Upper Pole Problem, Implant or Lift ?

I feel that my breast is slightly droopy,so i consulted with doctor, and he said that instead of lift, i should have implant/fat injection for more upper pole fullness. Length between my nipple to sternal notch is 23.8cm Should i have lift or augmentation ? If augmentation,which one is better,implant or fat injection?

Doctor Answers 13

Correction of upper pole - Implant or lift

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For starters, you do not need a lift. A lift only provides temporary improvement in upper pole fullness, and once they "settle in" much of that fullness fades. An implant is generally required to achieve sustained upper pole fullness.

Fat grafting is a potential option, but the results are not consistent and predictable. Your photos suggest that you have some assymetry with your right breast being slightly larger. If that is the case, then I think a modest bilateral augmentation with different size implants (or different volume fill of saline implant), would most consistently and predictably give you the result you are looking for.

Fat Injections And Breast Implants Do Not Create The Same Result

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It is very clear based on your photos that you do not need a lift. You need volume to fill out the entire breast, of which the greatest change will be in the upper pole. Whether you should have an implant or fat injections to achieve that goal depends on many factors. The most significant factor is what breast size are you trying to get to and do you want just the upper pole volume increased or do you want the entire breast volume increased. Fat injections in the breast work best for focal areas of enlargement but are not always reliable. Implants work best for an overall breast volume change and are very reliable.

Breast Implant or Lift?

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A review of your photographs does not demonstrate any sagging (ptosis)  of your breast so a breast lift is not necessary in your case.  You would do well to have carefully performed breast augmentation.  At this time I cannot recommend fat grafting for breast augmentation. 

Michael Sundine, MD
Orange County Plastic Surgeon

No recommendation for fat transfer for breast augmentation

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Thank you for your question. Based on your photos, you clearly do not need a lift. I would advise you to stay away from fat injections for breast augmentation; breast implants under the muscle are the standard of care for breast augmentation. Fat injections for augmentation are still very controversial and not widely accepted. To obtain the upper pole fullness that you are looking for, you would need a huge amount of fat injected and most of that will die and get absorbed.

Should I have a breast lift or augmentation ?

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Personally, i think a breast augmentation done well with a carefully chosen breast implant would greatly improve your appearance. although fat grafting is a possibility it would require 6-8 weeks before and after grafting of 8-12 hours daily of breast expansion and 2-3 sessions of fat grafting.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Breast augmentation

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I think that a breast augmentation will probaly give you a more consistent results. Using fat for primary breast augmentation is still controversial.

Options for upper pole fullness of the breast

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In your case, implants are the best choice and a lift would not increase upper pole fullness, as you do not need one. I would not recommend fat grafting at this time until long term studies have proven safe.

Best wishes,

Dr. Horndeski

No need for a breast lift

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Breast lift is more about nipple position than upper pole fullness, and your breast is normal and natural in every way. You do not need a breast lift. Other than slight volume issues, your breast is quite perfect. An implant will give the upper pole fullness you are looking for, and a submuscular breast implant is safe and straight forward and would be our choice over fat grafting.

Best of luck, peterejohnsonmd.com

Breast Lifting Candidate?

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Thank you for the question and pictures.

A breast lift is not indicated in your case.

Breast implants will most likely help achieve your goals.

In planning your breast augmentation procedure it will be very important to communicate your size goals with your surgeon.  in my practice I find the use of goal pictures to be very helpful.  in your case you could use your own before breast-feeding pictures as the goal. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.

I hope this helps.

Implant or lift

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You do not need a lift. An implant of appropriate size and dimension will give you the improvement you need.

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.