Best Way to Communicate Breast Surgery Expectations?

I had breast lift and implants done in 2006 after massive weight loss. I asked to be a perky full C to a small D. I ended up being a not perky 34DD! The skin still hangs off the implant when I bend over and the breasts seem so wide with no upper fullness. The implants (round saline) drift peripherally from under the muscle slightly while I'm standing. Almost as if the implants themselves were too wide for my ribcage, especially now that he's done the planned central body lift. Should I bring photos of what I'm looking for?

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13 Doctor Answers | Asked by Patchwork in Texas

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Yes that would help.

From your frontal view, I note that the nipples are low, and the breasts are large. I also do a lot of MWL surgery, so I can tell you that one of the big problems is relaxation of tissues after surgery, due to the stretched skin and supporting structures. I think that a secondary breast lift to raise the nipples and tighten the skin envelope will be needed. From your description of the inplants, you may need the pockets adjusted, and perhaps a smaller inplant. Bring pictures for both of... more

Breast surgery with implants after massive weight loss

As Dr. Rand has noted, the elasticity of the skin after massive weight loss is usually greatly diminished. You have relatively large implants in place and have already undergone a lift. We have found that patients with massive weight loss do best with smaller implants and a lift. That way, the compromised skin is less stressed from a large implant. It seems that your size wishes are smaller than what you currently have, so a redo lift with small implants and capsular reformation may be... more

You may not be able to have what you want

Please understand that after massive weight gain and loss, your tissue elasticity will never be normal anymore. This colors completely the type of result you can expect. For your type of starting point, you have a perfectly acceptable result with good symmetry. If you wanted to go smaller, you would need smaller implants and a complete re-lift done. The implants will look wider apart because they are smaller and you will settle and relax again because of the elasticity issues. So, while... more

Breast implant sizing

Thank you for the important question. Much of the final “look” achieved after breast augmentation surgery depends on several factors: 1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the preoperative breast appearance the more likely the breast augmentation “look” will be optimal. 2. The experience/skill level of the surgeon is important in determining the final outcome. For... more

Expectations for a breast lift with implant surgery

Communication is key when planning this procedure. Be sure that your board-certified plastic surgeon has great deal of experience with the many different techniques that are available for breast implant surgery. A great deal of time should also be spent discussing the ultimate size of the breast and the size of the implant will help you accomplish your goal. Your plastic surgeon should also be able to anticipate the types of scars will be necessary and there lengths more

Unhappy with lift and implants

Remember, that with massive weight loss, the skin does not have the same strength as someone who has not lost so much weight, so realistically this may be impossible to achieve for the long term. On the other hand, a lift alone at this point may improve your result.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Photos are sometimes helpful

You may have been someone who may have benefitted from a breast lift alone first (because of the amount of breast tissue you have) and then your could decide on an implant size by placing implants into a bra to try to visualize what you might get as a result. It sounds like the pocket around your implants needs to be tightened internally and possibly even a revision of your breast lift. There are a number of options, to include doing nothing, that are available to you. Dr Edwards... more

You don't have a bad result, but it can certainly be improved.

Hi! Communicate with your surgeon the same way you are communicating with me. It is clear what you want, and it is reasonable. I think two things can be done differently, and we see this commonly in breast lifts in New York. 1) You need another lift with implants OVER the muscle. Then the implants wil move with your breasts. 2) You need smaller implants. We use disposable implant SIZERS during surgery to find the right size, BEFORE we open the permanent implants. A sizer costs only... more

Your breasts are still large and behave independent of the implant

Perky may not fit your body type. Generally perky does not last forever. So be careful what you ask for. There is no way to defy gravity over time. From your description it sounds as if you still have a significant amount of breast tissue. That is why it "falls off" the implant when you lean over. It is likely that you will best be treated with a repeat lift, a breast reduction and a smaller implant. Really, the only way to get substantial perkiness is to do a very agressive... more

Otto Joseph Placik, MD

33 reviews

Chicago Plastic Surgeon

A redo breast lift and smaller sub mammary textured silicone gel implants may be your answer

I have stopped putting implants under the muscle when I do a simultaneous breast lift. It is very frequent to see many of these patients develop breast that hangs off their implant and the implant often slips all over the place under the breast and outside the breast confines. The best results that I can get come from putting textured gel filled breast implants under the breast and preforming a breast lift over the new implant during the same operation. This requires a surgeon... more