My main concerns are infections and breastfeeding in the near future. (Photo)

I am 25. 36DD. Although my size isn't outrageous, I dream about one day not wearing a bra and walk around the house in a t-shirt and panties only. I'd like to evaluate all of the drawbacks: how does one cope with the possible scars? What are the chances of them infecting? What about the afterwards pain? What of breastfeeding? I am a newly wed and plan to have kids in the near future (3-5 years). What of the result not being what you wanted? Perky and symmetrical breasts with beautiful nipples?

Doctor Answers 4

Lipo-lift, breast lift, breast reduction, mastopexy, benelli, augmentation mastopexy

I appreciate your question.

I perform a liposuction breast lift that removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast I then remove the skin to tighten the breast and create a better shape with nice cleavage. Since I perform this less invasively the recovery time is faster. The size would depend on the proportion with your body versus going for a cup size. It works very well if there are asymmetries. I can also use the removed fat as a natural breast augmentation by grafting the fat back into the breast to create more projection or into the top to create more cleavage. This procedure can also be combined with an implant if needed or wanted.  It should not affect nipple sensation, mammograms, cancer risk or breast-feeding. If you gain or lose weight, the transferred fat can do the same.

The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic plastic surgery.  

Best of luck!    

Dr. Schwartz 

Board Certified Plastic Surgeon



Possible complications after breast reduction surgery

I suggest you are done with your pregnancies before undergoing a breast reduction only because pregnancy and breast feeding can have unpredictable effects on your breasts. Most breast reduction procedures require vertical incisions or interfere with nipple sensitivity and the ability to breast feed. However, The Horndeski Method, was developed to improve aesthetic outcomes without breast implants, minimal scars and preserve the ability to breast feed. Long term results are achieved by securing the newly repositioned and reshaped breasts to the underlying chest muscles. Once the breasts are properly supported (unlike relying on the skin envelope alone like conventional methods) breasts remain perky (upper pole fullness without implants) without using a bra. Attached is an example of THM without implants. I hope this helps. 

Best wishes and kind regards, 

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 215 reviews

Breast Reduction

You have some good questions. The easy ones first....infections are extremely rare in cosmetic surgery and the majority of patients use narcotic pain pills for a few days but are on ibuprofen in 7-10 days.Scars are not "possible", they are guaranteed and sometimes they are pretty bad, but usually fade to soft white lines in a year or two. Scarring, for the most part, is based on your genetics. I tell all my young breast reduction patients to assume they will not be able to breast feed and make their choice regarding surgery with that understanding. Many patients do breast feed but almost always find they need to supplement due to inadequate volume. Since you have a fairly short timeline for having your children, it seems like it might be best to have the babies and put the surgery off for a few years. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 25 reviews

Breast Lift

Dear Unsure091:

Based on your photo alone, I would likely suggest you consider a breast lift to reshape your breasts, address the sagging, and restore volume in your cleavage.   The basic principle of a breast lift is that you have to accept some degree of scar to achieve better form.  As per infection, we give all our surgical patients IV antibiotics prior to surgery (incision) time to prevent surgical site infections.   Preoperative antibiotics is much more effective at preventing any infections that postop oral antibiotics.  As per breast feeding, with the technique I utilize, we keep the nipple areolar complex attached to the blood supply, lymphatics, nerves, and ducts.  You should be able to breast feed, but that is impossible for anyone to guarantee.  Besides, even if you don't opt for a breast procedure, you may or may not be able to breast feeding - this is simply an unknown.   Please see a board certified plastic surgeon to learn more about your options.  best wishes,

Dr. Basu
Houston, TX

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.