Some ladies like them teardrop shape, some like them rounder. Their breasts that is. This is something I always ask my ladies when they are consulting for breast enhancement. The very young crowd seems to like them very round and high, my more mature ladies wants totally natural, teardrop shape.
Most ladies want some upper pole fullness when dreaming of the perfect breasts. Unfortunately, over time, the breast tissue and skin will stretch due to gravity, not to mention pregnancy and breast-feeding. Adding an implant alone will look great initially, yet, over time, this added weight will accelerate the sagginess due to gravity and the now less-elastic skin post pregnancy.
A breast lift will help in repositioning the Nipple-Areolar-Complex (NAC) to its youthful position and will restore for some time the upper pole fulness. That being said, despite all the gland remodelling and suspension techniques I perform, the breast tissue will always go down to some extent and reassume a more teardrop look, curse gravity for this.
For many this is the optimal “look”. Yet, I have about 40% of my patients asking for rounder upper poles, permanently so to speak. Not so natural, true, but desirable for many. The “push-up bra look”, without the bra.
An anatomical implant would defeat the purpose by adding more to the lower pole and less to the upper pole but adding a ROUND breast implant will definitively help in giving this upper pole a rounder fuller look and this is always considered and discussed in my office.
But what happens when a patient is happy with her current breast volume but wants a lift and more upper pole fullness?
This is when I discuss excising some breast tissue in the lower poles and adding a weight-comparable ROUND breast implant to replace the amount of tissue excised. This alleviates the heaviness and pull-down look of a heavy lower poles and adds to the upper pole, while preserving a similar volume as requested by my patients. In some cases, I may even suggest a larger reduction, again, to alleviate the overall weight in the breasts.
This is a common practice in Brazil that we discuss every September at the Sao Paulo Breast Symposium.
I have found over 17 years of practice, soon 18 years, that doing this technique of combining lower pole excision and adding a “compensatory” breast implant or adding fat grafting to the upper poles (and often the cleavage areas), proves to be a very gratifying procedures for my patients desiring upper pole fullness.
Dr. Marc DuPéré