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Patient Details
This patient is now 7 years out from a combined breast reduction and augmentation—what I refer to as the BRA technique (Breast Reduction and Augmentation). It’s important to understand that this is fundamentally different from the more commonly performed “breast lift with implants.”
The traditional lift-with-implant approach attempts to elevate dense, sagging breast tissue. The problem is simple: heavy tissue tends to fall again over time. Gravity always wins.
My approach is different. Rather than trying to lift compromised tissue, I remove the sagging, low-quality breast tissue and rebuild the breast shape around an implant. The concept is straightforward—tissue that has been removed cannot sag in the future. What remains is a more stable, long-lasting breast shape that holds up better over time.
For patients, this translates into a breast that is more youthful in shape and structurally sound. Just as importantly, the final size is fully customizable. By controlling how much tissue is removed and selecting the appropriate implant, I can design both the shape and volume of the breast—rather than being limited by the patient’s existing anatomy.
In this particular case, the patient also had significant chest wall asymmetries and depressions. These were dramatically improved with careful implant selection and placement, further enhancing overall balance and contour.
The BRA technique is not widely offered. It requires a different way of thinking and a level of experience that many surgeons have not been exposed to, in part because it is not yet broadly embraced by the traditional plastic surgery community. As with many advancements in medicine, meaningful change takes time.
I have performed this procedure for over 20 years with consistently high patient satisfaction. For the right patient, it offers a powerful and lasting alternative to conventional breast lifting techniques.
