Suggestions for a procedure of lift & mild augmentation for a natural look & improved shape?

Question

Hi! I am thinking since quite a bit to have a breast lift/ augmentation to improve the shape of my breast for a congenital condition and breastfeeding changed. I don’t want to be much bigger just a bit plump and soft in the shape. Overall I am looking for a natural look. Or would a breast lift with fat transfer would do better than an augmentation?

Ram Kalus, MD, FACS · Answer

Thank you for your question and photos. An examination in person is required to properly evaluate you and determine how to best help you achieve your goals. That said, a “natural” appearance can best be achieved with implants in a more predictable way than fat transfer. Based on your photos, a mastopexy is definitely indicated to reposition your nipple/areolae, reduce their diameter, and reshape the breast. The implant would increase overall volume and enhance upper pole fullness.

Please consult with an experienced board certified plastic surgeon whose aesthetics seem to align with women based on his or her Before and After gallery. Best of luck to you.

Please consult with an experienced board certified plastic surgeon whose aesthetics seem to align with women based on his or her Before and After gallery. Best of luck to you.

Jed H. Horowitz, MD, FACS · Answer

Mild forms of TBD can be undiagnosed often leading to incorrect or incomplete surgery. The surgery must address all of the anatomical problems including: breast fold malposition, constricted or narrow breast base. Surgical procedures may include the following:

Implant aloneType and shape of implantOne or more stagesThe use of tissue expansion and implantsPocket placementPlacement of incisionsBreast lift and typeCorrection of the breast base and breast fold,Correction of the areola.The use of fat grafting or natural breast enhancement to help shape the breast with or without implantsChoosing Your Breast Surgeon

Jonathan Heistein, MD · Answer

Hi.  I think you could have a very nice result with a breast lift and implant.  You can choose a very small implant so that you won't look much larger, but having the implant will help fill some of the deflated area at the top of your breasts.  Alternatively, breast lift and fat grafting is possible, but may not provide as good of shape especially at the top.  Talk to a surgeon with lots of experience with cosmetic breast surgery so you can get a better idea of what to expect with the different options.  Best of luck!

Gary M. Horndeski, MD · Answer

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 can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Gregory Sexton, MD · Answer

I am not a big fan of fat transfers to the breast. I believe you would be very happy with a small implant and the standard mastopexy . I’m not certain a fat transfer would make you as happy, nor do I think a breast implant alone will make you as perky as you want to be.
 Good luck, 
Greg Sexton, MD

Columbia South Carolina

Suggestions for a procedure of lift & mild augmentation for a natural look & improved shape?

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