Will I have fullness after a breast reduction?

Posted on March 26, 2010

No, this is not a ridiculous question.

Large breasted women have been blessed.  Too blessed.  I know I know. Those of us who do breast reductions should be shot, incarcerated, taken to a small island in the middle of the sea.  But large breasts are heavy, unweildy, and cause back pain.  Not to mention the bras you need look like Fort Knox.

The question about fullness after breast reduction is a valid one.

When you remove breast tissue and lift the breast, it changes the shape and firmness.  When a woman comes in wanting smaller breasts, the idea of smaller is good, but they worry.  Large breasted women are used to the fullness and proportion large breasts give.  Your belly doesn’t look so big when your breasts are bigger.

Now lets be honest.  When you are large breasted, you are big, and may pop out of a bra, but you likely don’t have a lot of fullness in the upper area.  When you are naked,  the cleavage area (what we call the “upper pole” ) is the first place to flatten out as the breast migrates south.

When I reduce and lift the breast I try to get as much fullness in that area as I can.  I like the vertical breast lift.  I think it reshapes and cones the breast better.  The breast will feel more firm. Immediately after surgery my patients look fantastic.  Unfortunately it will settle (I warn you about this so you won’t be shocked), but people settle differently.  The more breast tissue (not fat) you have, the better you support the tissue after (good bras), being at your ideal weight prior to surgery (weight loss usually loosens things up so you droop), and not stressing them out (jogging, babies, breast feeding) are important.

I find everyone gets good projection and roundness, but the upper cleavage area is tougher.  Don’t get me wrong- you’ll look good in a bra, but naked you may have less there than you’d like.  For this reason you will hear doctors advocate doing an implant.  I am happy with the shaping I get with a vertical breast lift and tend to steer away from implants. Why? Implants add volume.  Implants add weight.  There are issues with implants over time: hardening, migration,deflation, and infection.  Implants don’t age with time and gravity like natural tissue does, which can be an issue for larger breasted women who have a fair amount of natural tissue (it’s not so pretty when the natural tissue droops but the implant has not).  So in general, if you do a lift with an implant,  you must expect you will do a second surgery at some point.

So if you do a reduction (with no implant), you will be full. And firm. And rounder. And lifted.  What you have is better.  It is all natural.  And all yours.