Breast Auto Augmentation

Breast auto-augmentation uses a woman's own breast tissue — not implants — to optimize breast shape and projection. Additionally, it incorporates breast lift (mastopexy) techniques to correct any sagging in the breasts and remove excess skin. The procedure is also referred to as breast lift with auto augmentation or breast augmentation-mastopexy because it augments and lifts the breasts.

So just how does a surgeon do all this without breast implants?

Breast Auto-Augmentation: The Procedure

Breast auto-augmentation is performed under light sleep sedation or general anesthesia as an outpatient procedure. It takes approximately two to four hours to perform.

Techniques may vary from surgeon to surgeon, but typically the surgery begins with a modified "lollipop lift" incision that runs around the perimeter of the areola (the colored area around your nipple) and then vertically down from the bottom of the areola to the breast crease.

The surgeon identifies the breast tissue, or gland, in the lower area of the breast that is to become the "implant" and prepares it to be moved. The lower end of the gland remains attached to preserve the blood supply. The rest is rotated and repositioned to the upper pole of the breast (between the collar bone and nipple), where it is attached to the chest wall and surrounding upper breast tissue.

The surgeon completes the breast lift portion of the procedure by relocating the nipple and areola to a new, higher position, removing the excess skin and suturing the incision closed.

Candidates for Breast Auto-Augmentation

While breast auto-augmentation has a lot to offer women who are interested in higher, fuller breasts, the procedure is not for everyone. The best candidates for breast auto-augmentation are women who are basically happy with their breast volume, but would like to correct sagging and add fullness without using saline or silicone breast implants.

A board-certified plastic surgeon with experience performing breast auto-augmentation can evaluate you as a candidate for this procedure. First, he or she will determine your degree of breast sagging (ptosis), which can occur as a result of pregnancy and/or breastfeeding, massive weight loss through diet or bariatric surgery, and the natural aging process.

The surgeon will also discuss with you how you feel about breast implants. Many types of saline and silicone implants are now available, and there are a variety of incision techniques and placement options to choose from. However, some women simply prefer not to go the implant route, and they're not interested in fat grafting to the breast. If they have adequate existing breast tissue to provide the fuller contours they are seeking, breast auto-augmentation may be an option.

A Word from Our Executive Medical Advisor, Walter Erhardt, MD

Some plastic surgeons might consider breast auto augmentation as simply a variation of a breast lift. After all, the patient's breast tissue is being lifted up — as is typical for a breast lift — and arranged in a manner to give the maximal amount of projection. For this procedure to work effectively, a woman must have enough breast volume to create the desired augmentation. However, too much volume to be supported adequately by the breast tissues may result in premature sagging. This specific operation seems best suited to women who have lost a significant amount of weight and appear to have rather deflated breasts. When these breasts are consolidated and lifted, frequently there is enough tissue available to create a nicely shaped breast without the need for an implant. Breast auto augmentation can be effective, but you must also be willing to accept the tradeoffs and scars associated with a breast lift or mastopexy.

The surgeon will also evaluate your general health to determine if you are a viable surgical candidate. He or she will ask about your medical history, including your experience with other surgeries and anesthesia, and about any chronic diseases you may have, including diabetes, asthma, and cardiovascular disease. You may also be asked about any medications (over-the-counter and prescription) and supplements you take on a regular basis. Be honest when answering these questions.

Additionally, during your consultation with the surgeon you should also be upfront about the results you hope to obtain from this surgery. Be specific about what you do and don't like about your breasts and how you hope to improve them. Then listen carefully to the surgeon's comments and rely on his or her expertise to guide your decision. It's very important that you and your surgeon are "on the same page."

The Recovery Process

Recovery from breast auto-augmentation is similar to that of breast lift recovery and other breast surgeries.

When you wake up from surgery, your breasts will be swollen, bruised and covered with gauze dressings and a supportive compression garment. There may also be drains to help get rid of excess fluids. You will be uncomfortable for several days and your breasts may be temporarily numb. You can shower immediately after surgery, but you may require some assistance. Use the pain medication and antibiotics prescribed by your surgeon as directed to stay ahead of any discomfort and complications that may develop. Report any postsurgical issues to your surgeon immediately.

Your surgical dressings will be changed at your first postoperative visit, usually within a few days after surgery. If you have surgical drains, they may come out at this visit, too. The stitches will dissolve on their own. Your surgeon will tell you when you can exchange the compression garment for a soft support bra.

Restrict your activities during recovery as directed by your surgeon to avoid complications. Generally this means no bending, lifting or straining for several weeks, so you may want to arrange for someone to help you around the house during that time. You may also be directed to sleep with your head and torso elevated. Two or three pillows or a wedge-shaped pillow should do the trick.

You should be able to return to work after about a week if you have a sedentary job; if your job is more physical, it may take longer.

Swelling, bruising and tenderness should abate within a month, but it takes about six months for your scars to fade and for the full results of your breast lift to emerge. During this time you may want to use scar-minimizing products, including silicone sheeting and creams, to improve their appearance. Ask your surgeon which products — if any — he or she recommends.

The Risks of Breast Auto-Augmentation Surgery

The risks associated with breast auto-augmentation include anesthesia complications, loss of sensation in the breast (usually temporary), hematoma (a pooling of blood under the skin that may form a clot), seroma (collection of fluid under the skin), infection, wound separation, scarring, asymmetry and general dissatisfaction with the results.