Pseudoptosis Correction Without Implants? Fat Transfer Option? (photo)

      You can have fat transfer to the breast, but that will not help the ptosis or pseudoptosis.   You could have fat grafting with a breast lift.  I think that a full lift would allow you to have much nicer looking breasts than with a circumareolar lift, though I perform both frequently.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast lifts each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Thank you for your question and for the posted photos. In the frontal view, your arms are elevated and this actually lifts the breasts (I often use that pose in the office to demonstrate approximate appearance after a lift), and the amount of sagging therefore will be understated in that photo. 

Only with the benefit of an actual in person exam can a precise recommendation be made. My hunch, based on these photos, is that you should consider a lift, and probably more of one than can be accomplished with a donut incision only.  If the breast size is OK, think about a lift alone, Only if you wish to be larger should you think about implants or fat grafting. 

Fees with vary region to region, office to office. A lift alone may vary from 6,000 to 9,000, but you can check some actual fees in your area on this site, though the quoted fees may not match exactly what you may choose to have done.

When you are ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S. Thank you for your question, best wishes.

based upon your posted photos I recommend full mastopexy with fat grafts obtained via liposuction. fee range from $8,000 to $10,000. 

Of course it is not possible to be certain without examining you, but from your photos it appears that you have true ptosis, not pseudoptosis. It would also appear that the most appropriate procedure to correct the problem is likely a full breast lift. A circumareolar lift would not adequately correct the drooping and shape of your breasts and an augment alone (even a large augment) or fat transfer, would still leave you drooping.

The best way to get advise regarding the most appropriate treatment for your problem is to schedule an appointment with a Board Certified Plastic Surgeon.

It is hard to tell with your hands raised up if you have a curvature of the chest as this may be the reason for the breast shape.  Sometimes the breasts are normal but the contour of the chest makes them look farther apart or not as natural.  With all breast procedures, it is critical to figure out "what is missing".  How will a procedure compliment your natural breasts.  It does look like adding volume to the upper pole with change the breasts to a rounder shape.  So yes, fat grafting may be a reasonable option, providing you have fat to use.  Otherwise there may be other options.

The periareolar lift without implants is usually not a good choice as it flattens the breast. You would look very nice with a full lift which takes away skin and repositions the breast tissue to a higher and more youthful look. You need to decide if the scars are worth the dramatic improvement you will get. You can do fat grafting but generally that won't be enough to fill out your loose skin which is the main culprit in this case.