2-stage lift & implant post MWL. Is my lift a failure or good? What implants and other procedures do I need in stage 2? (Photos)

 5'7" 160lbs, 41.5-33-38, 36" band, 50yo, RNY 2003, plastic surgery 2013. Based on my photos a number of surgeons have said I have an awful breast lift. My surgeon said it looks fine. He plans to add saline mod profile submuscular and then relift the NAC. He suggests 420cc, up to 520cc. He has not measured me or calculated BWD - are these important? No use of Strattice. Surgery combined with revision to Thigh lift and revision to LBL w/muscle plication. Is my lift good? Is the surgical plan good?

Doctor Answers (7)

Decent Plan and Good Result

+3
Thank you for your pictures. Your breast lift looks pretty darn good considering that your massive weight-loss patient. I think your surgeon's plan is spot on. I would continue to follow your surgeon's recommendations/advice.

Earl Stephenson, Jr, MD, DDS,FACS


Atlanta Plastic Surgeon
5.0 out of 5 stars 8 reviews

Breast lift results

+2
There are quite a few good things about your lift.  Let me list a few:
1.  Good symmetry.  
2.  decent scar appearance.
3.  normal nipple areolar appearance.
4.  Good maintenance of results in a MWL patient

And while it might be nice to have the nipple position a little higher, this is easy to correct at a later stage.

There is no reason to consider this a bad result or "awful".  The other surgeons were unjustified in making those comments.

As for your "wish" photos, that would take some large implants.  The only problem with that choice is that MWL patients often have skin that doesn't support these well over time, and the lower breast skin stretches out or the pocket expands.  Better to pick a smaller, lighter implant to minimize future surgeries.

Thomas Fiala, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 26 reviews

2

+2
A two stage approach to augmentation mastopexy, particularly in patients with Grade 2 or 3 ptosis, is a reasonable and sound approach.  Your ptosis has been corrected and your have a nice result from your mastopexy.  I would caution you against choosing an excessivley large implant (as implied in one of your photos) as you are at high risk for soft tissue stretch.

Michael B. Tantillo, MD
Boston Plastic Surgeon
4.5 out of 5 stars 13 reviews

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2-stage lift & implant post MWL. Is my lift a failure or good? What implants and other procedures do I need in stage 2?

+2

Thank you for the question and pictures. Base on your photographs, you are starting at a great place and should have a very nice outcome with breast augmentation surgery. Based on your photographs also, I do not think that your breast lift is "a failure” or “awful”. In regards to specific size/profile of breast implant, despite good intentions, online consultants will not be able to provide you with  meaningful specific advice.  Ultimately, careful measurements, dimensional planning, and careful communication will be key.

Generally speaking, the best online advice I can give to ladies who are considering  breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work. Given your concerns, I would suggest that you spend additional time with your plastic surgeon;  ask the same question of him/her regarding the use of ultra-high-profile implants  and the greater projection that results from the use of these breast implants.

2.  Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C or D cup" etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.  The use of computer imaging may be very helpful during this communication phase.

3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.  The use of temporary intraoperative sizers with the patient in the upright position are very helpful.

 I hope this, and the attached link, helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 718 reviews

Two-stage breast lift and augmentation should give you a very nice result

+1
Based on your photographs I think the results of your breast lift are very good.  The result does not look as good to you because you have not had the second stage breast augmentation.  I agree with your surgeons planned to do an augmentation at which time the surgeon can also make any adjustments that are necessary to the lift.  500 cc breast implants seem very large to me.

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
4.5 out of 5 stars 29 reviews

Is my lift a failure or good? What implants and other procedures do I need in stage 2?

+1
Very hard to advise over the internet. As you state other IN person consult felt the lift was below acceptable. Maybe you should listen to them... 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

2-stage lift & implant post MWL. Is my lift a failure or good? What implants and other procedures do I need in stage 2?

+1
As the initial stage of breast rejuvenation after MWL with a lift alone I feel you have a very nice result. Yes, you are still missing some of the upper pole fullness and overall volume that the implant will fill very nicely. I believe your current surgeon has done a nice job and taking a staged approach is conservative, yet will give you a safer and more predictable result. 

Brian J. Lee, MD
Fort Wayne Plastic Surgeon
5.0 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.