Best Way to Communicate Breast Surgery Expectations?

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

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

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

  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

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.

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

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

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

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

I cannot evaluate your current appearance without seeing your pre-op pictures. Depending on what your breasts looked like, the current appearance may not be too bad. The final volume is your choice by trying on implants before surgery. Gravity will always interfere with getting the breast really 'perky'. Putting the nipples higher may just give the breasts a 'bottomed out' appearance in the future.

Evan without an examination your picture is worth a thousand words. The entire point of an augmentation mastopexy is to elevate the nipple/areolar complex back to its proper position with the implant added to provide upper pole fullness. Obviously the nipple is still too low and I agree that the size seems a bit large. The revision will require removal of the current implants and replacement with small implants. I generally use low profile implants in mastopexies when the patient... more

Pictures are extremely helpful to show the plastic surgeon what you think you want to achieve BUT it is only a starting point. It gives the plastic surgeon an idea of what is in your mind. Whether or not that can be achieved is a totally different story. Also making a list of "I want x, y and z but not a, b and c." is helpful. These will start a discussion of what the current situation is, what can and cannot be done and how it is done and what are the expected results. There are... more