34E, want perky 34D without major reduction — best option to minimize scars? (Photos)

Your request might be possible. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Thank you for sharing your photos! The breasts are quite symmetric but exhibit upper pole deficiency. I would recommend an "anchor type" breast lift with minimal reduction. After the lift, depending on your satisfaction with the results, you might consider a small implant to enhance the upper pole and achieve a perkier appearance. However, most patients are typically happy with the results after the lift alone.

I think you are an excellent candidate for a breast lift. To achieve this, you will need the necessary "anchor" type of lift with removal of some of the heavier breast tissue. A proper lift/reduction will lead to a durable result with a lifted, perky, proportionate breast. I would also recommend liposuction of the side breast area to help define and frame the breast. I hope this helps. Thank you!

A breast lift and slight reduction alone would be sufficient in improving the perkiness of your breasts. If you want significantly rounder breasts, a small implant may be needed.

You appear to have a grade 2 ptosis. A small breast reduction through a Wise pattern would allow you to reduce the size of your breasts and elevate your breasts to the correct level. Slightly reducing the size of your breasts will help them maintain their results over time. There should be no need for fat grafting or breast implants as that would be counterproductive to the reduction in size that you’re seeking. The scarring from a wise pattern reduction, performed well, should be minimally visible. Trying to minimize the incision lines, but ending up with a worse result would also be counterproductive. Best wishes.

Your surgeon should be able to lift your breasts up higher onto your chest wall and you both can talk about how much smaller you potentially want to be. A breast lift alone would give you an aesthetically pleasing look, and if you desire a small reduction, that should be easily possible. Scarring will be around areola, down vertically and in the entire crease of your inframammary fold. I encourage a routine of scar care for an entire year post op and you can also typically get scars lasered for a better appearing scar as well.

The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief and long term stability. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. The areolas can be reduced to the size you desire.

Best Wishes,

Gary Horndeski, M.D.