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Can a breast lift make my breasts appear larger or smaller?
After a mastopexy my patients frequently say that they feel their breasts are one cup size smaller. When you have more skin, the breast lays in your bra loosely and makes it look like it is bigger. You can see this yourself by pulling your breast tissue closer and higher to your chest and look at your size. Frequently you need to remove some of the breast tissue at 6 o'clock as it is out of place and the skin will not hold it up. Removing some of this breast tissue makes it a bit smaller also.
A breast lift will make your breasts look neither larger nor smaller, only perkier. They will be essentially the same size also since the only thing removed is a small amount of skin. It will frequently make the superior pole of the breasts look fuller.
A breast lift might make your breasts “look” smaller. The reality is that the actual size of the breasts changes minimally from a breast lift. No breast tissue is usually removed and the amount of skin that is removed doesn’t contribute much to the total volume. There may be a visual illusion when you’re without a top on that the breasts have gotten smaller. The reason is this: You’re used to looking at the breasts in a mirror. You see the long vertical distance from the sag and the width from the flatness. After the lift, the breast tissue is raised on the chest wall and shaped more into a cone. In the mirror, the breast doesn’t hang as low and is not as broad. What has happened, that you cannot see in the mirror or in a two dimensional picture, is the increase in projection (perkiness). So the actual volume is about the same but because it is not as broad, long and flat, it might “look” a little smaller.
A.: A breast lift might make your breasts “look” smaller because the preoperative drooping of the lower portion of the breast is improved and the breasts fit differently in a bra. Generally, no breast tissue is removed during a breast lift, only the excess skin, so the breast is actually the same volume after surgery, but has an improved shape. The actual volume is about the same, since the skin adds very little volume to the breast, however the breast may seem to be smaller because it is not as wide and not as sagging at the bottom.
I would suggest that you see a plastic surgeon that you are comfortable with and trust. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California