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Breast Implant Sizing After Gastric Bypass - 650cc Too Big?

asked 2 years ago by princez76 in Sacramento, ca
Latest answer by Joseph G. Bauer, MD
Question viewed 2,608 times
Tags: age 25-34, female, 130-149 lbs, 5 ft 0 in to 5 ft 3 in, weight loss, 650-699cc

Hi, I am a 33 yr old, 5'2" 140 lbs (medium frame) I currently wear a size 5-7 pant and small-medium top. I had gastric bypass surgery almost 5 years ago. I lost 85 lbs. Lucky for me, the only part of my body that had extra skin, after the weight loss was my breast. Before surgery I was a 38D and now a 34B with extra tissue. Thankfully, after five years post op from the by pass I have regained some of my breast mass, and do not need a lift.

I have had several consults with board certified plastic surgeons. However, I am nervous about the whole "650cc" for breast implants. Are they too big? I am scheduled for surgery on Feb 6th. I have tried on the gel implants with a tight shirt, and have visited my surgeon a few times to do this. I seem to like the larger look, but I am also concerned with the long term outcome.

19 answers to Breast Implant Sizing After Gastric Bypass - 650cc Too Big?

Breast augmentation after massive weight loss

After massive weight loss, the elasticity of the tissue is poor. Breast implants tend to "bottom out" fast. The larger the implants, the greater the tendency to bottom out quickly. This then requres redo surgery. My advice to most patients who have had massive weight loss is to have a breast lift (often with an extension into the armpit), and, if necessary, the smallest implant that gets the job done. 650 cc would in my opinion be much too large for somebody with your frame. more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

650 cc is a very large implant

Looking great after a gastric bypass is a true blessing. The last thing I like to see happen is when patients want a very very large implant after losing the weight since their breasts deflate and sag. If someone's breast are maintained in a good position and don't deflate much despite massive weight loss, that's a good sign that they have retained pretty good tissue elasticity and have a better capacity to retain an implant long term than those that completely deflate and sag. That being... more

Ricardo A. Meade, MD
Dallas Plastic Surgeon

Staged mastopexy and augmentation after massive weight loss

Congratulations on your weight loss! It sounds as if you are contemplating placing a very large implant to "take up" the excess skin. I would caution you that this approach can create very large, droopy breasts that sit low on your chest. Massive weight loss patients have unique concerns and I would not consider a one-stage augmentation-mastopexy for you. I would recommend a staged approach. This would optimize both safety and cosmesis. The first stage would be a breast lift. If... more

Jeffrey Horowitz, MD
Baltimore Plastic Surgeon

Breast implant size

It is possible that your breast skin is very good and does not need a lift after massive weight loss. Sizing for breast implant depend on many factors. 1. your present size 2. desired size 3. Amount of breast tissue available to protect the implant. (PINCH TEST) 4. width of the breast 5. Height of the breast These are few of the measurements we do to recommend an implant that fits your measurements.

Samir Shureih, MD
Baltimore Plastic Surgeon

Implant Size in the Massive Weight Loss Patient

Generally speaking, massive weight loss patients tend to experience breast sagging. If an implant is considered in the treatment plan, something needs to be done to tighten up the saggy breast skin. Otherwise, the implant could worsen the sagging or give a very bottomed out look. However, as my colleagues stated, it is difficult to make recommendations without a physcial examination/assessment. I would first assess breast ptosis (breast sagging) and determine the quality and amount of... more

C. Bob Basu, MD
Houston Plastic Surgeon

www.basuplasticsurgery.com

650cc is a heavy breast implant and will cause drooping

You need to be examined by an experienced surgeon to both measure your breasts and more importantly, determine elasticity. Given you were a 38D, your breasts have been stretched and probably would accept a 650cc implant, however your breasts may droop quickly with this heavy implant (the average size implant is 350cc). You may do better going with a 450-500cc high profile implant. This would accomplish 2 things: A high profile implant would help to lift and elevate your tissue and... more

Michael L. Workman, MD
Portland Plastic Surgeon

Breast augmentation after gastric bypass or weight loss may need a lift as well

After gastric bypass or very significant weight loss the breast often will have an elongated or a deflated appearance. With breast lift or mastopexy we usually consider the position of the nipple relative to the fold under the breast as the key in reshaping. However when there has been massive weight loss such as in gastric bypass the skin or envelope of the breast is just too large for the remaining breast volume. For augmentation to be at its best, the implant should fit the breast like a... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

www.peterejohnsonmd.com

Massive weight loss breasts: mastopexy (breast lift) with implants

I would concur with Dr. Moelleken' s and Dr. Rand's comments. 650cc is a larger than average implant. and given your history of massive weight loss it is likely that implants of this volume would likely result in breasts with a large sagging appearance. I tend to prefer lifts with smaller implants. However, I do realize that this involves significantly more scarring and I discuss this with patients.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Hard to tell if 650 cc breast implants would be the right size for you

I have had a few gastric bypass patients who did not need a lift afterwards. It sounds like your skin does have pretty good elasticity since the other areas of your body have firmed up as you say. The biggest issue is what your goal size might be. If you are trying to get back to a D cup then you might need a large implant like 650 cc but the cautionary note by Dr. Moelleken applies...you might experience significant sagging of your breasts due to the weight of the implants. I would suggest... more

Robert B. Pollack, MD
La Jolla Plastic Surgeon

650 cc breast implants after bariatric surgery

650cc implants in a post bariatric patient will almost certainly cause more stretching and sagging as you age. Consult a board certified plastic surgeon for your options.

Barry H. Dolich, MD
Bronx Plastic Surgeon

650cc breast implants will probably be acceptable

Congratulations on the terrific appearance from weight loss. The photo was helpful, but the real appearance of your breast could give us more details. My guess is a 650 cc will be acceptable. You could use the expander implant that is post operatively adjustable. Please see 3 board certified plastic surgeons. Regards

Darryl J. Blinski, MD
Miami Plastic Surgeon

650 cc breast implants after gastric bypass

When the breasts deflate the treatment is to wither fill them up (augmentation) or to remove the excess skin (breast lift) or both. It is not a simple process to determine what volume will be needed to fill out the deflated breasts so what I do is have patients try on implanst and see what they want to look like. If I feel the size implant thaty they use is big enough to fill out the extra skin then we do not do a lift. If it is definitely not enough then they will need an implant at the... more

John P. Stratis, MD
Harrisburg Plastic Surgeon

650 cc breast implants

It is very rare not to need a lift after massive weight loss. However, if that is the case, a 650 implant will be quite large on you and may possibly have the undesirable effect of making you look heavy again. Check with some other surgeons for an exam and recommendation.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Breast augmentation and weight loss

Deflation from weight loss is common in many women. For many women the breasts are the first place where they lose and gain weight noticeably. Breast implant size is hard to determine without being integrally involved in the process. Discuss with your surgeon the sizes you are considering and see if they can supply some pictures of women in your similar situation.

Joseph G. Bauer, MD
Alpharetta Plastic Surgeon

Breast implants and weight loss

The right implant size for you depends upon your goals and the quality of your skin. This is impossible to determine without an examination. 650 cc implants are heavy, and will almost certainly further compromise the quality of your skin over time. I would suggest seeing a surgeon in your area who has experience with gastric bypass patients, and who can discuss your goals with you while assessing your tissues. Good luck, /nsn.

Nina S. Naidu, MD
New York Plastic Surgeon

Breat Implants and Massive Weight Losst

That is a large implant, but I would like to know how you came up with the size implant. I generally like to fit the implant to the patient, not the other way around. Meaning I would like to do some measurements and determine how big you want to be by having you perform the rice test: http://www.feplasticsurgery.com/journal/orange-county-breast-augmentation-sizing/66/. Then I sit down with the patient and go thru their implants size and profile options.

Farbod Esmailian, MD
Orange County Plastic Surgeon

Massive weight loss and breast implants

You probably are a good candidate for a lift and an implant. Without examining you I could not be sure. Remember the larger the implants the heavier they are, and the sooner they will sag.

Steven Wallach, MD
Manhattan Plastic Surgeon

Breast Implants after Gastric Bypass

Congratulations on your weight loss. I think 650cc implants are probably a bit too large for your situation. You probably require a breast lift in addition to your implants. If you have a large amount of excess skin, it is probably prudent to have these procedures staged, beginning with the mastopexy. I agree that you should seek a second opinion.