Auto-augmentation breast lifting is an exciting option for women interested in breast rejuvenation surgery. “Auto”, in a medical context, is simply another word for “self”. Hence, “auto-aug” is using one’s own tissue to enhance one’s breast, rather than using a breast implant. Traditionally, breast implants (beyond just making breasts larger) are utilized to fill upper breast contours. In other words, implants fill out the upper breast scoop, or gap, between your breast and your bra. 😊 Obviously, patients’ preferences for amount of fill vary, but I am frequently asked for subtle breast fill, with a goal of “keep ‘em guessing” outcomes that align with natural-appearing plastic surgical results.

So, what defines a “natural” breast appearance after breast rejuvenation surgery? 1. Breasts that are well-positioned on the chest wall. 2. Breasts with modest upper breast fill, and gently curved lower breast shape. 3. Breasts with nipples that sit in the middle of the breast mounds. Rejuvenated breasts do NOT notably drift onto the abdomen when upright, or into the armpits when lying down. Nor do the nipples of rejuvenated breasts droop onto one’s thighs when bending over! Said differently, #breastgoals.

I often broach the topic of auto-augmentation breast lifting when I notice a fair amount of breast tissue on the underside of a patient’s breasts (causing breasts to feel heavy, drift and droop). I can put that extra “under breast” tissue to good use. Modern, gold-standard breast lifts discard the “under breast”.  The “under breast” can be reshaped and repositioned in “auto-augs” as a “tissue implant”. This is very different than breast fat grafting, or fat transfer…a topic for another article. To be fair, “auto-aug” results DO NOT compare to breast implant results in that a lesser degree of upper breast fill will be achieved by using one’s own tissue, rather than an implant. I am very clear about that fact. For the patient desiring a breast lift, who also has a little extra tissue to provide some “oomph”, and who does not wish to use an implant…this may be the ideal procedure for you!

I have one public service announcement to add…please consult with a plastic surgeon certified by the American Board of Plastic Surgery (ABPS) for this type of work. The ABPS website (www.abplastsurg.org) can verify a surgeon’s credentials, or conversely, shed light on the truth behind deception in advertising to the public by those that dub themselves, “board-certified cosmetic surgeons”. That “credential” is not an actual thing in the true field of plastic surgery. The ABPS mandates continuing medical education, high ethical standards, and regular passing of maintenance of certification testing from its diplomates, such as myself. No real plastic surgeon backed into offering cosmetic procedures by going to a weekend course, or by completing one year of study, and claiming superiority as a “board-certified cosmetic surgeon”.

Quite frankly, I am not a general plastic surgeon, I am a plastic surgeon. The former phrase (general plastic surgeon) is used by surgeons that attempt to persuade patients that we 7000+ ABPS diplomates are somehow less qualified and less capable of offering top-tier plastic surgical care. Websites and advertising are like the wild West. You must filter through the dust. Four years of medical school, six years of plastic surgery residency training, and two years of advanced fellowship training in eyelid/facelift surgery, breast/body surgery allow me to call myself a real plastic surgeon, with expertise in cosmetic surgery, who has taken very seriously the practice of perfecting my craft. ABPS board-certification is certainly not the sole credential to check, but please be a smart consumer, and do not be misled.

Regarding skillsets of surgeons…there is no BEST. There are plenty of surgeons who feel compelled to tell you how great they are, with egos as big as the Earth, and then there are those of us who confidently offer you outstanding care with a touch that makes us human, and your experience life-changing. Select a plastic surgeon to care for you with the training outlined above, with results that align with your goals, AND who gives you the gut feeling that he/she has your best interest in mind when you are on the operating room table. Keep in mind when the surgical social media feed is off, and when the fancy branding of this/that procedure is truly realized as meaningless, you want an expert taking care of you on the operating room table who would do unto you as he/she would do unto their spouse, and who walks with you, side-by-side, throughout your postoperative recovery. This is what I would want if roles were reversed, and I was the patient. Do unto others. It is that simple.

Brian Derby, MD, FACS
Sarasota Plastic Surgery Center

Diplomate – American Board of Plastic Surgery

Member – American Society of Plastic Surgeons, The Aesthetic Society, Southeastern Society of Plastic and Reconstructive Surgeons, Florida Society of Plastic Surgeons (Board Member)