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Breast Implants for Small Breast Tissue Large Chest Wall , A to DD is It Good Choice? (photo)

I am post gastric bypass, 5'5" 165lb 38Acup. I lost 130lb, I was a 40DD.Three surgeons don't believe I could go to DD again. Im not understanding why I can only be a small C. The last one gave me a 3d scan and poss. augmentation measure from my base measur. This is an actual picture of my chest and poss augmentation to a small C. The base width and the Height It ends up being I feel is only enogh to seem lifted not bigger.He plotted with115-322/354/378 Nat.Biocell Midrange Sili.ANY other suggets

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14 Doctor Answers | Asked by jt2007 in Clarksville, TN

Doctor Answers (14)
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It can be done

Placing large implants in the breast that has lost significant volume is probably going to require an internal brassiere with acellular dermal matrix. This is a tissue product that forms a sling on the lower half of the breast and is sutured to the chest wall along the inframammary crease and lateral gutter and superiorly it is sutured to the chest muscle. The implant is then placed behind the muscle and into the sling. The overlying skin would probably need to be treated with a mastopexy. more

Augmentations after gastric bypass.

Placing very large implants in post-bypass patients lead to the same issues we see in any patient with over-sized implants, only much sooner. The problem is the laxity of the tissue. Large implants over 400 or 500cc are heavy and will eventually droop over time. Even with a lift (which appears that you will need based on your photos), the implants will sag. This can be prevented to some degree with a dermal matrix to provide internal support, however this adds significant cost to the... more

David Bogue, MD

6 reviews

Boca Raton Plastic Surgeon

www.drbogue.com

A to DD for breast augmentation

Thank you for the question and photo. The problem with going large is that your breast tissues have probably thinned and will not likely support such a large implant long term. It may look good for awhile, but the implants will weigh heavily on your tissues and cause worse thinning and rippling over time. You may be able to go with a larger implant if you have a wide base diameter. To be sure, see at least two board-certified plastic surgeons for an evaluation. Clarksville, TN is... more

Implants after large weight loss

Without an exam it is hard to say what would be best for you. Yes, you may have a lot of excess skin, but remember the larger the implant, the more likely they will sag sooner especially with skin that has most likely been stretched like yours.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

DD augmentation should be possible

Jt, You may consider one or two more consultations to get several opinions as to whether you can achieve your goal of a breast size of DD. After a 130 lb weight loss you should have enough excess skin to accommodate a large enough implant to get you to a DD cup. Good luck! see video

Don't always believe the computers!!

Computers can not pinch on your skin and assess the degree of elasticity loss after massive weight loss. The post op 3D image doesn't seem to have a handle on the possible need for a lift and your short nipple to fold distance that could lead to double bubble. I believe that based on your photos you could get DD again with the correct implant, but you may need a mastopexy depending upon how the skin fills out. As you embark upon larger implants be sure you are... more

Implant choice and base width

Based on your photo on the left, you appear to have ptosis (droopiness) and need a mastopexy (lift). Also, your breast base width appear to be narrow and thus will not likely accommodate a large implant to get you to a DD cup. High profile implants will allow you to put more volume in a narrower base, up to a point. When you get into larger implants (over 500 cc), there are other potential risks. You should discuss your desires and concerns with a board certified plastic surgeon. more

Todd C. Case, MD

14 reviews

Tucson Plastic Surgeon

Breast augmentation together with breast lift

I assume the left photo is your current condition and the right is a computer simulation of the result. I don't see how you can get from left to right just putting in breast implants. For instance you are not going to shorten the breastbone notch to nipple distance by a half inch+. You may have liked 40DD breasts but 40DD implant breasts are not the same and the effects of gravity on such implant sized breasts will be magnified. Wanting to fill the breast skin envelope rather than... more

Breast size and preference

Your preference in style and size does not always follow the reality of what options are available to you. More than agreeing or disagreeing with your surgeon's counsel on the size you can go, I would tell you there is great wisdom in not exceeding the volume your tissues can handle and can stretch and droop. You could convince me to go larger, but a true DD might be difficult to achieve. Good luck.

The answer is yes as long as you understand the drawbacks of a large implant

Hello, Congratulation on your weight loss. The reality is that you can have just about as large an implant as you desire since your breast tissue will not be a limiting factor. A very large implant in tissue that has lost some of its tissue integrity will be prone to settle down on your chest. As long as you know that the longevity of your breast shape with a very large implant will be less than with a more moderate size implant than you will be fine. All the... more

A to DD

Usually when you ask four different plastic surgeons for their opinion you get four different answers. So this is a bit unique, but I vote with the 3 previous consultants in that you can get a much fuller breast than your surgeon displayed on his computer. You might want to talk to someone without a computer!

DD is not only possible, but preferable for excess laxity after major weight loss!

Congratulations on your weight loss! Fortunately, your breast photos show forward-facing nipple/areola complexes with position at or slightly above your inframammary creases. The surgeon who provided the 3-D analysis seems to have allowed computerized analysis to trump surgical experience and judgement, since the suggested implants will add only about 1 1/2 cup sizes to your present size, while leaving you with significant residual skin laxity, too-wide cleavage, and a high likelihood of... more

Is DD possible for me? (photo)

You are broad with elliptical breast bases on a transverse axis, and plenty of skin. Breasts are low on the chest due to massive weight loss. YES, you can be DD. My choice would be an implant that most closely matches your existing breast shape, will give you maximal projection and fill redundant skin, cross your broad breast width to minimize intermammary separation, yet not drop the already low inframammary crease so low that the bottom of your breasts will be sitting on... more

You need a larger volume implant with less inherent projection to attain desired breast augmentation results

You actually need a much larger implant. Without seeing you in person it is hard to say but i would say at least a 480 style 10 Allergan low profile. My choice of placement would be with what I call the 'cold-subfascial' technique to allow for added support. Using a narrow implant with high profile like in the picture will not yield an acceptable result in my opinion. All the best, Rian A. Maercks M.D. see video