Anchor lift with auto augmentation? (Photo)

I always endeavor to use the smallest scar pattern possible, which would be a vertical.Kenneth Hughes, MDLos Angeles, CA

A breast lift if no tissue is removed from the breast is an autoaugmentation. Mastopexy techniques can not maintain upper pole fullness and that is why surgeons use small implants to enhance breast shape.You have great volume and will have a very nice result. Fat grafting to the upper pole of the breast at the time of the lift is another way to achieve upper pole fullness with out having to use an implant. The degree of upper pole fullness you desire will need to be described to your surgeon to give you the proper guidance.Seek out a board certified plastic surgeon with experience in fat grafting.Good luck and I hope this was helpful.

Thanks for your pic. While the use of an implant would provide the best upper pole fullness, it certainly is possible to reposition some of the breast tissue that would normally be removed in an effort to add fullness. Definitely worth a discussion with your board-certified plastic surgeon

I agree you need a full anchor lift, but think you may have enough breast tissue to avoid adding an implant.  The so called auto augmentation with fat adds very little volume and you can expect to pay a lot for very little benefit.  Get the lift first and see where you are after that.  Good luck!

Hello,Using your own breast tissue for upper pole fulness would be ideal, and many a surgeon has tried to create a mastopexy (breast lift) that would accomplish this.  Unfortunately, variations on incisions, various tissue 'pedicles', and the use of internal sutures has not really changed the inevitable: a mastopexy is a skin bra, and the internal breast tissue has no supporting system. The bigger the breast, the greater the skin stretch after surgery, with the subsequent loss of upper pole fulness. Your breasts appear large, and without adequate reduction, you'll be looking at a persistently hanging breast in a short period of time if you opt for a skin only mastopexy. Best of luck!

The upper pole fullness you desire will not be long lasting without a small implant placed at the same time.

Thanks for your question.  You will always need a full consultation, but I believe any breast lift should be able to include an auto-augmentation flap to help with upper pole fullness.  This is a great option for women who have enough breast tissue already, or who do not want a breast implant.  Although I agree you may need to have incisions that include the anchor pattern, many surgeons don't know how to combine this with re-arranging the tissue.  Modern breast surgery techniques allow the breast tissue that is heavy in the lower part of the breast (think of a pie wedge below the nipple) to either be removed or replaced to help reshape the breast.  The breast tissue, and the skin are treated completely separately.  I believe this not only gives a more attractive result, but also lasts longer with shorter incisions.  Even if you need the scar below, it should be shorter so it doesn't come into your cleavage, or show in a bikini on the side.  Seek some additional Board Certified opinions.  Homework pays off.  Good luck.Dr. Schwartz

Although obtaining upper pole fullness is more predictable with breast implants it is possible to perform a breast lift and rearrange the breast tissues to increase upper breast fullness. The photos show you already have fairly large breasts so I can see why you might want to avoid implants. It also appears that the amount of ptosis will require a fair amount of skin removal so an anchor pattern scar seems likely. A thorough exam is necessary to come up with the right surgical plan for you. Get a second opinion from an experienced plastic surgeon who is certified by The American Board of Plastic Surgery and good luck!

Hi and thanks for your question.  You have a lot of breast tissue to work with, and a lift will definitely shift breast tissue towards the upper pole of the breast. I would differentiate that from auto augmentation in which we take tissue from somewhere else on your body and shift it into the breasts to add volume. This is something typically done for massive weight loss patients where there is considerable extra tissue in the axilla (area under the arm).See some more board certified plastic surgeons. During a consult we can give you an idea of how much a lift will shift your breast tissue into the upper pole. If you like what you see then a lift may be sufficient. That being said, if your are really focused on great upper pole fullness then I would suggest looking into an augmentation mastopexy. This will be a more dramatic change and is much more predictable in terms of delivering that kind of result. In patients like you who already have a considerable breast volume one option is to actually remove some breast tissue as part of the lift. If you feel strongly against implants then another option is to start with the lift. If you get the result you want then you're set. If not, you can always add implants in a second procedure. It means having two surgeries but sometimes the results are more predictable when staged like this. Hope this helps. Good luck to you.Dr J

Thank you for your question and photos and I would go on more consults with experts in your area as from the photos you should get an excellent result with a vertical lift or at most a small TDr Corbin