Would a breast lift or reduction be the better option to help me achieve a more even, shapely result? 25 y/o (photos)

You certainly would benefit from a breast lift. During the procedure, your breasts would be reshaped and brought up to a much higher position. Your breasts would look more rounded and nipples positioned higher up on your chest with more upper pole fullness than when you have your arms raised in that photo you provided. Unless of course you specifically requested they just be brought up to that position of the smaller breast, which women rarely ask for, usually the higher the better, but everyone has a different Opinion of perfection. At the same time of the procedure you can also have your areolas reduced and made symmetrical if you’d like. I would love to see you here at Smith Plastic Surgery for a consult so we can go over in person how we can help you meet or exceed your breast goals!

Both breasts require a lift while only the larger breast requires a simultaneous reduction. So essentially, the approach is lifting of the smaller breast and then lifting and reducing the larger breast to match the lifted smaller breast. The incisions (scars) required to do this are around the newly placed nipple areolar complex (NAC), straight down the middle of the breast inferior to the NAC, and some element of an incision underneath the breast in the fold. It's called a modified anchor. We performed this procedure in the office with the patient awake and comfortably relaxed on oral medications while the breasts are completely numbed.

Hello @xofu, thank you for your question. You could consider a breast lift with BRALift technique and it will for sure enhance the shape and projection of your breast. This procedure will remove excess skin, reposition breast tissue in order to create a better shape, symmetry and cleavage. The scar can be varied, mostly the inverted T-shaped scar is used however in my experience of 23 years I have made a modification to improve the extension of the scar being the L shape for minimal scarring and the most adequate result. I link a video to shed more light. A consultation is vital to establishing a surgical plan that meets your needs, meets your expectations, and takes into account what is possible. I link a video that sheds more light on the matter. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery Member (SCCP).

Dear xofu,
based on your photos, it looks like you have severe asymmetry so you will need reduction of larger breast and lift. 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.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

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.

From your photos you appear to be a good candidate for a breast reduction in order to address breast shape and asymmetry. You can consider autoaugmentation as part of your surgery. This approach uses your own tissue to create upper pole fullness. It does not require fat transfer or an implant. I've included a video on this approach that I hope you find helpful.

A breast reduction, which includes a lift, would be the best option for you. Ideally, you would be at your weight loss goal before doing surgery.