37 years old - Will a lift with fat transfer help restore the lost volume and positioning of my breasts?

Question

Hello. I am a 37 year old female who had a 50 lb weight loss a few years ago, and gained 25 of it back over time. Between that, and having a child, my breasts are kind of deflated. They’re sagging, and the nipples are pointing more outward to the sides and downward than I’d like. I am a 36DD, and have no interest in being larger. Will a lift with fat transer help restore the lost volume and positioning of my breasts? I do not want implants. Thank you.

George Bitar, MD · Answer

I believe you have two choices.  First, you can have a breast lift done, preserving the volume that you already have, which may be enough because that volume that is spread over the chest and abdomen will be concentrated in just the breast.  That may create the look that you want.  The second choice is to have fat grafting either with the breast lift or to wait 6-12 months afterwards and then decide if you even need the volume that fat grafting may give you.  Without looking at your pictures, it is difficult to give you more specific advice.  If you decide to do fat grafting to the breast, seek a plastic surgeon who has good experience in that procedure.

Alan Gonzalez, MD, FACS · Answer

Hello @Lavender388, thank you for your question. A breast fat transfer or Lipotransfer can help a patient obtain a better breast shape. By transferring fat to the breast, the patient can achieve a more harmonious look with a better ratio between the size of the areola and the shape of the breast. There is typically minimal scarring associated with this procedure. If you are considering a breast Lipotransfer, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS

Miguel Mota, MD · Answer

Very good question. A lift with fat transfer could help. But fat transfers to the breasts don’t really fill out the breasts as much as most patients might think. If you want volume on your upper pole, a fat transfer wont really stay in that spot. Fat transfers to the breasts help in overall fullness but not on the upper pole. Plus, they tend to work less when combined with a lift.

Most importantly, many patients have enough breast tissue for it to be rearranged in order to fill out the breasts with a lift/reduction. We can use a flap of breast tissue almost like an implant. We lift the sagging tissue and fold it up and over. Then we suture it to the muscle as high as possible. I believe a 36DD, even if deflated, is big enough to have a good amount of tissue for this technique.

Because of your size and saggyness, I would recommend  researching this possibility rather then a fat transfer.

Best of luck,
Dr. Miguel Mota

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.

Daniel Barrett, MD · Answer

Dear Lavender388,
it is hard to tell for sure without an examination. 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

Connie Hiers, MD, FACS · Answer

It sounds that you need a lift. If you are already a DD, you do not need to add volume with fat. Fat is no substitute for the lift.  You might even consider a small reduction which includes the lift.

Douglas Taranow, DO, FACOS · Answer

If you do not desire larger breasts, do not consider either an implant nor fat transfer.  An anchor mastopexy should lift the breasts, give you more upper pole fullness and elevate your nipple/areola back up to the center of your breasts.
Dr. Taranow

Mats Hagstrom, MD (license on probation) · Answer

Without seeing pictures we can’t begin to make an assessment.
Fat transfer will only make your breasts slightly larger and will not contribute to shape or contour in any way. If you don’t want your breasts to be larger than having a fat transfer makes no sense.
It sounds like what you need is a breast lift with or without a reduction.
This will put the nipple and areola back where it belongs. It will however most likely leave the breast fairly flat without a lot of projection.
One option is to do a lift with the reduction and addition of an implant for the purpose of giving projection. This may sound counterintuitive but may be a viable option especially for patients with a history of substantial weight loss.
Some women have divergent nipples. Nipples should be placed on the center of the breast divergent or not.
I suggest scheduling a few in person consultations with local board-certified plastic surgeons. I’m sure any of them would be happy to walk you through the process.
From what you describe it down sound sound like fat transfer is something you need.
Best,
Mats Hagstrom MD

37 years old - Will a lift with fat transfer help restore the lost volume and positioning of my breasts?

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