Which breast surgery is right for you? Explaining augmentations, lifts and reductions

Breasts come in a wide range of shapes and sizes – much like the women who have them. Body positivity aside, embracing what you have naturally isn't always easy. Whether it's feeling insecure about their breast shape, not liking the way shirts fit or breasts getting in the way of daily activities, chances are good that there s at least one aspect some women don't like about their chest.

Knowing what kind of procedure is needed for a specific situation can be the tricky part, especially for people who are new to the idea of plastic surgery.

Breast augmentation with implants

Statistics from the American Society of Plastic Surgeons (ASP) have shown that breast augmentation remains the most popular plastic surgery procedure. More than 300,000 women chose this surgery in 2018. If a woman's main goal for breast surgery is to enlarge her breasts, breast augmentation with saline or silicone implants may be the ideal solution.

There are many factors to consider, including the size, type and shape of the chosen implants, their position in the chest area (in front of the pectoral muscle, partially in front of the muscle or behind the muscle) and where the incision will be made. The plastic surgeon can help each woman make these decisions by assessing her body shape, lifestyle and overall goals.

Fat transfer breast augmentation

Traditional breast implants may not be the best solution for every person. Fat transfer breast augmentation (otherwise referred to as fat grafting, lipo-filling or living fat transfer) is typically a great choice for women who desire a subtle increase to their breast size of half a cup to one full cup.

Fat transfers make use of a popular form of fat reduction surgery known as tumescent liposuction to remove small amounts of fat from stubborn pockets on the body. This can be from the thighs, abdomen or flanks. The fat is then purified and carefully re-injected into the breasts in layers to sculpt the patient's requested shape.

Breast lift

Breast augmentations and fat transfers are useful for making the breasts larger, but what they can't do is correct issues related to drooping or sagging. Age, gravity, weight fluctuations and breastfeeding may cause the skin and tissue of once firm breasts to become stretched out, allowing the breasts to hang down instead of sitting high on the chest.

Women who have noticed that the skin of their breasts has a significant degree of laxity or that their nipples are pointing toward the floor and are positioned at or below the fold of the breast may want a breast lift. The surgery entails making an incision on the breast, shifting the position of fat and other tissues, cutting away excess skin and repositioning the nipple where necessary. While this is a reliably effective plastic surgery procedure, with results visible virtually as soon as the surgery is over, it does not prevent breasts from becoming saggy in the future if there are future weight fluctuations or further changes to the skin's elasticity.

Many women will choose to add volume to their breasts using either implants or their own fat as part of a lift procedure.

Breast reduction

Chronic back, shoulder or neck pain caused by larger, pendulous breasts is a problem faced by many women. Some women may wish to make their breasts smaller to relieve physical discomfort or to get them to look more proportional when compared to the rest of the body. A breast reduction, or reduction mammoplasty, consists of extracting excess fat, tissue and skin from the breasts via incisions, liposuction and the removal of other tissue.

Women considering any of these breast surgery options are encouraged to get answers to their questions and find out more about their procedure of choice by consulting with a board-certified plastic surgeon.

Next steps on your breast surgery journey

If you think any of these breast surgeries are right for you and you're ready to meet with a board-certified plastic surgeon for a consultation, be sure to use the ASPS Plastic Surgery Connect referral service to find an ASPS member surgeon in your area.