What are my options to create fullness after a Breast Reduction? (Photos)

Question

I had a breast reduction six months ago. I have lost all the fullness (due to initial swelling) on the upper breast area that was there. I was totally flat, almost 'caved in' looking before the surgery as well. My skin is not elastic. What are my options to create more fullness on top (maybe closer to what they looked like a few weeks after the surgery)? Are implants my only option? Are there any other methods (fat transfer etc) or is this as good as it's going to get for me...

Richard Baxter, MD · Answer

All breast lifts and reductions are prone to loss of fullness in the upper pole over time. An internal bra can be used to minimize this. A material called Galaflex mesh works well and we have been using it for a few years now with good success.

Daniel Barrett, MD · Answer

Dear starbuckslover87,if you want to achieve upper pole fullness, you might consider breast implants which should provide great results. If you want to avoid implants, then you can consider fat transfer but there are some limitations. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. You will get the best recommendations after a thorough examination.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. In comparing your pre-op photos, you certainly have a drastic improvement in your overall aesthetic. Unfortunately, often many breast reductions do settle over time and tend to take a more "natural" shape. You have some degree of pseudo-ptosis where the nipple position remains constant but the area between the nipple and fold stretches out. If this is not to your liking, you can consider tissue rearrangement with internal mesh support. This can be a natural way to maintain tissue support without an implant. But, an implant is also not a bad option if you want to be slightly larger and more full. Make sure you see your PS to discuss your concerns and your options.Best of luck!

Curtis Wong, MD · Answer

in that there is 'bottoming out' and loss of upper pole fullness.  You can correct this with a shortening of your lower pole with a transverse plication (utilizing your transverse scar if present) with possible fat grafting to the upper pole.  Implants are only needed if you wish to be significantly larger.  Realize that there are no results that are permanent and if someone suggests that they can achieve permanent, go for it BUT get it in writing and know what happens if your results sag again.

Emese Kalnoki, MD · Answer

Hello!  Overall, your postoperative outcome is very nice.  You actually have very elastic tissue as can be seen in your preoperative photos (your breasts are stretched and almost all of your breast tissue is located at the bottom of the breast creating a hollowed-out appearance of your upper chest).  So, this will cause your breasts to stretch and regain that type of shape after surgery.  A few things that you can do to try to regain more upper pole fullness are placement implants, fat grafting, or auto-augmentation to relocate some of your breast tissue from the bottom of your breast to the top of it.

If you want to have the same size and shape as when you were swollen, an implant is the best answer.  If you only want a small addition to your volume, than fat grafting can be done.  But, fat transfer can only increase the size of your breast by about 1 cup size unless you use a BRAVA system.  Auto-augmentation using the same tissue of your breast and rearranging it to fill out the upper pole will not add volume to the breast, but may add some fullness to the upper portion.

Overall, you have a very nice shape to your breasts after surgery.  Talk to your plastic surgeon about your options if you want more volume in the upper portion.  Good luck!

What are my options to create fullness after a Breast Reduction? (Photos)

Answers (5)

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