Can I get super perky breasts with a breast lift without implants? (Photo)

Question

Hello, I'm a 21 year old female and I've always had saggy boobs shortly after I started growing them. I'm currently a size 36DD. I plan on getting a mastopexy but the problem is I want very firm and perky boobs but I don't want implants but from what I've read and seen, a breast lift only basically gives the breasts a better shape. But I want more than that. I really do not want implants and I was wondering if getting a fat transfer would achieve similar results to implants? Or is there any other way?

Gary M. Horndeski, MD · Answer

Thank you for your question and photo, The Bellesoma Method is a current technique to lift and/or reduce breasts without using implants or the ugly vertical scars.  The incisions are hidden around the areola and in the inframammary crease. The vertical incision has been completely eliminated. The areola incision heals almost invisibly due to the fact that there is hardly any tension on the closure. With this particular technique, ducts are preserved along with nerve supply maintaining nipple sensation and the ability to breast feed. Because the breast is reshaped internally and is secured to your chest muscles, upper pole fullness is possible without an implant. Usually patients do not go down in size very much with this technique.  Attached is a patient who underwent The Bellesoma Method. Please note that her tissue was used to create upper pole fullness and cleavage without any foreign materials (mesh, implants, etc).  It is a proprietary technique that only surgeons that have been trained by me can perform. I hope this helps. Best wishes and kind regards, Dr. Gary Horndeski

Jeffrey LaGrasso, MD · Answer

The most important thing is finding the right doctor, having a physical exam with the doctor is a great way of having an idea of how a plastic surgeon can help you achieve what you want. A breast lift with no implant is possible. Find a doctor and get a consult!!

Ellen A. Mahony, MD · Answer

You'll get a great result with a breast lift alone because you have substantial breast tissue, you're young and have great quality skin!  They will sit higher, your areola can be reduced in size and will also be positioned higher.A breast implant won't add to the great result you'll get without them!In good health,Ellen Mahony, MD

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you are a
great candidate for a breast lift.  This can be designed to result in an
improved shape and contour of your breasts while minimizing scar
appearance.  I do not think an implant or fat grafting will be needed to achieve your goals.  Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and evaluate their results.  The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Daniel Barrett, MD · Answer

Hi hopeful95,
Determining whether you need simply a breast implant versus a breast lift or both 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 breast augmentation depending on the size of the implant the patient wants. I often use an implant when I perform a breast lift because it provides more upper breast fullness after the lift. Also, breast implant selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals. 
Daniel Barrett, MD, MHA, MSCertified, American Board of Plastic Surgery Member, Am. Society of Plastic Surgery

Daniel Brown, MD, FACS · Answer

Hello Hopeful95,
Thanks for your questions and photos. After reviewing your photos, I don't think that you need any implants at all to achieve a fantastic result with just a lift.  You do seem to have a moderate amount of ptosis or sag in both breasts - your nipples appear to be sitting below the fold under your breast. There is a new breast lift technique called Bellesoma that seems like it should be a great fit for you. The Bellesoma procedure lifts your breast, preserves the nipple sensation, and looks as full and perky as if an implant had been placed without using any implant, so no need to compromise.  One of the huge positives of this technique is that there is no vertical incision traveling down the front of your breasts. 
Some of the differences between Bellesoma and the traditional breast lift techniques:
-Bellesoma creates upper pole fullness that traditionally needed an implant to achieve.
-There is NO vertical scar, only well-hidden scars in the fold under the breast, and around the areola.
-The breast is dynamically supported by attaching it to the muscle, so there is no recurrence of sagging which are expected with traditional lifts or reductions.
-The entire central portion of the breast is undisturbed, so nipple sensation remains intact and is very unlikely to be compromised.
The procedure is accomplished by using the skin of the lower pole of the breast (the part below the nipple that sits in the bra cup) to shape the whole breast into a perky dome, then straps are made of the extra skin, anchoring it to the underlying chest muscle so that there is virtually no chance of repeat sagging.  The skin that above your nipple and below your collar bone is utilized to cover the perky, lifted dome that has been created and then a new (usually smaller) circular opening for the areola is placed at the high point of the cone, creating your new lifted, full and shapely breast.
From your photos, you appear to be a very good candidate for this new technique and should really get the look that you are desiring without implants or unnecessary visible scars. I would recommend that you search for an ABPS board certified plastic surgeon who is also a member of the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons in your area or an area that you would like to travel to on holiday who offers the Bellesoma technique to discuss your breast lift options and possible results.
Best wishes!
Dr. Brown

Jean Paul Giudicelli Saba, MD · Answer

Hi, thanks for sharing your concern and photos with us!
  
First I want to congratulate you for making this important decision. Deciding to get an aesthetic procedure to change your body and get a new life style is a big step!
  
Looking at your photos I might say that you´ll be a great candidate to get a breast lift with implants, this is because your chest looks a bit saggy and the implants will definitely help you fill the superior pole of your breast giving you an excellent and beautiful shape.
  
Before all this, of course, you need to get to a complete medical evaluation and laboratory exams to check everything is fine. For us your safety, always, is going to be first.
  
Have a great day! 
  
Dr. JPG

Robert T. Buchanan, MD (retired) · Answer

With breasts already a DD size, there is absolely no reason for you to have either implants or fat grafting in addition to a lift. You get firmer breasts with implants only when you have problems with them and you get a capsular contracture around them that makes them feel firmer or hard. Basically what implants or fat transfer does is simply make the breasts larger. Your present problem is that you have too much skin for the amount of breast tissue you have. A breast lift or mastopexy removes the excess skin, and moves the breast tissue and nipple/areola to a better shape and position. By removing the excess skin, the underlying breast tissue feels firmer though it really isn't.

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