Breast Lift - do I need a reduction to have a lasting positive result? (photos)

Question

5'9" - 180 pounds - 46 years - 2 pregnancies I want perky boobs (with upper fullness) with horizontal nipples... Surgeons advised that I must get a reduction to have a lasting result as my boobs would otherwise be too heavy and bottom out - so become hangy again... true? What would the best technique be? How to prevent disappointment with procedure? Can a result be simulated like for breast augmentation? And I inject 50mg Golimumab monthly to treat my AS - reason for concern?

Gary M. Horndeski, MD · Answer

The technique I recommend is The Bellesoma Method. This will reduce and 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 without excessive reduction. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Donald R. Revis Jr, MD · Answer

Good morning,
I think you may have surgery with your injection protocol, and I would also recommend at least some reduction to give you better longer lasting results.

Irena Karanetz, MD · Answer

Hello,
Thank you for the question.
Based on your photos, you appear to be a great candidate for breast reduction surgery. During breast reduction surgery, excess breast tissue is removed, the breast is lifted and nipple/areola is typically made smaller. It is easiest to think of breast reduction as including the breast lift. 
The goal of breast reduction surgery it to make the breasts smaller and lifted, but also proportionate with the rest of your body. 
I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Breast Reduction surgeries to further discuss your options, specific techniques, concerns and expectations. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results. 
I hope this helps.Best regards, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

Scott W. Vann, MD, FACS · Answer

I think you will need a two stage procedure if you want to reach all your goals. First you need a breast reduction to rid yourself of the massive excess skin and elevate and reshape your breasts. This should give you a  nice result, but  might not be perky enough or have enough upper pole fullness. Adding a small implant at a second stage after full healing from stage one should fix those two issues. I do a lot of augmentation lifts as one procedure, but your situation I feel would get a much better and safer result with two stages. Good luck.

Daniel Barrett, MD · Answer

Dear Sibylle,
my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. 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

Jon S. Wilensky, MD · Answer

A breast lift (mastopexy) can provide a lasting positive result by improving the shape and position of your breasts without necessarily reducing their size. Whether you need a reduction along with a lift depends on your individual goals and circumstances:
1. Breast Lift Only: If your primary concern is sagging or drooping breasts without excess volume, a breast lift alone can be sufficient to achieve a more youthful and perky appearance.
2. Breast Reduction with Lift: If you also want to reduce the size of your breasts because they are too large or heavy, combining a breast reduction with a lift can address both issues simultaneously. This can provide relief from physical discomfort caused by the weight of your breasts.
The choice between these options should be based on your desired outcome, as well as consultations with a board-certified plastic surgeon. They can assess your breast size, shape, and your specific concerns to help you decide the best approach for your individual needs and goals. Keep in mind that both procedures can provide long-lasting results when performed by a skilled surgeon, but the longevity of the results also depends on factors like aging, genetics, and lifestyle.

Connie Hiers, MD, FACS · Answer

A small breast reduction, which includes a lift, would be the best option for you.  Just doing the lift will leave your somewhat large and prone to repeat sagging.

Derek Fletcher, MD · Answer

If your goal is to have a lift and maintain breast volume, you may be a candidate for mastopexy and autoaugmentation. This technique repositions lower breast tissue behind the nipple to add volume and projection to your breast. How long breast shape remains stable after surgery is determined by the technique, skin type, and breast tissue type. Skin with few fine stretch marks tends to hold its shape longer after surgery than skin with many wide stretch marks. The same is true of breasts that have a higher percentage of glandular/ductal tissue than fatty tissue because the glandular tissues are more dense and can be shaped more easily. Regarding your immunotherapy, I always obtain explicit clearance from my patient's specialists prior to surgery.

Douglas Taranow, DO, FACOS · Answer

You require a substantial breast lift (anchor scars) to bring your breasts north.  If your breasts are heavy, they will certainly slowly travel inferiorly with time, but never as low as they appear now.  I would have to examine you to determine if a reduction is necessary at this point in time.
Best wishes.
Dr. Taranow