Breast lift & breast fat transfer - should I have them done together or one before the other? (Photos)

Hi, thank you for sharing your question. You will have a good result with a breast lift. The fat transfer may not be needed, so I would recommend that you do the lift and then see whether you want any more fullness. Both procedures can be done together if you currently feel that you need the volume.

The symptoms you are having are very common in women after breast-feeding multiple children. It is common for the nipple to slide to the bottom portion of the breast, the breast skin to be loose, and the areola to widen. It is difficult to say whether fat grafting would be the best first option for you during mastopexy(breast lift) as a formal examination of the amount of underlying breast tissue that you have would need to be done, and your ultimate goals for shape and size would need to be discussed. Based on your pictures I feel that it is unlikely for you to have your desired result with simply fat grafting at first, and therefore I would not recommend that.
This is a very common procedure that we do in our office on women like yourself. Please see the attached link for more information on this topic.

Thank you for your question. The key is to understand what your goal size is. You are certainly a good candidate for a breast lift, and an auto augmentation mastopexy can provide you with some good upper pole fullness. However, if you are looking for an increase in size, fat grafting can be done at the same time as the mastopexy. I would recommend doing them at the same time if you are looking for a larger size because some of the fat will reabsorb. Therefore if three or four months after surgery you would still like more volume, you can then undergo a second round of fat grafting at that time, which could potentially save you an extra procedure if you didn’t do any fat grafting at the initial operation. Good luck.

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. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Hello @trashcan25, thank you for your question and showing you pictures. Everything depends on the surgical technique of the plastic surgeon. Personally I suggest that you have the breast pexy (lift) first to reconfigure the tissue, to lift it and give it a good shape as well to reduce the size of the areolas. It would have a very favorable esthetic result because you have good mammary gland that must be fibrous for having breastfed. If you find that you want more volume then have the fat transfer to the breast 3 or 4 months later to assure that the fat cells do not die. It is important that you have a consultation with a board certified specialist to determine a surgical plan according to your needs. Best wishes! Alan Gonzalez MD, FACS.

I would recommend doing the breast lift first, and then seeing if you even need the fat grafting. You have ample breast tissue and with a lift and a repositioning of your areolas and reshaping of the breasts, you may not want further volume.

Dear trashcan25,
I understand your concern. It is best however that you consult with a board certified plastic surgeon to determine whether you can have several aesthetic surgeries in one session, as this would depend on various factors including but not limited to your general health condition, the type of anesthesia that will be used, and the type of surgeries that will be performed among others.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

In my hands, I would do the breast lift first and let your tissue settle, and then do the fat transfer if you still wanted more fullness. The fat has a better chance of survival if not done with the lift.

You have ample breast tissue to give you high, round breasts. Because of the flaps elevated during a breast lift, I would prefer to discuss a fat transfer months after the mastopexy (lift) to see if a larger breast id still desired.
Best wishes.
Dr. T

Hi. As i see in the pictures, the best option for you is breastlift surgery. After this procedure, according to your expectations fat transfer could be performed, or prothesis.