Implants After Breast Reduction? (photo)

Question

Hello Doctors. I had a breast reduction 2 1/2 years ago. I'm wondering if adding a small implant (to give me the upper fullness) would be a good idea? What additional scars would I have? Would that make me likely to sag in the near future? I've included before/after photos for your review. Thanks ever so kindly. :)

Ronald J. Edelson, MD · Answer

As far as your size is concerned I think you have a good size currently and adding implants could make you appear heavy. Also, the implants may give you superior fullness for a while, but they will eventually sag and stretch out your breast requiring more surgery. You have a decent result, leave is a.one for now.

Kenneth Hughes, MD · Answer

Implants can be placed to increase superior pole fullness. The previous scars can be used for access. No new scars will be necessary. Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations, breast lifts, and breast augmentation revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA

Robert W. Kessler, MD, FACS · Answer

Implants after breast reduction is a reasonable approach to gaining upper pole fullness. Your photos are difficult to evaluate but it looks as though a repeat lift in addition to an implant would give you a superior result. This could be done with no new scars.

	Another thought would be to perform fat transfer to the upper pole of the breast and avoiding an implant completely. This has the advantage of body contouring with liposuction usually from the flanks or abdomen.

	Seek out a board certified plastic surgeon to help you understand your options. Good luck and I hope this was helpful.

Raffy Karamanoukian, MD, FACS · Answer

Breast implants will provide more fullness on the upper pole of the breast and may give you a volumetric improvement in breast shape. Raffy Karamanoukian, Los Angeles

Vincent N. Zubowicz, MD · Answer

From the photo it appears as though the distance from the areola to decrease is too long, greater than 6 cm. If this is the case that distance can be shortened with a revision that will enhance volume in the upper pole of the breast. Do breast augmentation only if you want to be larger.

Douglas Hargrave, MD · Answer

The only practical way to get fullness in the upper half of the breast is with breast implants. The scars from your breast reduction surgery can be used for the augmentation. If you choose an implant that is not excessively large, you should not have to deal with any excessive sagging.  This would also give you an opportunity to correct any asymmetry issues that you might have and do some additional shaping to the breasts. Dr. Douglas Hargrave

Curtis Wong, MD · Answer

can certainly be done but implant size and whether your old incisions have to accessed again depend on your physical findings and expectations. You need to see a local plastic surgeon. And know what their revision policy as so you won't have surprises should you not achieve what you anticipated.

Darryl J. Blinski, MD · Answer

Yes you can do this operation but be sure to address the size of implant. Have a present scar used to gain access.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures. Your “plan” seems quite reasonable;  if you wish to increase breast size/fullness,  especially upper pole volume, breast augmentation surgery may be a good option for you. Assuming you are pleased with the position of your breasts on your chest wall, additional breast lifting will likely not be necessary. If, on the  happened, you feel like you have some “sagging” present, breast lifting may be helpful, along with breast augmentation surgery.

I would suggest that you seek consultation with board-certified plastic surgeons. Ask to see lots of examples of their work and communicate your goals clearly.  In my practice, I find the use of goal pictures very helpful during this communication process.

You may find the attached link helpful to you as you learn more about options.

Best wishes.

Robert Singer, MD · Answer

The shape of your breasts can be improved and a modest upper pole fullness can be achieved with a breast lift (mastopexy) using your prior incisions.  If you like the size of your breasts in a bra then a mastopexy alone is a reasonable option. If you want to be bigger,  adding implants would be the option.  A combination of a mastopexy and a small implant is another option. Be aware that larger heavier breasts tend to have more recurrent sagging.

	Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you what to do based on two dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the various operative procedures would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

	Robert Singer, MD  FACS

	La Jolla, California

Implants After Breast Reduction? (photo)

Answers (14)

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