A breast reduction with lift surgery combines two procedures to improve the size and shape of the breasts. A reduction involves decreasing the size of overly large breasts by removing excess tissue and skin. A breast lift is done in order to raise and reshape the breasts. The breast reduction and lift procedure helps to alleviate problems caused by overly large, sagging breasts, including:
Prepectoral or subcutaneous: in a breast reconstruction following a skin-sparing or skin- and nipple-sparing mastectomy, the implant is placed above the pectoralis major muscle without dissecting it so that the implant fills directly the volume of the mammary gland that has been removed. To avoid the issue of capsular contracture, the implant is often covered frontally or completely with a mesh in biomaterial, either biological or synthetic.
One advantage of liposuction is that it won’t give you scars or loss of nipple sensation. Women who are in their menopausal years are the best candidates for liposuction because the fat content of the breasts increases during these years. Your skin has to have excellent elasticity for liposuction to work well. You also have to have a normally positioned nipple.
Breast implants are available in two basic shapes: round and contoured. Contoured implants were originally designed to be used for breast reconstruction, but are now used for cosmetic breast augmentation as well. Contoured implants are shaped like a teardrop to simulate the natural shape of the breast and are made with a textured surface to help prevent movement or rotation. Round implants can also be used to create a very natural appearance, especially when placed under the muscle.

Now, there is also the of a capsular contracture. A capsular contracture simply means that when you put an implant in a human body, your immune system or your body will recognize the implant as foreign. This is one of the main reasons the implant envelope is made from silicone and no other materials like rubber, plastic, etc. because silicone is the most medically inert substance known to man. Silicone is the least offensive material to your immune system, so your immune system is likely to detect it and say OK yes this is something foreign, but it’s not aggressive so it’s not any threat to us. Therefore, what your body will do is form a capsule around the implant, and that’s the end of the immune response.

I care about you and your concerns very much. Please call me at any time you have any questions about your breast lift or breast reduction surgery. Call if you have any excessive swelling, bleeding, soreness, fever, chills redness, or unusual wound drainage. It is particularly important if symptoms are present on only one side. During office hours (8:30AM to 4:30PM, Monday through Friday), call 952.449.4900 and we will answer your questions.  If the concern is not urgent and is able to wait until the next business day, you may leave a message at 952.449.4900 after hours or on weekends.

Meeting with multiple prospective surgeons is also a great way to make your choice. Make sure you are comfortable speaking to the surgeon, and make sure he or she asks you plenty of questions, and does not rush you through any part of the consultation. After you have fully described your goals, the surgeon should provide you with informative, thoroughly explained options.


Transumbilical: a trans-umbilical breast augmentation (TUBA) is a less common implant-device emplacement technique wherein the incision is at the umbilicus (navel), and the dissection tunnels superiorly, up towards the bust. The TUBA approach allows emplacing the breast implants without producing visible scars upon the breast proper; but makes appropriate dissection and device-emplacement more technically difficult. A TUBA procedure is performed bluntly—without the endoscope's visual assistance—and is not appropriate for emplacing (pre-filled) silicone-gel implants, because of the great potential for damaging the elastomer silicone shell of the breast implant during its manual insertion through the short (~2.0 cm) incision at the navel, and because pre-filled silicone gel implants are incompressible, and cannot be inserted through so small an incision.[75]
Thoroughly research surgeons who meet certain criteria before settling on one. First, make sure the surgeon is certified from the American Board of Plastic Surgery. Be wary of other “boards” that are not legitimate. Your doctor should also be a member of the American Society of Plastic Surgeons and American Society for Aesthetic Plastic Surgery, both of which have a very high standard of criteria and maintenance. Then make sure that the surgeon has experience in the type of surgery you’re wanting. Ask to see a body of their work and before-and-after photos. Speak to other patients. Schedule a consultation and get a feel for the surgeon’s approach.

While more experienced surgeons may charge more for their expertise, that’s not always the case. “You should not choose a qualified surgeon based on high fees any more than you should choose one based on low fees,” says Boca Raton, Florida plastic surgeon Dr. Hilton Becker in a RealSelf Q&A. “The most important factors should be education, experience, certification, and your ability to feel comfortable with your surgeon.”


In the mid-twentieth century, Morton I. Berson, in 1945, and Jacques Maliniac, in 1950, each performed flap-based breast augmentations by rotating the patient's chest wall tissue into the breast to increase its volume. Furthermore, throughout the 1950s and the 1960s, plastic surgeons used synthetic fillers—including silicone injections received by some 50,000 women, from which developed silicone granulomas and breast hardening that required treatment by mastectomy.[112] In 1961, the American plastic surgeons Thomas Cronin and Frank Gerow, and the Dow Corning Corporation, developed the first silicone breast prosthesis, filled with silicone gel; in due course, the first augmentation mammoplasty was performed in 1962 using the Cronin–Gerow Implant, prosthesis model 1963. In 1964, the French company Laboratoires Arion developed and manufactured the saline breast implant, filled with saline solution, and then introduced for use as a medical device in 1964.[88]
At the initial consultation, your plastic surgeon will discuss his or her ideas on how the procedure will be done as well as what type of results you can expect. He or she should have a large book of before and after photos that you can spend time looking at. When looking at these, consider the height, weight and build of the person in the photos and whether it matches yours or not. If it matches your specs, then it’s more likely you could have similar results.
Procedures that advertise using fat from liposuction and re-injecting it into the breast, also called fat grafts, are still considered surgical procedures, explains Dr. Doft. While it might be tempting to consider because it seems less invasive than a traditional boob job, the results are also harder to predict. Dr. Doft says: “Thirty to 50 percent of the fat will not survive. It is also not possible to know which fat will and will not survive, which may alter your results.”
The woman wanting a lift is usually slightly different. She had breasts she was happy with before, she had loving kids who she may or may not have breastfed, exercised and had a good life. They come wanting to restore the youthful breast they once they had(or better), they hate that it is slightly more deflated than before and it's slightly more south then they'd like. The formal name of this operation is "Mastopexy" and that's why you hear terms like "Mastopexy augmentation" because often in order to restore the youthfulness of the breast you not only need to reposition the nipple/areolar complex "up" with a mastopexy, you also need to provide some additional volume with an implant, hence augmentation as well. The discussion with implant also is entirely different discussion all together, but this highlights the primary difference in the reduction and a lift.
In 1988, twenty-six years after the 1962 introduction of breast implants filled with silicone gel, the U.S. Food and Drug Administration (FDA) investigated breast implant failures and the subsequent complications, and re-classified breast implant devices as Class III medical devices, and required from manufacturers the documentary data substantiating the safety and efficacy of their breast implant devices.[113] In 1992, the FDA placed silicone-gel breast implants in moratorium in the U.S., because there was “inadequate information to demonstrate that breast implants were safe and effective”. Nonetheless, medical access to silicone-gel breast implant devices continued for clinical studies of post-mastectomy breast reconstruction, the correction of congenital deformities, and the replacement of ruptured silicone-gel implants. The FDA required from the manufacturers the clinical trial data, and permitted their providing breast implants to the breast augmentation patients for the statistical studies required by the U.S. Food and Drug Administration.[113] In mid–1992, the FDA approved an adjunct study protocol for silicone-gel filled implants for breast reconstruction patients, and for revision-surgery patients. Also in 1992, the Dow Corning Corporation, a silicone products and breast implant manufacturer, announced the discontinuation of five implant-grade silicones, but would continue producing 45 other, medical-grade, silicone materials—three years later, in 1995, the Dow Corning Corporation went bankrupt when it faced large class action lawsuits claiming a variety of illnesses.[113]
The ‘gummy bear’ implant comes in both round and teardrop shapes. They have a firmer gel, which may give a better shape and may last longer. The round gummy bear implant is often a good choice for women with looser tissues and who want a more durable implant that remains soft. The teardrop shaped gummy bear implant may be a good choice for women whose tissues are relatively tight and desire a very proportionate and natural looking enhancement with less fullness of the upper portion of the breast and more projection and fullness of the lower portion of the breast.
A breast reduction typically includes a lift.  However, a lift does not necessarily require a reduction.  Both operations have similar incision patterns and resultant scars, but they have different indications.  One of the first questions I ask a patient who desires an improved appearance of her breasts is if she would like to be the same size, smaller, or larger.  The patient who wants to be the same size and is happy with her breasts when wearing a bra but unhappy with the amount of sagging without a bra is a candidate for a breast lift alone.  The patient who desires to be smaller or has one breast noticeably larger than the other, is a candidate for a breast reduction-lift combination.  Sometimes patients feel their breasts look smaller after removal of the excess skin with the lift even though no breast tissue was removed; the reason for this is that some of what fills your bra cup is excess skin.  The patient with sagging who desires to have larger breasts is a candidate for a breast lift with implants.

There are two types of breast implants approved by the Food and Drug Administration (FDA): silicone-filled and saline-filled. They come in various sizes and shapes, and with two types of shells: textured shells and smooth shells. A type of silicone-filled implant with a thicker filling, called a form-stable highly cohesive implant, or "gummy bear" breast implant, is currently under investigation and may one day provide another option for women undergoing breast augmentation with implants.


The cause of capsular contracture is unknown, but the common incidence factors include bacterial contamination, device-shell rupture, filler leakage, and hematoma. The surgical implantation procedures that have reduced the incidence of capsular contracture include submuscular emplacement, the use of breast implants with a textured surface (polyurethane-coated);[55][56][57] limited pre-operative handling of the implants, limited contact with the chest skin of the implant pocket before the emplacement of the breast implant, and irrigation of the recipient site with triple-antibiotic solutions.[58][59]
Breast implants are available in two basic shapes: round and contoured. Contoured implants were originally designed to be used for breast reconstruction, but are now used for cosmetic breast augmentation as well. Contoured implants are shaped like a teardrop to simulate the natural shape of the breast and are made with a textured surface to help prevent movement or rotation. Round implants can also be used to create a very natural appearance, especially when placed under the muscle.

Placing the breast implants on top of the muscle, which has been the traditional procedure, can result in a slightly higher risk of contraction. This issue is a cosmetic problem, rather than a medical or health issue. Gel/Silicone implants have been placed both above and below the muscle without a significant difference in the rates of having contraction.


In 2008, the longitudinal study Excess Mortality from Suicide and other External Causes of Death Among Women with Cosmetic Breast Implants (2007), reported that women who sought breast implants are almost 3 times as likely to commit suicide as are women who have not sought breast implants. Compared to the standard suicide-rate for women of the general populace, the suicide-rate for women with augmented breasts remained constant until 10-years post-implantation, yet, it increased to 4.5 times greater at the 11-year mark, and so remained until the 19-year mark, when it increased to 6 times greater at 20-years post-implantation. Moreover, additional to the suicide-risk, women with breast implants also faced a trebled death-risk from alcoholism and the abuse of prescription and recreational drugs.[12][13] Although seven studies have statistically connected a woman's breast augmentation to a greater suicide-rate, the research indicates that breast augmentation surgery does not increase the death rate; and that, in the first instance, it is the psychopathologically-inclined woman who is more likely to undergo a breast augmentation procedure.[14][15][16][17][18][19]
One of the biggest factors affecting the total cost is if you need to have a second surgery. Because your nose swells during the operation, the surgeon may get a false impression of the final shape of your nose. As the swelling goes down, it may become apparent that a second surgery is necessary to achieve the look you want. Approximately 15 percent of rhinoplasty surgeries require a second surgery.
Adam R. Kolker, MD, explains: Although silicone breasts feel similar to real breasts, they are still man-made and don’t feel like natural breast tissue. You’ll be more likely to notice there’s an implant in a woman who began with little breast tissue than a woman who had more breast tissue to begin with. Smaller implants and those that are placed below the muscle are harder to detect.
I never expected such amazing results. The cost and recovery time was completely worth it. My doctor was very honest and informed me that it is pretty much impossible to have perfectly symmetrical breasts. However he proved himself wrong, my breasts are completely even and look as if they have never been touched. He went through my nipples so there is no scarring whatsoever. It was a perfect procedure.

Please call the office between 8:30AM and 4:30PM during the workweek to make arrangements for me to see you one week after your surgery. Please call for appointments for follow up visits at six weeks, six months, and twelve months. The reason for this extended care is because it takes six months to one year for complete healing to occur. There are no charges for any of your aftercare office visits. It would be my pleasure to see you at any time to answer any questions about your breast surgery or any other cosmetic surgery you read or hear about. Finally, please mention me to you family and friends when they bring up the topic of cosmetic surgery or therapeutic injections. It has been my pleasure helping you through this cosmetic surgery experience!
If you feel your breasts are too large or heavy for the size of your body, you may be a good candidate for breast reduction surgery. For many woman, reducing the size of overly large breasts not only increases their self-confidence but provides relief from physical issues such as shoulder, back and neck pain which oftentimes interfere with normal everyday activities.
Traveling long distances or for long periods of time can be problematic after surgery. Generally, I do not recommend traveling longer than one hour for one week after surgery. When you do travel you must have help at all times with your baggage (do not lift more than five pounds for three weeks) and you must get out of your seat and walk for five minutes every hour. Remember, even small vibrations during travel can increase the amount of pain you experience. Finally, you will not have the same energy level as you did immediately before your surgery.

The current lifetime risk of BIA-ALCL in the U.S. is unknown, but estimates have ranged between estimated to be between 1 in 70,000 to 1 in 500,000 women with breast implants according to MD Anderson.[73] Certain geographic locations have demonstrated variable risks. For instance, a December 2016 update from the Therapeutic Goods Administration of Australia and New Zealand reported a risk of 1:1,000 to 1:10,000 for textured implants.".[71] To date (2017), there has not been a case of BIAL reported where the patient had only implantation of smooth shell breast implants or a textured tissue expander that was exchanged for a smooth implant. The paucity of cases reported in Asian populations has raised the possibility that there may be a range of genetic susceptibility to the phenomena, or alternatively merely reflect differences in how cases are identified and reported.
Disclaimer: Please note, any information on this page is provided to you for educational and/or informational purposes only, and should not be construed as an endorsement of any particular procedure, product or treatment. This information is also not a substitute for medical advice, diagnosis, or treatment by a doctor or other qualified health care professional. For medical concerns, including decisions about any procedure, product or treatment, visitors should always consult with their doctor or other qualified health care professional.
The human body's immune response to a surgically installed foreign object—breast implant, cardiac pacemaker, orthopedic prosthesis—is to encapsulate it with scar tissue capsules of tightly woven collagen fibers, in order to maintain the integrity of the body by isolating the foreign object, and so tolerate its presence. Capsular contracture—which should be distinguished from normal capsular tissue—occurs when the collagen-fiber capsule thickens and compresses the breast implant; it is a painful complication that might distort either the breast implant, or the breast, or both.
Dr. Larry Fan is a Harvard educated, Board Certified Plastic Surgeon in San Francisco, CA. He is a Master Artist who is known for creating beautiful, stunning, and natural results. Dr. Fan has been named One of America's Top Plastic Surgeons for the past 10 years running and has received several national awards for his work in Plastic Surgery. He has successfully performed more than 10,000 cosmetic procedures of the face, breasts, and body over a 20 year period. Dr Fan has been an invited speaker at the American Society of Plastic Surgeons and the American College of Surgeons, and has been featured in national media outlets such as CNN, NBC, and ABC.
A breast lift, also known as a mastopexy, is most beneficial for women who have sagging breasts. This type of procedure reshapes and supports the breast tissue to achieve a more youthful figure. It also helps restore the shape and volume that may have been lost due to age, weight loss or breastfeeding. Because a breast lift repositions the location of the breasts, they can appear smaller. However, only excess skin is removed, not the actual breast tissue. Often with breast lifts, the nipple and areolas are repositioned and reduced in size to create a more natural look.
Hello and thanks for your post and questions. It seems that you would potentially be a fantastic candidate to have a breast reduction and lift using the Bellesoma technique with NO vertical scar! With this technique you should be able to reach a smaller,  but perky and proportional breast size that fits your frame along with achieving upper pole fullness. You've provided great information - the only thing that would be more helpful in order to give you the best advice about your options would be an in-person exam.
If you’re hoping your breast implants will be covered by insurance because of something like asymmetry or changes after pregnancy, you probably need to explore other financing options. Breast implants are considered cosmetic surgery, so insurance companies typically won’t cover them. However, “Breast Implants are covered if they are being used as part of reconstruction after breast cancer or mastectomy,” says Houston plastic surgeon Dr. C. Bob Basu in a RealSelf Q&A.
“Insurance will typically cover procedures to help improve nasal function (i.e. septoplasty, nasal valve repair, turbinate reduction),” says Dr. Sam Naficy, a Seattle facial plastic surgeon, in a RealSelf Q&A. “The extent of coverage varies based on the details of the insurance plan. Insurance will not cover procedures that improve the appearance of the nose but are not necessary to improve nasal function.”
When it comes to determining the prominence and size to utilize for the breast augmentation, the first step is to determine what are your goals/desires for the end result. Once you have decided on what you would like the final result to look like, the surgeon will make recommendations and suggestions based on your body type and build as to what they know will be able to achieve your goal, or get you as close to them as safely possible. An individual may want a specific size, but the surgeon will be able to tell if that is a realistic option for that individual or not. For example, if the patient’s chest is small and the breast tissue is tight, it will not be recommended to use a large implant as it will not fit. This is why a surgeon with clinical experience is beneficial, because they will be able to help you understand and guide you towards the best implant for your body. It is not uncommon for patients to become focused on details such as the actual volume of CC’s, however, you need to keep in mind that there are many varying factors that have to be considered by the surgeon when recommending the best implant for your body so try not to get too caught up in those details and trust your surgeon.
A breast lift, also known as a mastopexy, is most beneficial for women who have sagging breasts. This type of procedure reshapes and supports the breast tissue to achieve a more youthful figure. It also helps restore the shape and volume that may have been lost due to age, weight loss or breastfeeding. Because a breast lift repositions the location of the breasts, they can appear smaller. However, only excess skin is removed, not the actual breast tissue. Often with breast lifts, the nipple and areolas are repositioned and reduced in size to create a more natural look.
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