American Society of Plastic Surgeons
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Breast Augmentation

Previous reduction and need agsin

Hockeymom77 hoffman estates, IL
9 months ago

Hi... I had a breast reduction at age 18 in 1990. I’ve been happy until recently in my mid 40’s. I want a reduction with a possible small implant to give me some fullness up top. Overall, my breasts aren’t bad... they’re just too big! 2 baby’s and gravity... HELP!

After 28 years and 2 children, it is completely understandable that there have been significant changes in your breasts. Pregnancy causes enlargement of the breasts as you prepare to breast feed. Couple this with possible weight fluctuations as well as gravity and suddenly you are dealing with breasts that are too big, droopy, and lacking upper pole fullness despite a breast reduction 28 years ago. As you correctly mentioned, what you likely need is a breast lift with a small reduction and a simultaneous augmentation. This is possible, but it will be helpful if you could find the operative note from your original breast reduction so your surgeon can determine what technique was used. That might be tough considering your records from 28 years ago were probably legally destroyed. The most important aspect here is to make sure the surgery is well-planned and safe. Be sure to consult with an experienced surgeon comfortable with performing complicated breast revision surgery.

Karol Gutowski, MD, FACS Glenview, IL
9 months ago

Yes, in most cases a breast enhancement with implants for upper breast fullness and a breast lift/reduction can be done years after a breast reduction. The best way to find out is with an in person evaluation.

Debra Johnson, MD Sacramento, CA
9 months ago

Secondary breast reduction can be performed successfully. However, you are at a higher risk of wound healing problems (both wounds of the incision line, the nipple/areola, and internally in the breast tissue) due to poorer blood supply. Your previous surgery altered the pathways of blood flow. That's why Dr. Petrungaro suggested getting an operative report to determine how your prior surgery was performed. Depending on what your breast looks like and how much tissue needs to be removed, it might be possible to do the small reduction/lift plus an implant at the same time. However, a plastic surgeon might suggest doing it in two stages, since the augment will further reduce blood to the breast tissue. Seek out a board-certified plastic surgeon to determine the best and safest way to go.

Jon Ver Halen, MD Colleyville, TX
9 months ago

Dear Hockeymom77,

Hello and thank you for your excellent question. A lift with implants at this time in your life is a GREAT option for you! It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!

Daniel Allan, MD Las Cruces, NM
8 months ago

I think it is likely you could obtain the result you desire without an implant.

Richard Greco, MD Savannah, GA
8 months ago

Thanks for a great question. Plastic Surgeons are seeing more patients that have had previous surgery of the breast years ago - then have the changes of life - including pregnancy, weight gain, weight loss, and gravity - now want to have an improvement of their breast appearance.

You need an exam by a Plastic Surgeon with experience in these areas. Secondary breast reductions and lifts require knowledge of your previous surgery and the blood supply to your nipple areolar complex . Thee are many options to get the results you want - to include repeat lift alone, or repeat lift with fat grafting to the upper pole or with an implant.

It is common to seek a secondary breast reduction after the body changes from pregnancy, perimenopause, and weight fluctuations. If you are too large, I would not plan on an implant, but would look at breast reduction to reduce the size, improve the shape and lift the breasts. This must be done with careful attention to blood supply in view of your previous surgery. Best wishes to you, find an ASPS surgeon in your area for consultation.


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