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Is It Normal to Appear Flat After a Breast Lift?

I am 3 weeks post lift and feel like I had a reduction. I have gone from a solid C-D to a small B and no cleavage. My PS says I am swollen in the sides and will fill out through the middle. Is this normal? My PS is already saying we can add implants so this leads me to believe I have an issue. Should she provide the impants at no or reduced cost?

Doctor Answers (13)

Flat Appearing Breasts After Breast Lift Surgery

+1

First of all, it is not uncommon to have a flat or square appearing breast after a wise-pattern or anchor-pattern breast lift. I will inform my patients of this possibility pre-operatively. Secondly, A breast lift alone should not reduce your size by 2 cups. You may see a very slight (maybe a half cup at the most) reduction due to skin tightening and compacting of breast tissue. I often suggest a small implant with a breast lift to give patients that "fuller/perkier" look. I would encourage you to discuss your concerns with your surgeon and I'm sure you will come to an agreement about future surgery and costs.

 


Minneapolis Plastic Surgeon
5.0 out of 5 stars 81 reviews

If your size is smaller, then you had a breast reduction, NOT a breast lift.

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Breast lift (mastopexy) surgery typically involves only skin removal and putting your existing breast volume in a higher, tighter skin brassiere. Even for very large droopy breasts where the patient wants to maintain her size and simply get her own breast volume to a more youthful and uplifted position on her chest wall, I will generally remove no more than an ounce of skin per breast (I always weigh and record the amount removed on the patient's chart). Perhaps your surgeon did this as well, as it certainly seems as if you had a "cosmetic" reduction rather than a lift.

Since both a full Wise (anchor) mastopexy (breast lift) and Wise-pattern breast reduction utilize the same incisions, the amount of tissue removed is not defined by the incision pattern chosen, only by the choice and judgement of your surgeon.

It certainly sounds as if you surgeon removed more than just skin in performing your "breast lift" and perhaps it is because there was some difficulty in safely closing your incisions with all of your tissue remaining. But that is a function of the design your surgeon chose, and experience with this procedure tends to reduce these concerns. If your surgeon is talking about "adding" implants at this stage of your recovery and newfound dissatisfaction, I suspect she may have felt the need to remove tissue in order to perform a proper closure, decreasing your size more than you prefer.

I'd ask your surgeon frankly about the cost for redo surgery, but I personally continue to be dismayed that patients don't ask this (and surgeons often don't discuss this openly) BEFORE surgery. Providing implants at no or reduced cost is not the only financial issue, as there are still operating room, anesthesia, and possible professional fees to discuss! Good luck, and understand that your surgeon always TRIES to do what the patient wants, but sometimes anatomy and other factors may change that plan. Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 123 reviews

Breast Lift VS Breast Reduction - What's e difference?

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Breasts can sag due to either 

- excess breast skin only

- excess breast skin AND excess breast volume

When the breasts sag owing to a larger breast skin envelope, removal of the excess skin restores balance between the volume and envelope and repositions the nipple complex back on the breast mound. Ths us a Breast Lift (Mastopexy). It is not covered by medical insurance and does not significantly decrease the size of the breast. 

When the surgeon has to remove both excess skin and breast tissue to make the breast smaller the operation is a Breat Reduction and subject to your insurance policy requirements, it may be covered by your insurance policy. 

Unless your surgeon performed a breast reduction there is no reason why your breasts shoud be significantly smaller. 

 

 

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 60 reviews

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Perception of Smaller Breasts After Breast Lifts

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While no breast tissue is removed in a breast lift (only skin), the breasts can appear smaller to many patients. This is because the skin tightening and lift create overall smaller breast dimensions higher up on the chest. This is why many breast lifts benefit by at least a small implant, if only to create sustained upper pole fullness. An implant should not be used in a breast lift only if one can accept the potential for smaller appearing breasts.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 27 reviews

Loss of bra size after breast lift

+1

Many patients perceive a loss of volume with a breast lift if no implants are used, this is why I recommend to most patients that they have a small implant placed at the time of a breast lift. There may be circumstances why your plastic surgeon did not want to place an implant at the same time that she was doing a lift and you should discuss this with her. It is unusual to drop 2 cup sizes, however depending on how stretched out her breasts were before, it could certainly be possible to see this. You would have to discuss with your plastic surgeon what their policies are regarding additional or provisional surgery.

Johan E. Brahme, MD
San Diego Plastic Surgeon
4.5 out of 5 stars 13 reviews

Is It Normal to Appear Flat After a Breast Lift?

+1

Breast size or volume should not change after a breast lift, since only the excess skin is removed, unless the surgeon specifically performed a breast reduction and removed breast tissue.  A breast lift reshapes the breast, lifting the nipple position, reducing breast overhang, and tightening the skin. It can take some time for the breast to "relax" and settle, so if there was some "overtightening" to account for later skin stretching, the breast might seem a little less projecting at first until the tissues relax.  In the meantime, the tissue may not "distribute" itself into your regular bra in quite the same way. Of course, a breast lift does not create better upper pole fullness without an implant. Give it time.  If the surgeon performed a breast lift, removing skin only, and discussed with you pre-operatively what a lift would and would not do, the surgeon should in no way feel obligated to perform a breast augmentation at no or reduced cost.

Robert M. Grenley, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 70 reviews

Breast lift

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Breast lift surgery ineveitably has to remove some tissue to properly mold the breast. I am not sure why you dropped two cup sizes.   This should be discussed with your doctor.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Breast lift should not reduce cup size

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A breast lift will recruit tissue into the breast and many will feel slightly fuller after a lift. Hard to say why you went from a D to a B cup. Where did it go?

Best of luck, peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 28 reviews

Results from Mastopexy

+1

Without seeing before and after photos, it is impossible to give you specific advice.  In many cases, patients need both an implant and a lift to achieve the best results.  Many surgeons do the lift as a first stage and then implants as a second stage surgery or visa-versa.  However, it is also possible to do both procedures at the same time.

 

Good Luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 57 reviews

Changes in size and shape after Breast Lift

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A breast lift is an operation designed to reposition the nipples and brest tissue on the chest in patients with varying degrees of breast sagging. ( Was a small breast reduction done with removal of some breast volume?, as a breast reduction may involve similar incisions but involves removal of stretched out skin and breast tissue as well.).  

Although a breast lift may provide additional upper breast fullness early on, this will probably lesson as things stretch out.  If additional breast volume was desired, breast augmentation may be appropriate even at a second setting.  Discuss your concerns with your plastic surgeon as good communication with your surgeon is of most importance.     

Stephen Delia, MD
Boston Plastic Surgeon
5.0 out of 5 stars 10 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.