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Post Breast Lift Sagging After Weight Loss

I lost about 65 pounds over the past 4 years. I had a breast lift 7 months ago, after losing the weight. The top of my breasts has loose skin again already. They are very squishy and I can pinch the extra skin on the top of them. When I bend over they are super saggy. I am so upset about this. If I get a revision lift and get them reduced to a small C will this help?

Doctor Answers (8)

Post weight loss sagging after a breast lift

+2

Patients who undergo massive weight loss have sagging and stretching and overhang of their skin, and the skin has been damaged.  A breast lift is designed to lift the breast and nipple and reduce the overhang while still keeping the scars under a swimsuit line.  Breast lifts do not tighten the upper pole of the breast, and in MWL patients the skin of the entire chest has been stretched in all directions. So, although a lift will tighten the skin in the lower breast, the damaged skin will have some tendency to restretch...not as much as before, but probably more than you would like to see.  And the upper breast will not be tightened...only filling out the relatively empty and oftentimes flattened upper pole with an implant may help.


Seattle Plastic Surgeon
5.0 out of 5 stars 70 reviews

Revision breast lift requires exact diagnosis of anatomy.

+2

Hi.

It is quite hard to get a good long term result in breast lift after big weight loss.  Revision will probably help you and there are four general options:

1)  The skin elasticity is usually not great.  The skin envelope may need to be re- tightened.  This just involves redoing the breast lift with the same scars.

2)  Tissue under and to the side of the breasts can be tucked inside the breasts as flaps.   This maneuver is tricky, but it adds volume and firmness.

3)  If you are still too large, then a small breast reduction as part of the revision breast lift will improve shape and firmness.

4)  Finally, breast implants can have a role, particularly in producing fullness in the upper part of the breasts.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Post-breast lift sagging after weight loss

+1
Hello! Thank you for your question! The mastopexy (breast lift) procedure raises the breast, which ultimately provides a more youthful and perky breasts. This is done by removing the extra loose skin and rearranging the surrounding breast tissue in order to reshape and support the newly formed breast. At the same time, the nipple-areolar complex (NAC) is raised to the ideal position above the fold beneath your breast (the inframammary fold) as well as being placed at the most projecting portion. Oftentimes with age or following pregnancy, the NAC becomes widened and enlarged. This may be reduced in size during the breast lift procedure.

It is common for the breast to lose its firmness and uplifted appearance over time, which is also accentuated with age, pregnancy/breast feeding, weight gain/loss, and gravity. This results in breast ptosis, or sagging of the breast, with a “deflated” appearance. Women seek the mastopexy procedure to regain the previous youthful appearance of her breasts and women report increased confidence, self-esteem, and femininity once achieving this desired shape and fullness. Breast lifts may or may not be performed with implants – the implant would add increased size but also greater fullness in the upper pole of the breasts which creates more cleavage.

I would discuss your concerns with your plastic surgeon. Increased size of the implants as well as laxity of the native skin do cause increased stretching inferiorly. Revisions certainly may be considered - allow your surgeon to examine and evaluate you and then go over which procedure(s), if any, will be the right one for you. Best wishes for a terrific result!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 11 reviews

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Revision Breast Lifting After Weight Loss?

+1

Thank you for the question.

Unfortunately, given your significant weight loss and how loss of skin elasticity as well,  your situation is not uncommon.

Although difficult to give you good advice without direct examination or viewing pictures, it sounds like you may be a good candidate for revision mastopexy as well as the use of breast implants.

In-person examination with well experienced board-certified plastic surgeons will be helpful.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 701 reviews

Fat grafting or implants will help

+1

You have the common problem with the lift which is lack of upper pole fullness. Your options are implant or fat grafting. I offer my patients fat grafting to the upper pole of the breast.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
5.0 out of 5 stars 53 reviews

Recurrent sagging after breast lift

+1

Massive weight loss can have significant deleterious effects on breast  skin tone and elasticity. This can result in restretching and recurrence of some of the sagging after a breast  lift. If it is  enough to really bother you, at  7 months post op you are at a time when revision may be considered. If you are concerned at maintaining size, lateral breast tissue can be repositioned into the central and upper breast regions. This , if it has not already been done, along with more skin excision and tightening, could be of benefit. Breasts with smaller size typically have less forces creating recurrent sagging. Therefore, if you are happy with a smaller size, a small reduction with revision lift may also be a good alternative. Regardless, in some large weight loss patients, lifts and reductions alone can never achieve perfect upper breast fullness.

David A. Bottger, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 26 reviews

Weight loss and breasts

+1

Sagging of the breasts depends alot on the quality of the skin. Considering that you lost a lot of weight, your skin more than likely rebounded a bit from the lift with some laxity. A revision may help.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 16 reviews

Sagginess after breast lift

+1
After significant weight loss there may be a lot of excess skin and loss of breast volume. The solutions to looseness are to either go small enough so that the remaining volume fills the reduced skin envelope or add an implant to fill out remaining skin laxity.

Neal Goldberg, MD
Westchester Plastic Surgeon
5.0 out of 5 stars 3 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.