Can I get a breast lift without implants? [Austin Hayes, MD, Portland]

Dr. Hayes (00:00):
My name's Austin Hayes. I'm a plastic surgeon in Portland, Oregon.

Eva Sheie (00:04):
When you are seeking a breast lift but don't want implants, is there a range of size from small or, really what I'm looking for is how large could you be without, can anyone do this without implants?

Dr. Hayes (00:19):
The technique that I use, so I use a, it's called a superior medial pedicle or a superior pedicle. And so I have to remove some tissue, so automatically they're going to have to go down a little bit. And that's anywhere from on the low end, maybe like a quarter to a third of a cup. Sometimes it can be smaller if somebody starts with a small B, but let's pretend somebody starts with maybe a C cup. They would go down maybe a third to, yeah, a quarter to a third of a cup. And sometimes somebody with a larger breast would have to come down more. I feel like when I do a breast lift on somebody who has larger than a D, they will land somewhere in C D, as far as bra cup size. And I have some flexibility there, there's tissue that has to be removed for my technique to work, and then there's some tissue that's optional.

Dr. Hayes (01:08):
But if people want to be smaller than a C, I'm worried that that will, too much tissue will be removed and they'll risk perfusion to their nipple. And if they want to maintain more than about a D, that there will be too much tissue and they'll stretch and sag again. So usually I feel like C D is where I have to land them. That's the key is when somebody comes to see you for a breast lift or for any, yeah, for any breast lifting surgery, I would say, is figuring out what their goals are. And for people who desire a truly natural breast, they're probably a good breast lift or breast reduction candidate. For people who desire more fullness, a rounder look at the top, they probably need an implant. But if we take traditional breast lift and we take breast lifts where the fold is really secure, it creates more fullness.

Dr. Hayes (01:59):
Now, does it look like an implant? No. But does it look more full than a traditional breast lift? In my experience, it does. So you might take the person who assumed they were going to need an implant, and all of a sudden once their breast lift is done, they abort. They don't feel like they need it. And the other thing is when you sew the fold, the skin envelope is tighter. And so I think breast fat grafting works better. So they could always come back and be fat grafted later because the envelope is more taut. And so as you add fat, it kind of is, it's hard to describe, but essentially it's held in a better position and it's more impactful. The breast has a more kind of solid, it's like a more solid construct to fat graft into than a breast lift that hasn't been secured and is kind of settled and bottomed out. And so I think a double bra even improves the results of fat grafting. But the number of people who come back to get fat grafted, I don't think I fat grafted anyone yet after a double bra. So that's so far just a theory.

Eva Sheie (03:01):
Where can we find your Instagram? What's your handle?

Dr. Hayes (03:04):
At Dr. and then my name Austin, A-U-S-T-I-N. Hayes, H-A-Y-E-S. That's my Instagram. That's the best place to find me

Eva Sheie (03:12):
On this podcast, we bring you directly to the doctors who are, where before meets after. Links to our guest's website and contact info are in your show notes. Follow us on Instagram @wherebeforemeetsafter. Where Before Meets After is a production of The Axis, the podcast agency for aesthetics, theaxis.io.