First and foremost, Thank you all for taking the time to answer my questions. I am 4 months post op from a full TT with MR as well as BL/BR. I was originally a 36dd and am still a 36DD. I'm confused as to whether my results are ideal or they could've been better. I feel like I have smaller but still saggy breasts. I have included before and after pictures. Can someone share their opinions with me? Thanks! Naty's Mommy
Could I Have Gotten More of a Lift?
Doctor Answers (11)
Too much skin
After reviewing your photos, I agree you are still a bit lax. Your scars are wonderful but the trade off is laxity. I may guess that you still have too much skin so your lift could be improved. This is just a guess as your surgeon may have reasons to avoid a tighter closer.
Breast Lifting Results?
Thank you for the question and pictures.
At 4 months postop is too early to judge the final results of surgery. However, it may be that when you evaluate the results of surgery you may find that there is still too much “loose skin" along the lower poles of the breasts. If you find that this is the case, discuss your concerns with your plastic surgeon.
Additional skin excision ( tightening of the skin envelope) may be necessary to improve the results of the breast lift. If you decide you wish to have more fullness superiorly (upper pole fullness) then breast implants may be indicated.
I hope this helps.
Skin does not suppport the breast in a large size breast lift
Patients with large breasts who undergo breast reduction or breast lift may experience a delayed sag due to relaxation of the breast skin. Most common lift techniques are based on the removal of what appears "extra" skin and breast tissue, and the reshaping of the breast on the basis of predetermined patterns of skin.
Breast skin however is designed to relax in response to tension, and after a certain amount of tension is applied, the skin behaves like a non-elastic tissue, and simply gives out.
Patients or Doctors who plan for a larger breast size than their breast skin may tolerate, will see a gradual drop in the initial excellent shape, sometimes to the point of recreating the original shape.
Internal support for the breast shape is necessary to maintain shape in these cases. The spiral flap technique, and other breast tissue based suspension techniques can help in these cases.
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A revision of your mastopexy may be able to improve shape, create cleavage and improve the lift.
My approach would be to revise the vertical scar, elevate skin flaps used sutures to change the shape of the breast mound creating cleavage and and tighten skin that the base of the breast to give more support under the breast.
Waiting 6 months to a year after the surgery the best before attempting a revision to try to decrease the complications from a 2nd surgery.
You can look at my profile page or my website to get an idea of what shape can be created with the techniques listed above.
Results after a breast lift
It appears that you had more of a breast lift than reduction. A breast lift is just tightening of the skin envelope without reducing the volume. A reduction would be where a certain amount of breast tissue has been removed, reducing the volume and weight of the breasts. A plastic surgeon will usually be guided by the patient about whether they wish to have a smaller breast, or just a tighter, less droopy breast.
The surgery did lift up the position of the nipples quite well. But as the breasts are still quite heavy (and this where your agreement with the surgeon comes in) the lower part of the breasts have stretched to some extent.
BTW the early photo of the tummy looks nice, I presume you are happy with it.
Not enough lift
It is unclear from your photos what type of lift and or reduction was performed. Poor skin elasticity with heavy breasts can cause some bottoming out. Your scars have healed nicely and I think it is unrealistic for you to expect high perky breast. If your breast are over reduced then they would not appear to fit will your tummy. Overall you have an acceptable result. Have you spoken to your surgeon about your feelings?
Inadequate removal of skin in the lift.
From the photos you have provided, it appears as though your breast reduction is suffering from poor elasticity of your tissues. You appear to have bottomed out with excessive skin volume in the lower pole and persistent width of the breasts. Correction of this requires additional skin/breast gland removal with or without a supporting framework within the breasts. Different breast reduction techniques allow for longer term results and without this information, it is difficult to further speculate as to your options.
More lift with mommy makeover?
First of all, you have an excellent result in both the abdominal and breast areas. It is not clear from your photographs whether you had a full Wise-pattern (anchor) lift or a vertical (lollipop) or modified vertical lift on your breasts. Your vertical limb length does appear a bit long in your pre-op markings which may well be reflected in your post-op photos as your breasts settled.
It is clear that your nipple position is lifted by the degree shown in your pre-op markings, as well as the higher and forward-facing position in your post-op photos. The lower poles of both breasts have stretched and settled, perhaps too much for your liking, but this can be anticipated by the surgeon pre-operatively and taken into account in the surgical plan. Of course, that's easy for me or anyone else to say after the fact as we look at your time-lapse results, but your skin stretch, sagging, and lack of elasticity are the reasons you needed the surgery in the first place. So, it's not unreasonable to expect and anticipate a certain degree of what you are seeing.
Frankly, this is a very solid surgical result, and I have seen far too many results that are significantly worse. You should be grateful for the expertise of your surgeon, but if he or she is as good as it appears, then it is appropriate for you to express this gratitude with a slight "But . . . I would like to be a bit [higher, tighter, perkier, smaller, etc.] and I would like your opinion on that." Any touch-up or revision surgery will be less costly by the surgeon who did your initial work, so please start there. Good luck and best wishes!
Results after your BL/BR
The photos are helpful but do not totally tell me what specific type of BR you received. It seems as thought here was very little actual reduction in breast size. I cannot comment about whether this is what you wnated because the amount of tissue that is removed is determined through a discussion with your surgeon before surgery. I always show my patients how much tissue is being removed and what they can expect to look like afterwards. Some women want to be just a little smaller, and some want to be much smaller. It does appear that you have slightly high nipples with some excess breast tissue in the lower pole. You should discuss your concerns with your doctor. Sometimes revisional surgery is necessary.
From reviewing the photos you posted I wowuld say the upper half of the breasts look nice with a very good location of the nipple areola complex. However, the distance from your areola to the fold under the breast is too long and heavy. That is very easily corrected by removing that excess skin and breast tissue. It does require a scar across the bottom of your breast in the crease and there is no shortcut to get that result.