One of my favorite operations in plastic surgery has always been Breast Reduction. It is the only operation I still do that is not purely cosmetic. It has been done for over 100 years, though techniques have changed.
I had always been very happy with my results, and still think my traditional breast reduction results compare to any I have seen. The one thing I did not like, and is a limitation in breast lifts as well, is the lack of fullness in the upper part of the breast to make it seem more full and youthful.
Patients come to me because they have very large and heavy breasts, and want to remove the extra weight, and lift them so they appear more attractive. What they want to look like is someone who had breast implants. That’s when I got inspired.
Why not do a breast reduction and put in an implant at the same time? Breast Reduction Augmentation- BRA. Of course, you need to be very careful technically to insure you preserve sensation and blood supply to the areaola and nipple.
I have performed the BRA about 30 times now, and have been more than thrilled with the results. Implant selection and care with the size is crucial. I hope to publish my series soon.
So, going smaller does not mean it is necessarily a reduction alone. Sometimes you need to go back a little farther to move ahead..