Breast lift with fat transfer or implant? Which would be more suitable for me? (photos)

Question

Im 26 & lost a lot of weight. My boobs are sagging quite abit and the areola is large too. I was thinking of getting an implant but I was told that if I were to do that, I would have to get a breast implant that is on the larger side but Id prefer a medium sized (B-C cup) one. Another suggestion I got was to go for a lollipop lift with implant/fat transfer. I dont know if Im okay with the scarring so I was wondering if an implant/fat transfer with just areola reduction would help?

Finny George, MD · Answer

Hi, thank you for sharing your question. You are a good candidate for donut lift with an implant. The implant sizing is based on your preference and your breast measurements. This plan will eliminate the sagging, large areola and relative lack of volume. I hope this helps.

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. 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 size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Gary M. Horndeski, MD · Answer

The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. The areolas can be reduced to the size you desire. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

Look at photos of fat transfer to the breasts on the internet. You will find very few decent results. That's because fat transfer doesn't work as well as you may believe. I agree with the lollipop lift but you need an implant.

Daniel Barrett, MD · Answer

Dear rkawk25,
tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.The type of surgery best for you will depend on the severity of your condition.My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.That said, it is best that you visit a board-certified plastic surgeon for an in person examination. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Donald R. Revis Jr, MD · Answer

Good afternoon,
You don't need a large implant, or a vertical lift, or fat grafting- you've been getting some terrible advice. You are an excellent candidate for a donut mastopexy to reduce your areolas and tighten your skinand a modest (not large) sized augmentation. You may choose saline or silicone gel, depending on your preference, and we would determine the exact size and profile when I measure your chest, we review photos together, and you have an opportunity to try on the implant sizers here in the office.

Connie Hiers, MD, FACS · Answer

You should be able to have the doughnut lift with the areolar reduction and implants. Implants will give a better shape and more volume than fat.

Camille Cash, MD · Answer

From your photos you appear to be a good candidate for a periareolar lift with a small implant.  You do not need to get a large implant.  The incision would only go around the areola and the implant can be inserted through this incision.  The diameter of the areola can also be reduced using the same incision.  I encourage you to visit with a board certified plastic surgeon near you to learn more.

Aleksandr Shteynberg, MD · Answer

Hello, rkawk25. Breast implants with areola reduction will probably provide the best result to increase volume, lift breasts and reduce areolas. Areola reduction may be performed in a way to allow for an additional breast lift if needed right after an implant is inserted. Using fat transfer without implant will increase breast volume but will not allow for good support to lift breasts. Based on the pictures it does not look that you need a lollypop lift. Some apparent asymmetry may be corrected by using slightly different implants and areola reduction will allow symmetrizing areolas. 
Best. 
A. Shteynberg, M.D. F.A.C.S.Diplomate, American Board of Plastic SurgeryNew York, NY.

Gokhan Temiz, MD - Account Suspended · Answer

Hello. Thanks for the information that you provided. According to your case, the best treatment plan for your case is donut lift with the breast implant operation. I generally use the fat transfer procedure as a supporting treatment to the breast implant when it is necessary. The main reason that I use the fat transfer as the supporting option is the most majority of the fat cells is absorbed by the body in time and additional fat transfer operation is needed in the future to have the satisfactory result.