A version of the same request walks into my clinic every few years wearing new clothes. These days, the lines sound something like this: “I want more volume, but I do not want anything artificial inside me.”
There is a real procedure hiding behind that line, not just some newfangled marketing gimmick, and it is worth explaining plainly and clearly what it is.
The Idea, Stated Simply
An auto augmentation breast lift uses tissue the patient already has and reshapes it to gain a little bit of volume that goes predominantly into the upper pole, during a breast lift. There is no implant involved. When they have plenty of tissue (usually after some weight loss), I use tissue from the breast and sometimes from the lateral chest wall.
To maintain the shape, I incorporate a GalaFLEX mesh, which functions as an internal bra and helps hold everything perfectly in place. It forms a nice capsule, similar to how an implant’s capsule works, allowing the volume to sit high and circular post-lift, but without any artificial device.
What It Will Not Give You
This is the part where I get blunt with patients like this. Any marketing you see for ‘natural augmentation’ is basically overselling this technique, so I make it clear up front just what someone looking for an operation like this should and should not expect. Implant-level upper pole cleavage does not occur utilizing your own soft tissue, which has more tendency than implants to eventually soften over and reshape. The result is a more tapered, natural-looking upper pole. If anyone starts talking to me about hoping for significant, round cleavage, I clarify that this operation simply will not achieve that, even before we consider booking.
The patient population who really shines with this technique are massive weight loss patients. There is real tissue left to begin with, but almost certainly, not enough structure underneath to maintain an upward position. We take care of that structural problem with this, no device needed.
The Technical Trade
I perform with the same Wise pattern or anchor incision pattern I use for any full mastopexy. The difference with auto augs is that I carry the incision laterally. So, for mastopexy, I extend to the area underneath the armpit, then elevate that skin portion before lifting it to form a nice contour. After elevating the skin, I then add some internal sutures to try and redistribute parenchyma over, and once all that is done, I raise my mesh higher on the patient than I would in a typical implant placement to assist with further support. This way, we put gravity to less of a test going into the future. That also goes for women having a mastopexy, for example, from an implant explant.
I would say for patients, it is pretty much a one-or-the-other consideration, having the auto aug is not an add-on option to any plans for implants. The options are either a mastopexy with an implant or a mastopexy with auto augmentation. I have not found any clear, viable way of doing combined operations on the unique individual. And what is more, I would not pretend otherwise with a patient that is actually asking for exactly that when she approaches me.
Recovery, No Surprises
Recovery is much like that for any similar breast lift. A week to light duty. Four weeks light exercise and normal life. Then four weeks full exercise, no holds back. There will be bilateral drains, which come out around a week after the surgery. Then there is an anti-underwire, anti-push-up, supportive bra regimen, which lasts a while beyond that and for the laundry too; it is a two-bra situation all the way with this one so the clothes pile does not pile up!
The Honest Limitation
Long-term durability with an auto-augmented breast lift, even without implants, comes down to the same constraints as any similar breast procedure: The longevity or durability will be the same after the procedure, including even when implants are present later in life, provided no changes are made to the patient’s weight or body condition. We are talking weight changes including swings, gaining it and losing it later, and in particular to pregnancy; it moves the result same way any other lift will be displaced.
Why I Reach for This Technique
As a Mayo Clinic fellowship-trained and double board-certified plastic surgeon and a Castle Connolly Top Doctor for thirteen consecutive years, I see plenty of and perform a lot of post-weight loss reconstruction. That is why an auto augmentation earns its place within the population with some added specific conditions. The truth is that when you have a support problem and can actually take care of that particular problem with the technique, without a need to add a foreign body to your body when an implant could just be avoided, a patient who has just gone through sufficient amounts of change might just really end up being the best candidate for this treatment which can give her more stability. All the way from incision to what needs to be considered, see the full guide on agulloplasticsurgery.com.
Ready to Talk?
If your own tissue can do the job, let’s find out before anyone talks you into a device it does not need.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. #StayBeautiful
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
Cross-links
- Full surgical guide on agulloplasticsurgery.com: “Auto Augmentation Breast Lift: A Fuller Lift Without an Implant” (canonical)
- Med spa side on swplasticsurgery.com: “No Implant, Still Fuller: The Auto Augmentation Lift at Southwest Plastic Surgery” (link once live)