My patients that want to get perky breasts make an consultation for a number of different reasons. Most commonly, empty, low, and saggy breast shape is the result of pregnancy and breastfeeding. More recently I am seeing more and more women with the same concerns who have lost significant weight following diets, exercise regimes or bariatric weight loss surgery. Patients also present with breast asymmetry, where one breast is smaller or shaped differently to its opposite.


The key question for patients to consider is, are you happy with your current breast size? If you wear a well fitted bra and are content with your cup size then a breast lift (mastopexy) alone will be the operation of choice for you. If you are smaller than you desire then you may need one of the following two options.


If you have minimal droop and want a lift and a moderate to large increase in breast size then you maybe a candidate for an augmentation alone, as the moderate to large breast implant will give a small degree of lift as it fills out the loose breast skin.


If you have moderate to significant droop and want a larger bust then it is likely you will need some form of breast augmentation. Traditionally, augmentation has been performed using implants. Most often the lift and the augmentation can be performed at the same time, this is known as a breast augmentation mastopexy. Sometimes the two portions are too significant for one surgery and the lift and augmentation need to be staged 3-6 months apart.


More recent developments allow a lift with augmentation using the patient’s own tissue rather then implants. Some women only need a small augmentation and these patients maybe suitable for autologous fat transfer, in this process the fat is liposuctioned from the tummy or hips and then injected into the breast tissue.  Other patients that have lost a lot of weight often have a fold of excess skin and fat to the side of their breasts. This tissue can be harvested and shaped under the breast tissue to provide enough volume for their augmentation. By using their own tissue the patient gains a result that is totally natural.


Every patient is different in their desires and these need to be well matched to their physical characteristics and the surgical options mentioned above. I would advise you to seek a consultation with a plastic surgeon experienced in breast surgery, they will guide you through your options to get the best possible breast lift.


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