Lift/implants after reduction with no med records. Any suggestions? (photos)

I'm scheduled for TT & lift in 2 months. I love my surgeon but need help fine-tuning my decision. Lift records from 17 years ago are gone and I'm worried about my nipples. I'd prefer to stay a DD, am 175lbs, lost 50lbs, have 20lbs to lose before surgery. I'd like full/perkiness and going for a natural look like the last pic. Questions: -Should I just do implants because of the record issue and deal with a larger size? -If I do a lift/implant: lolli or anchor? I'd like less cutting. Thank you!

Doctor Answers 6

Lift or just implants after previous reduction

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Thank you for asking about your breast lift and/or implants.

  • I believe you will need a lift, at least, especially if you lose twenty more pounds.
  • If you want to stay a DD, you may need a small implant as well.
  • Let your surgeon decide on the technique that will give you the best and safest result -
  • From the photo a vertical pedicle lift should be safe for your nipples and should avoid an anchor incision.

Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Breast Lift Technique 17 Years Ago Irrelevant Today

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There is good literature that says it doesn't really matter how they did this operation 17 years ago.  That said, I understand why your surgeon wants to see the record if it were possible.  Frankly, at this point you can probably completely ignore the old scars and go right ahead with whatever operation you like.

I would use a modest sized implant and a Lollipop scar to create more fullness above the level of the nipple (like your example) and minimize scarring.  When sizing, consider the fact that you will want to remove a bit of the lower pole breast tissue to prevent a "double bubble" phenomenon.

Good Luck!

Thomas P. Sterry, MD
New York Plastic Surgeon
4.8 out of 5 stars 23 reviews

Breast Lift and Implants with Mommy Makeover

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It is certainly possible to incorporate a breast lift with implants in addition to your Mommy Makeover. However, you will learn more about your individualized options during a one-on-one in-person consultation. The intentional result of a Breast Lift (#Mastopexy) is to improve the shape and position of the breast without reducing their size. It is used especially for breasts which sag or droop (#ptosis). However, many women report more satisfaction if an implant is used at the time of #mastopexy. The implants further shape their breasts, restoring superior fullness or volume which may be decreased over time.

In regards to implants alone, this is usually said to be mistake by patients reflecting back at the decision. Most breasts will look larger and more droopy with solely implants. They will sag more and sooner, due to the sudden and excess weight. At times it's possible for a “Snoopy” breast or double bubble to develop as a result.
Additionally, an implant with lift may be useful to re-position the nipples which may have been affected by ptosis or drooping. 
Your Plastic Surgeon will measure you to determine the best shape and size of the implants to be used. Shaped implants are all textured and should not rotate when used properly. In my practice, about 20% of the patients benefit from shaped implants.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Revision of previous breast reduction with mastopexy and implant #plasticsurgery

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Based on your photos, I would recommend a revision of your previous breast reduction - the sagging portion of your breast in the lower pole needs to be removed - and this is likely the location of the original dermo-glandular pedicle - but 17 years hence, a revision with superior pedicle should be safe. A reasonably sized submuscular implant will impart some upper pole roundness, like the 'wish' photo you included.

You'd do best with implants and a lift

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You have really wide breasts -- that's the main difference between you and your wish pic.  Also, I believe you have more breast tissue so the look may not be realistic.  To get the best look, I believe it would take a lift to narrow your breasts and an implant to give the fullness in the upper pole.  The prior technique for your breast reduction is irrelevant -- your nipple position is not off by much so they don't need moved much.  Plenty of time has passed since your last surgery and your nipples have a new blood supply.  You do need to make sure your surgeon is experienced with repeat breast reduction/lift surgery, but you should be fine.  Good luck!

Robert S. Houser, DO
Columbus Plastic Surgeon
5.0 out of 5 stars 17 reviews

Breast decisions

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Hi there!  Based on the fact that you are not looking to decrease your size much, your surgery should be lower risk with regards to blood supply as you will not need as much deeper tissue dissection or removal.  I would suggest avoiding implants because you already have a lot of volume and implants can increase the weight of the breasts and therefore accelerate re-drooping.  I would normally recommend fat grafting to the upper breasts as an alternative to implants in someone with your anatomy (if you want more upper pole volume).  As far as the scars, you can probably get away with a vertical (lollipop scar) lift, but it is hard to tell with just photos.  I always explain to my patients that if there is too much loose lower skin after the lollipop lift, I will convert to an anchor scar to get them the best overall result.  Breast shape should be prioritized over scars in my opinion.  Good luck with your surgery!

Robert Cohen, MD
Santa Monica Plastic Surgeon
5.0 out of 5 stars 58 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.