I was recommended auto-augmentation mastopexy. Would I benefit from adding implants? (photos)

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.

Thank you for your question.
Based on your photos, I believe you would achieve the best overall aesthetic by using implants. While a lift will place the nipple at a more favorable position, you will be lacking volume to the upper poles of the breast. Auto-augmentation would be great at keeping you in the same cup size, or slightly larger; however, an implant would allow for additional cup sizes to be added. In addition, placing implants will create a more youthful, fuller appearing breast. I recommend speaking with a board certified plastic surgeon to discuss your options.

Autoaugmentation Mastopexy with fat grafting can be performed and implants can be inserted at the same time. Implants are a very effective means for filling the upper pole, for better shape, and for enlarging the size. However, there are disadvantages to that foreign materials. If the implants are used, the operation and post-operative management are complicated and the cost is high. Currently, your breasts are not small, so please consider a method that does not use implants.

Hello, thank you for your question. I agree that a breast lift will be very powerful in reshaping and re-positioning the breast in a more youthful, perky manner. Autoaugmentation and fat grafting can help increase some volume and improve contour/"cleavage" specifically in the upper and inner portions of the breast, which can tend to "settle" or "flatten" over time if only a mastopexy alone is performed. The big question that you need to answer is what kind of volume do you desire? If you are happy with your current cup size and perhaps want a 1/2 to 1 cup increase, this could be achieved with fat grafting alone (if your donor sites are sufficient, which with your plans for further weight loss may make less donor fat available to your surgeon). If you want a reliable 1-2 or more cup size increase in volume, this can be more predictably achieved with implants. Some women may not want the foreign body concerns of an implant and this would also lean them towards an "all-natural" procedure with fat grafting. You can have a great result either way! The answer to these questions can be very patient-dependent and perhaps a follow up consultation with a board-certified plastic surgeon would be helpful. Good luck in your journey!

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants, and they choose what looks right for them. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Auto augmentation type of mastopexy usually refers to a type of mastopexy where deeper tissue in the breast with possible overlying dermis layer of the skin is sewn up higher on the chest wall, usually to the fascia of the pectoralis muscle, to increase fullness in the upper part of the breast. Although some surgeons do this rather routinely, many surgeons do not and just rely on removing excess skin and repositioning the nipple to a higher position. This more complex technique of breast lifting is very difficult to perform if an implant is placed (under the muscle) and it is difficult to predict the final results. Although in my practice I often perform auto augmentation if I am not placing implants at the type of lifting, I do not perform both auto augmentation and placement of implants at the same time. I would recommend autoaugmentation first and consider fat grafting or implants at a later time in the future.

You would definitely benefit from a mastopexy to get better symmetry of the breasts and correct the breast sagging. The question of whether to proceed with implants or not depends on whether you like the size and shape of your anticipated breasts after a breast lift. An implant will add fullness and more cleavage to the breasts. Based on your photographs, you have enough breast tissue to make a full breast with a breast lift alone with a similar cup size. If you wanted to be larger, then an implant would be recommended. Your breast size may change after you lose weight, so I would recommend revisiting your breast plan once you reach your goal weight.

You seem to have good size breasts for your torso. A breast lift will correct size and asymmetry of breasts and areolas (small reduction of larger breast) and keep you within your current bra size, possibly slightly smaller. You can always do more (implant, fat grafting) if you are unhappy with your size. Both implants and fat grafting are viable options if you want to be bigger. Good luck.

hello, for you better to plan mastopexy with implant to have a not only the filled but also shaped marks. you have a breast asymmetry and may go with asymmetric implant with T scar operation plan.
best regards

Dear Fierce142281,
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 surgery, I would suggest you 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