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Will I need to have implants along with my breast reduction?

Q:

I went from a large B cup to a DD cup after having two children.  I want a breast reduction (I'm having back pain) but aesthetics are very important to me.  I want my breasts to be natural looking, not like beach balls, and to be perky.  Will a breast reduction alone be enough or will I also need implants?   I've heard reduction plus implants are difficult and risky.  Your thoughts please!

A:

If the goal is for you to have smaller breasts, then no, you do not need implants. Some women, requiring breast lifts may need an implant in order to have the upper pole fullness they had in their youth. With both breast lifts and breast reductions, the goal is to make the breasts youthful looking with upper pole fullness.

This need for increasing upper pole fullness can be accomplished in one of two ways: by using the patient's own lower pole breast tissue (auto-augmentation mastopexy) or by placing a breast implant. Auto-augmentation mastopexy is a surgery in which some of the patient's own lower tissue (from the area of the breast below the nipple/areola complex) is moved into the upper pole of the breast. A pocket is created behind the upper pole of the breast and the lower pole tissue is advanced, with its blood supply intact, into the upper pole pocket. This truly remarkable procedure can create a mastopexy appearance that previously has only been possible by means of breast implant placement.

M.M. Law, MD

A:

You may be confusing Mastopexy or lift and implants with what you want. The only way you could need breast implants at the time of a breast reduction is if your surgeon removed too much breast tissue. This is extremely unlikely with an experienced Plastic Surgeon. Implants add volume, whereas a reduction makes you smaller and lifts and reshapes your breasts to make you perkier.

R.T. Buchanan, MD

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