Breast lift/areola reduction after weight loss. Will fat transfer help gain the results I want? What should be done? (Phtoo)

Question

I am 30 years old, no children, caucasian, 5'5

Semih Yildiz, MD, FEPOBRAS · Answer

From the photos, there appears to be post-weight-loss breast deflation with sagging, low nipple position, and larger/asymmetric areolas. A breast lift with areola reduction is the procedure that most directly addresses nipple position, breast shape, and areola size. Fat transfer can add some soft volume, but it will not reliably lift the breast or correct the areola position by itself.

If your goal is a modest, natural increase in fullness, a lift plus fat transfer may be reasonable if you have enough donor fat and accept that the volume gain is limited and sometimes requires more than one session. If you want a rounder upper pole, more cleavage, or a larger cup-size change, a lift with an implant may be more predictable. The best plan depends on your desired size, skin quality, breast measurements, and whether your weight is stable; an in-person consultation is needed to decide between lift alone, lift with fat transfer, or lift with implants.

Matthew C. Camp, MD · Answer

You have a two-fold problem - dilated areolas, and loss of breast volume. A cut around the areola can reduce the diameter of the areola, and perform a lift. A short vertical scar under the areola may left after this procedure - “lollipop” lift. Fat grafting to the breast is not a reliable way of volumizing the breast. Often the fat does not survive, and the difference is not noticeable. Another factor specific to you is the fact that you are lean. No fat to harvest. The most predictable option would be a petite silicone breast implant performed along with a lift and areolar reduction. Seek out a board certified plastic surgeon, review before and after photos, and ask as many questions as you like. Best wishes!

Gary M. Horndeski, MD · Answer

The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Sean T. Lille, MD · Answer

Dear Lisa, I recommend a donut lift only if you want the areola downsized. I don't like putting a scar on the breast unless your result would be unacceptable without it.  I am not a fan of fat transfer to the breast, and you must have a lot of fat to harvest. You appear to be pretty lean. 
If you desire more volume and shape, my recommendation is to get breast implants if you want volume and shape.  
Best Wishes!

Daniel Barrett, MD · Answer

Dear lisa penfold,
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

Camille Cash, MD · Answer

From your photos it appears you would be able to achieve a look similar to your wish photo with a breast lift (which includes an areola reduction) and a small implant.  A moderate profile implant placed under the muscle will give you a more natural look.  Visit with a board certified plastic surgeon near you to learn more.

Michelle Copeland, MD, DMD · Answer

Thank you for sharing your photos! If you're sagging or asymmetrical, and are looking for perkiness, you'll need a lift--or, if you also want more volume, a lift and implants or a fat transfer. A mastopexy (breast lift) raises droopy breasts from one to several inches and excess skin is removed. To perk up a drooping breast, your surgeon will remove excess skin, reposition the nipple, and redrape and tighten the remaining skin to support the breast. It is possible to enlarge your breasts without implants using a technique called autologous fat transfer, and autologous simply means “your own”. Specially prepared fat taken from another part of the body, such as the stomach or hips, is placed under the breast tissue to provide increased breast size without the need for artificial implants. And who doesn't have a little fat to spare? The great thing about these techniques is that they can now be done with minimal scarring and performed as an outpatient procedure without the need for general anesthesia. I suggest making an appointment with a board-certified plastic surgeon to discuss your options in more detail!

Connie Hiers, MD, FACS · Answer

I am not certain what you want done. However, a lift would be needed to raise your nipples and remove excess skin. If you want more volume, implants can be added. Fat alone will give your somewhat larger, half to one cup in size, and still sagging breasts.

Hilton Becker, MD · Answer

You do have some asymmetry.
Fat grafting would give you some extra volume .You may also want to consider the sub-areolar lift

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question and photographs.

You appear to have adequate breast tissue to achieve the result that you want with a breast lift alone without fat grafting or breast implants.

Fat grafting will add significant time to your surgery, possible fat donor site deformity and likely need for a secondary fat grafting procedure.

If you were my patient I would suggest doing the breast lift only as the result that you wish does not show excessive need for volume.  If you want more volume that in that picture than a small breast implant will more easily achieve a permanent result

Breast lift/areola reduction after weight loss. Will fat transfer help gain the results I want? What should be done? (Phtoo)

Answers (10)

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