Breast Reduction W/ Implants?

I have DD breasts with significant droopage with extra skin under my arms where my bra sits making them look completely shapeless;I've been told by surgeons to consider a lift w/ implants, but I'm concerned that's just not going to hold out for very long. I have seen many pics of women with reductions and it seems they look great right after, but after they settle they seem flat and shapeless again. Is it possible to get a reduction with a small implant to achieve the smaller/full/perky look?

Doctor Answers 10

Breast Reduction with Implants?

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Thank you for the question.

It would be in your best interest to proceed with breast reduction first;  select your plastic surgeon carefully and communicate your goals in regards to fullness etc.  After the successful breast reduction procedure,  you will be able to evaluate the need for breast implants which can be much more safely than if done at the same time at the breast reduction procedure.

Best wishes.

Breast reduction with or without implants

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Your best bet may be to have a breast reduction first and then see if you need or want implants. Doing both at the same time is possible but is less predicable. The final result will depend on your skin quality and breast shape to start.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 76 reviews

Treating a large sagging breast after massive weight loss

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You are correct. This is a difficult operation to perform in one stage with a predictable result. The best results may require two or more procedures because your tendency for recurrent laxity and sagging is quite high. Another option is to consider fat grafting to the upper portion of the breast to achieve selective fullness while reducing the redundant sagging portions of the breast.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Breast reduction and implants?

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I would probably just do the reduction first and see how the breast hold up over time. If they need a lift and an implant to give you more fullness then I would do that at a later time. I haven't had to do this on my patients.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast Reduction W/ Implants?

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Yes it is possible but better to have the reduction first than allow settling. As a second operation have any size implant to achieve the look you desire. From MIAMI Dr. Darryl j. Blinski

Breast reduction doesn't include implants

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The first thing you should do is to have a reduction done by an excellent sculpting plastic surgeon.  You can tell if this is the case by looking at long term photos from that doctor's portfolio.  Your own tissues can prevent the perky long term result but the technique of the doctor is also very important.  Later on you can decide if you want more upper pole fullness and that's want an implant will give you.

Breast Reduction with Implants

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It is important to determine if you truly need a breast reduction, or rather a breast lift or mastopexy. Often, pendulous breasts can fill a bra if "poured" into the cups, but truly don't have much breast tissue, just skin. 

An "augmentation/mastopexy" is a breast lift with a breast implant. It will help lift the breasts, but also give "upper pole" fullness and projection lost with the deflation of breasts. 

Breast reductions, done often for medical reasons, and often covered by insurance, would be denied by insurance were implants placed at the time of the reduction. 

Breast reduction with implants

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Each patient will have specific anatomical characteristics to her breasts and will want variable results. That will determine what needs to be done surgical. Some patients definitely need a combination of reduction, lift, and augmentation to achieve their size and shape. Each component has its own risk and combinations can have additive risk that you will need to discuss with your surgeon but this does not preclude the possibility of doing all three procedures at the same time. You just need to walk through the rationale and risks with your surgeon.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Breast reduction and implant placement. Is this an oxymoron?

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Breast reduction is to decrease the size of the breasts, raise the nipple areolar complex give more projection. Placement of an implant will increase the volume of your breasts. So you have to decide if you want an augmentation or a reduction. At times, a breast lift can be done with an augmentation with implants if one has "deflated" breasts with saggy skin. I always do liposuction of the bra rolls and lateral chest wall on any type of breast surgery that I do if it is indicared.

It is best to do only a reduction on women with very large breasts

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Women with excessively large breast are best treated with a reduction mammoplasty only. The problem you describe of the breast looking good right after surgery and then flattening out and loosing their shape with time is a real problem. this is usually caused by the surgeon not correctly shaping and positioning the breast underneath the skin before closing the skin. In these cases the skin shapes the breast but only as long as the skin takes to stretch out. Get your surgeon to show you some late 6 month to a year post op photos to confirm that the surgeon is using a technique to shape the breast tissue and not use the skin to shape the breast. 

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 17 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.