I'm 27, no kids, 38/40 H, want a breast reduction without implants but I want them perky. Is this possible? (Photo)

I would like some fullness at the top instead of smaller still saggy breast.

Doctor Answers 10

Careful selection of plastic surgeon and careful communication goals will be key.

Based on your photographs, you seem to be an excellent candidate for breast reduction surgery. It will be important that you select your plastic surgeon carefully. Make sure that he/she is a board certified plastic surgeon who can demonstrate lots of examples  achieving outcomes that you will be pleased with.  Demonstrate what you mean by "perky" and make sure that you have realistic expectations prior to proceeding. Best wishes for an outcome that you will be very pleased with.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,485 reviews

How to keep upper pole fullness with breast reduction surgery

Of course its possible. I have attached a short video of a woman who desired a breast lift without breast implants. There is also no vertical scar that weakens the lower pole and allows the breast to sag again like in traditional anchor methods. With the Horndeski Method breast reduction you get to keep nipple sensitivity, the ability to breast feed and your results are longer lasting. Look into it. Best wishes and kind regards, 

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 222 reviews

Breast reduction and perky

There is no question, based on your pictures, that getting to an aesthetically pleasing smaller and functionally better breast size is possible.  The "perky" part is more complicated.  The experience of a surgeon, design of the reduction and quality of your skin and underlying breast tissue all play a role in how perky and for how long.  They will look very perky and high initially,  Gravity and the level of stretch relaxation that your tissues will go through determine how long the "perky" will last.  Seeking the opinion of an experienced, board certified plastic surgeon who can give you an honest evaluation of your tissue quality will also help you understand the likely outcomes of the surgery you seek to have.  Other factors such as regular weight fluctuation of more that 10-15% and pregnancy/breast feeding will impact the long term outcomes as well.  All the best.

Paul G. Ruff IV, MD, FACS
Washington DC Plastic Surgeon
3.8 out of 5 stars 19 reviews

Breast reduction: You can be perky without implants

I believe your desire to be perky after a breast reduction (without implants) is a reasonable goal. To see before and after photos of women similar in height, weight and starting size, tclick on the link below. For more information on this and similar topics, I recommend a plastic surgery Q&A book like "The Scoop On Breasts: A Plastic Surgeon Busts the Myths."

Ted Eisenberg, DO, FACOS
Philadelphia Plastic Surgeon
5.0 out of 5 stars 78 reviews

Breast reduction candidate, some advices:

Thank you very much for sharing your concerns with us. 

After having analyzed all the information provided to us, i can realize that you have very large breasts for your height and weight, and they are responsible for back and shoulder pain.
In the future may cause  permanent osteo-articular damage in the back and shoulders and skin problems (mainly under the breasts).

For these reasons we should consider performing a breast reduction surgery on you.

Dr. Emmanuel Mallol Cotes.- 

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 252 reviews

Getting what you want from breast surgery depends most on who does your procedure

Hi there-

When executed with skill on appropriately selected patients, breast reduction can result in outcomes that are quite round and perky but this will depend greatly on who you choose to do your surgery and how they perform the procedure. Find a surgeon whose work demonstrates the outcomes and quality you are seeking.

Armando Soto, MD, FACS
Orlando Plastic Surgeon
4.8 out of 5 stars 157 reviews

Breast reduction

Hello and thank you for your question and photos. It is very common for women with large heavy breasts to request smaller uplifted breasts. 

Many women experience pain and discomfort with large heavy breasts. Some will often resort to using multiple bras,  Motrin,  pain medication and attempts at chiropractor or physical therapy. To date, there is no medical or scientific study proving that non-surgical options are of any value in treating this. 

The only treatment that is successful is surgery. Your photos show you would be a very good candidate for a breast reduction. All reductions are also lifts. Most will have improvement in shape and "perkiness" but will NOT look like an implant. You have enough tissue that I would not suggest getting implants, just the reduction alone. 

You should seek several consultations with board-certified plastic surgeons in your area before making any decisions.

As always it is best to be healthy, no smoking, and to make sure any health concerns you have are managed by your primary care physician.

Best to you

Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 21 reviews

Smaller and Perky.

Thanks for your photos and the question.  You can absolutely be smaller, but I find that "perky" is a dangerous word.  When I show my patient pictures and they pick out a result that is "perky" they usually pick photos of patients with  breast implants and very little starting natural tissue. Natural tissues goes south over time, implants defy gravity more and have more fullness up top.

You can definitely be smaller and less droopy. You will always have a wide breast because your chest is wide. The more volume your surgeon leaves behind  the more  droop you will have in the future. Proportionally, from your photos I would be thinking a c-ish size, but a c-ish breast will take on a tear drop shape over time. If you want Upper pole fullness ("perky") you might go even smaller with an eye towards an implant in the future.

With a clear understanding between you and your surgeon you are more likely to be satisfied.

Best wishes.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 103 reviews

Possibilities from breast reduction

The goal of breast reduction is to reduce the breast size, reposition the nipple areola complex so that it is more centered on the breast, to correct the breast sagging, and to improve the symptoms typically noted in women who have large breasts, such as back/neck pain, shoulder grooving, or rashes beneath the breasts.

You seem like an excellent candidate for a breast reduction, and the expectation would be that the breasts would be smaller, perkier, with more upper pole breast fullness.  You would have incisions around your areolas, vertically on the bottom half of the breast, and possibly horizontals scars in the breast fold at the transition between the breast and the abdominal wall.  Most woman are happy with the scars, and the improvement of breast shape, perkiness, and symptoms relief leads to high levels of satisfaction.

A consultation with a board certified Plastic Surgeon, to understand your medical history and your expectation from surgery, and to perform a physical examination in order to design a customized treatment plan would be recommended.  Good luck!

Stephen U. Harris, MD
Long Island Plastic Surgeon
5.0 out of 5 stars 15 reviews

Breast reduction

Yes it is possible. You are young and the photo you provide suggests you have good quality youthful skin and breasts. You would benefit greatly from a well performed breast reduction which in the right hands can provide a perky youthful result for you. All the very best!

Jonathan Adamthwaite, FRCS (Plast)
Manchester Plastic Surgeon
5.0 out of 5 stars 28 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.