In my Louisville Cosmetic Surgery practice I occasionally have a patient request a breast reduction with an implant placed. This really isn’t possible for a few reasons so I thought I would elaborate. After fielding this request several times, I asked why in the world someone would want to make their breasts smaller via the reduction then put an implant right back in. Seemed counter-intuitive. Well, what the patients were envisioning was having all of their breast tissue shelled out and then the skin tightened around the implant. The ultimate goal being a more firm, perkier breast.
It doesnt really work that way though.
When we do Breast Reductions we leave a central portion of the breast intact with the nipple attached to protect the blood supply to the nipple. Without adequate blood flow, the nipple dies. That is a bad thing. So we cant just shell everything out. If we then elevate the muscle to place an implant in behind, this can compromise the blood supply and result in a disaster. Also, it would be difficult to shape the breast.
Now, I can, after the breast is well healed, perform a breast augmentation behind a previously reduced breast to increase upper pole fullness. This isnt a very common request because the last thing most reduction patients want is to get that weight back on their chest but it has been done.
Lee Corbett, MD
