Which is better for going from DDD to C-Cup: Breast lift with implants or reduction with implants? (photos)

Question

I am currently a DDD I want to be smaller like a C cup if possible I have 350cc in one breast and I think 450 in other . I have a lot of tissue but I want to be as small as possible. is this possible with just a lift and implant or will I need a reduction? also if that size is not attainable - how much cup size can I decrease. Will I have to have surgery in two phases like lift /reduction done first then implant placed

Finny George, MD · Answer

Hi, thank you for sharing your question. Removing a large implant will likely require some element of volume replacement with another smaller implant along with a lift procedure to correct the sagging.

Leila Kasrai, MD, FRCSC · Answer

If you’d like to reduce the size of your breasts, you can just get a lift. Excess tissue can be removed from the larger breast in order to match the size of the smaller one. Implants would not be necessary. The procedure can be in a single phase.

Gary M. Horndeski, MD · Answer

The technique I recommend is explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated 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, if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

The simplest thing would be to revise the lift and remove the implants. You can always have implants placed later if you think you need them.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. A large portion of my practice is dedicated to revisionary breast surgery Over many years, I developed a technique called "Reductive Augmentation" in which an internal bra-capsulorrhaphy, mastopexy - lift, and removal of inferior pole breast tissue is performed. This procedure is particularly suitable for patients who would like a smaller, more round appearing breast, and upper pole fullness. I have treated many patients with very similar breast issues as yours. I published this technique in the International Journal of Aesthetic Surgery in 2017. Best wishes to you,

Michele A. Shermak, MD · Answer

This is an excellent question.
If you want to come down from a DDD to a C, typically the answer would be a straight up breast reduction. You should be able to get to a C cup with a reduction; however with reduction you will not get cleavage fullness. The breasts settle without an implant. If you are looking for a youthful upper breast with cleavage, then you could pair a reduction with an implant, called "addition/subtraction." And you can certainly do that in a single stage. Some surgeons like the better predictability and lower risk of 2 stage, but most patients are interested in single stage and that is done most of the time, understanding revisions/tweaks may be needed in the future.
Be sure to see a board certified plastic surgeon. Check the reviews and photo gallery, as well as credentials.

Ram Kalus, MD, FACS · Answer

Thank you for your question and photos. In order to properly evaluate you it would be required to evaluate you in person. That said, if you wish to be “as small as possible” you may not need implants at all. To achieve optimal symmetry without implants you would need both breasts lifted, and your larger breast reduced to match your smaller breast. Without implants you may have less upper pole fullness than you wish, but your breasts would appear natural.

Please consult with an experienced board certified plastic surgeon whose aesthetics align with your own based on his or her Before and After gallery. Best of luck to you.

Please consult with an experienced board certified plastic surgeon whose aesthetics align with your own based on his or her Before and After gallery. Best of luck to you.

Daniel Barrett, MD · Answer

Dear Nkas954,
it is hard to tell for sure without an examination. Based on your photo, it looks like you might get good results from smaller implants and probably breast lift. If you are considering a surgery, I would suggest you to 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

Donald R. Revis Jr, MD · Answer

Good afternoon,
I would recommend an explant, a drain in the pockets for five days, and a lift- it is unlikely you will need significant tissues reduction to achieve a nice, smaller result. However, since you know your breast tissue is not equal and symmetric, there may need to be a small amount of tissue removed from the breast with the smaller implant to make things nice and even!

Connie Hiers, MD, FACS · Answer

You might consider removing your implants and doing a lift. The larger breast might need a small reduction or the smaller breast might need a small implant to keep you even. An examination is needed to be sure, and needed to see if everything can be done at the same time, or in two procedures.

Which is better for going from DDD to C-Cup: Breast lift with implants or reduction with implants? (photos)

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