Lisa J. Peters MD Plastic Surgery & Medical Spa

A: The size of your areola won't change significantly with weight loss.  You are a candidate for a breast lift and during that procedure the areolar size can be adjusted to a diameter that's more youthful and appropriate for your breasts.  Achieving your goal weight prior to surgery would be ideal, as weight changes after surgery can affect the long-term result of any body contouring procedure.

A: More upper pole fullness can be achieved using several different strategies including larger/wider implants, a more cohesive silicone (gummy bear-type) gel in a silicone implant, or overfilling a saline implant.  Whether the 640 cc implant your surgeon recommended for you would be appropriate would depend on your measurements and the size of your current implants.  Yes, a 640 cc implant is a large implant, but your wish photo is also consistent with a large implant, so that recommendation may achieve your goals.  A word of caution, however, is that large breast implants cause strain on the natural breast tissues and may thin your skin and settle more over time than a smaller implant.  Your wish may be achieved in the short-term and cause problems in the long-term.

A: Generally speaking, I recommend at least a 100 cc difference if you're going to have surgery for a size change.  Less than 100 cc is just too subtle a change for most people to feel that the cost and risks of surgery (though low) are worth it.  In your case going up to the 485 cc range would be reasonable, but if I were your surgeon I would suggest doing so with a higher profile implant so that your new implants aren't too wide for your breast width (base diameter).  That way your additional volume will be in projection rather than under your arm!

A: Having lipo does not make your body more prone to gaining weight.  If you consume more calories than your body burns, you will gain weight and the fat will be apparent somewhere.  Liposuction permanently removes fat cells from the treatment area.  When you gain or lose weight, your body doesn't grow new fat cells, it just fills up the ones you have or empties them.  The trick after liposuction, is that what used to be your problem area (for example your stomach and flanks) is no longer going to be the first area you notice a couple extra pounds.  You will still be able to gain weight in your stomach and flanks, but less so than prior to surgery because there are fewer fat cells in that area to fill!  You will need to be careful about monitoring your weight regularly to make sure 2 extra pounds doesn't turn into 10 pounds before you realize it.  My other recommendation is to keep an eye out for another part of your body that tends to show minor weight gain first, since 1-2 pounds is easier to lose than 15 pounds.  Again I'd like to emphasize that this "new" area of weight gain will be gaining weight just like it did prior to surgery, but because you're going to be happier with the contour of your stomach and flanks, you are just going to have to teach yourself to monitor minor weight changes by looking elsewhere.