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Surgical Options for a Fuller Upper Pole – Breast Augmentation

When considering breast aesthetics, upper pole fullness plays an important. In clinical terms, the “upper pole” refers to the upper portion of the breast, the area that extends above the nipple line. This region contributes significantly to the overall shape, projection, and perceived perkiness of the breasts. A well-defined and adequately volumised upper creates a gentle slope and a natural fullness that complements the contours of the chest. However, many women experience a loss of volume in this area due to various factors, leading to a flattening or even a hollowing appearance above the nipple.

In this blog, Sydney Specialist Plastic Surgeon Dr Bish Soliman will explain what upper pole fullness is and how it can be achieved.


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What Causes Loss of Upper Pole Fullness?

Different factors can contribute to a loss of fullness in the upper pole of the breasts. While some degree of volume loss is a natural part of ageing, other factors can accelerate or exacerbate this process:

  • Ageing and Gravity: As we age, our skin naturally loses elasticity, and the supportive tissues within the breasts, such as ligaments and collagen, begin to weaken. This, combined with the relentless pull of gravity, can cause the breast tissue to descend, leading to a loss of volume in the upper pole and a drooping appearance.
  • Weight Fluctuations: Significant weight loss or gain can also impact upper pole fullness. During weight gain, breast tissue may stretch to accommodate the increased volume, potentially leading to sagging and a loss of fullness in the upper pole. Conversely, weight loss can result in a reduction of fat deposits within the breasts, further contributing to a deflated appearance in the upper region.
  • Pregnancy and Breastfeeding: Pregnancy and breastfeeding are natural processes that cause significant changes in a woman’s breasts. During pregnancy, hormonal shifts stimulate breast growth and milk duct development, often leading to increased volume and fullness. However, after breastfeeding, the breasts may shrink back down, sometimes resulting in a loss of volume and elasticity, particularly in the upper pole.
  • Genetics: Genetics play a significant role in determining breast size, shape, and how they change over time. Some women are genetically predisposed to having less naturally occurring breast tissue in the upper pole, while others may experience more significant volume loss in this area due to hereditary factors.

How Does Loss of Upper Pole Fullness Affect Appearance?

The impact of upper pole volume loss on a woman’s appearance can vary depending on the individual’s natural breast shape, the degree of volume loss, and personal aesthetic preferences. However, some common concerns include:

  • Flattening of the Upper Breast: A primary concern is the loss of the natural curve and fullness in the upper portion of the breasts. This can create a flatter appearance, making the breasts appear less projected.
  • Visible Hollowing or Indentation above the Nipple: In some cases, the loss of upper pole volume can be more pronounced, leading to a visible indentation or hollowing above the nipple. This can create an uneven contour and detract from the overall harmony of the breast shape.
  • Changes in Breast Symmetry: While perfect symmetry is rare, significant volume loss in one breast’s upper pole compared to the other can accentuate asymmetry, making it more noticeable.

Options for Addressing Upper Pole Fullness

Various options are available for women seeking to restore or enhance upper pole fullness. The best approach depends on individual anatomy, the degree of volume loss, desired outcome, and personal preferences.

Fat Grafting

This technique, also known as fat transfer or lipografting, offers a natural approach to restoring upper pole fullness. It involves a two-step process: harvesting and injection. First, using meticulous liposuction techniques, fat cells are gently harvested from donor areas where the patient has excess fatty tissue, such as the abdomen, thighs, flanks, or buttocks.

The harvested fat is then carefully processed to isolate healthy, viable fat cells. These purified fat cells are strategically injected into the breasts, specifically targeting the upper pole region to restore lost volume and create a smoother, more youthful contour.

Fat grafting is particularly appealing to patients seeking a natural look and feel, as it utilises the body’s own tissue. It eliminates the need for foreign materials like implants and typically results in minimal scarring. However, it’s important to acknowledge that fat grafting outcomes can be somewhat unpredictable. Not all of the transferred fat cells will survive the transplantation process, as some may be reabsorbed by the body. Consequently, multiple sessions spaced several months apart might be necessary to achieve the desired level of fullness.

Furthermore, fat grafting might not be suitable for all women. Those with significant volume loss or those who are very thin may not have sufficient donor fat for successful transplantation. Additionally, patients with certain medical conditions or those who have undergone extensive previous breast surgery may not be ideal candidates for fat grafting.

Breast Implants

Breast augmentation with implants remains a cornerstone procedure in addressing upper pole fullness and achieving breast alterations. Advancements in implant technology have led to a diverse array of options, each tailored to address specific aesthetic goals and anatomical considerations.

  • Round Implants: As the name suggests, round implants feature a symmetrical, circular shape that provides uniform volume distribution throughout the breast. This can be particularly beneficial for women seeking to enhance upper pole fullness, as the rounded shape can create a fuller appearance in the upper portion of the breast. However, round implants might not create the most natural-looking slope in all cases, particularly for women with minimal pre-existing breast tissue or those who desire a more subtle, teardrop-shaped contour.
  • Anatomical (Teardrop) Implants: Designed to mimic the natural slope of the breast, anatomical implants, often referred to as teardrop implants, are contoured with more volume concentrated in the lower pole and a gradual taper towards the upper pole. This shape creates a natural-looking tear-drop silhouette. While anatomical implants may not directly address upper pole fullness as effectively as round or high-profile implants, they can create a balanced and harmonious breast shape overall.
  • High-Profile Implants: High-profile implants are characterised by their greater projection relative to their base diameter. This unique shape allows for significant volume enhancement in the upper pole, creating a lifted appearance. High-profile implants are often favoured by women who desire a more dramatic augmentation or those with a wider chest width, as they provide more projection without requiring an excessively wide implant base.

Combination Procedures

In some instances, achieving optimal aesthetic outcomes may necessitate a combination of techniques. For example, Dr Soliman might recommend a combination of fat grafting and breast augmentation with implants to address both volume loss and shape concerns simultaneously. This approach allows for targeted volume restoration in the upper pole using fat grafting, while implants provide overall breast enlargement and lift. This combined approach can create a truly bespoke result, tailored to the patient’s unique anatomy and aesthetic goals.

Choosing the Right Approach for Upper Pole Fullness

Selecting the best approach to address upper pole fullness is a highly personalised decision. During a consultation, Dr Soliman will thoroughly assess your individual anatomy, discuss your aesthetic goals, and recommend the most appropriate options based on your unique needs and circumstances.

Factors that will be considered include:

  • Desired Outcome: What are your specific goals for improving your breast aesthetics? Are you primarily concerned with restoring lost volume or enhancing projection?
  • Degree of Volume Loss: The extent of volume loss in the upper pole will influence the recommended treatment approach.
  • Existing Breast Size and Shape: Your current breast size and shape will also play a role in determining the most suitable options.
  • Overall Health and Medical History: It’s essential to discuss your overall health and medical history with Dr Soliman to ensure you are a suitable candidate for any surgical procedure.

By carefully considering these factors and engaging in open communication with Dr Soliman, you can make an informed decision about the best approach to achieve your desired breast aesthetics.

What Happens during a Consultation for Breast Augmentation?

During the breast augmentation consultation, you will have the opportunity to:

  • Discuss Your Aesthetic Goals: Openly communicate your desired outcome. Do you envision a subtle enhancement or a more dramatic transformation? Be specific about your concerns and what you hope to achieve.
  • Undergo a Comprehensive Assessment: Dr Soliman will conduct a thorough examination of your breasts, assessing your anatomy, skin elasticity, and the degree of upper pole volume loss. This assessment is important in determining the most appropriate treatment options for your unique needs.
  • Explore All Available Options: Dr Soliman will present you with a range of surgical options, explaining the benefits and limitations of each approach. He will guide you through the different types of implants, if applicable, discussing their shapes, sizes, and profiles to help you visualise the potential outcomes.
  • Address Your Concerns and Ask Questions: This is your time to ask any questions you may have about the procedures, recovery process, potential risks, and expected results. Dr Soliman will provide you with honest and transparent answers, ensuring you feel confident and informed about your decision.
  • Develop a Personalised Treatment Plan: Based on your individual goals, anatomy, and lifestyle, Dr Soliman will collaborate with you to develop a tailored treatment plan that aligns with your expectations and aesthetic vision. He will discuss the potential risks and complications associated with each procedure, ensuring you have a realistic understanding of the journey ahead.

FAQs about Upper Pole Fullness and Breast Augmentation

Will exercise and a healthy diet help restore upper pole fullness?

  • While a healthy lifestyle is always beneficial, it’s unlikely to significantly restore lost volume in the upper pole. Exercise can strengthen chest muscles and improve posture, which might create a subtle lifting effect, but it won’t address the underlying issue of fat loss or skin laxity.

What is the recovery period like after a procedure to address upper pole fullness?

  • Recovery time varies depending on the chosen procedure. Fat grafting typically involves minimal downtime, while breast augmentation requires a longer recovery period, usually a few weeks. Dr Soliman will provide detailed post-operative instructions to ensure a smooth and comfortable recovery.

Will addressing upper pole fullness affect my ability to breastfeed in the future?

  • The impact on breastfeeding depends on the chosen procedure. Fat grafting is less likely to interfere with future breastfeeding, while breast augmentation, particularly if it involves incisions around the areola, can potentially affect milk ducts. It’s essential to discuss your breastfeeding goals with Dr Soliman during your consultation.

How long do the results of upper pole fullness procedures typically last?

  • The longevity of results varies based on the chosen method and individual factors like ageing and lifestyle. Fat grafting results can last for many years, as the transferred fat cells become a permanent part of the breast tissue. Breast implants have a limited lifespan and may require eventual replacement, typically after 10-20 years.

Further Reading about Breast Surgery with Sydney Specialist Plastic Surgeon Dr Bish Soliman

Medical References about Upper Pole Fullness and Breast Implant Surgery

About Dr Bish Soliman

Dr Bish Soliman - Sydney Plastic and Reconstructive Surgeon, about us 01 2x
Specialist Plastic, Reconstructive and Cosmetic Surgeon
FRACS (Plas), MS (Plas), MBBS (Hons 1), BCom

AHPRA Registered Medical Practitioner MED 0001679053 Specialist Registration in Plastic Surgery

Dr Bish Soliman is a Sydney-based Specialist Plastic and Reconstructive Surgeon who performs aesthetic surgery of the face, breast, and body as well as skin cancer surgery.

He currently holds two consultant microsurgery positions in major Sydney hospitals performing complex microsurgical reconstruction including DIEP breast reconstruction.

After graduating from The King’s School, Dr Bish completed a Bachelor of Commerce degree at the University of Sydney. After working briefly at a major Sydney finance firm, he decided to pursue his passion and long-term goal of a career in medicine. He graduated from the University of Notre Dame at the top of his class, receiving First class honours and the prestigious Bower and Sherrard medal. He then went on to complete his junior medical training at Westmead Hospital during which time he was awarded Junior Medical Officer (JMO) of the Year, as well as a finalist for NSW Doctor of the Year.


Next Steps

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