also keep in mind that large implants are heavier so even if you elect for an augmentation alone now, you may need a lift in the future.