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Advice for Sagging Breasts After Weight Loss?

I am 29 and have recently lost 100 lbs. I have always had large breasts (46 DDD) now that I have lost the weight I feel so insecure, my chest is saggy and looks like giant rasins. I have always loved my large chest. Now I wear a 38 DDD, the cup size didn't go down, but my skin is just loose and gross. I still want very large brests. The rest of my body is responding nicely to all my working out. I want to be excited about my weight loss. Do you have advice?

Doctor Answers (25)

Breast Surgery Following Weight Loss

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         Massive weight loss of more then 100 lbs can significantly affect a women’s body. Weight loss of this magnitude can cause loose saggy skin in multiple anatomic areas. It’s not unusual for women to lose breast volume and develop breast sag, when this type of weight loss occurs. For this reason, they frequently request breast lift and breast augmentation surgery.

 

         Without pictures and a physical exam it’s hard to know what option is best for you. The majority of patients want restoration of breast volume, correction of breast sag, upper breast fullness and symmetry. The majority of patients require a keyhole mastopexy. In some cases a breast implant is necessary to create upper breast fullness and restore breast volume.

 

         Breast implants can be placed at the time of the breast lift or delayed and performed as a secondary procedure. Both approaches have advantages and disadvantages and many surgeons have strong opinions about this topic.

 

         When both procedures are performed together, revisions are frequently necessary. For this reason, some surgeons feel that staging the procedure is appropriate. Advocates for a combined procedure feel that this approach saves the majority of patients a secondary procedure. They don’t view a secondary procedure as a complication but instead as a necessary next step.

 

         It’s appropriate to individualize care for each patient. In some patients, a combined procedure is indicated while in others a staged approach is necessary.

 

         If your considering breast augmentation and breast lift following massive weight loss, consultation with a board certified plastic surgeon is appropriate. This surgeon should be able to help you formulate a treatment plan that will meet your needs. 


Omaha Plastic Surgeon
5.0 out of 5 stars 74 reviews

Breast lift after weight loss?

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Almost all female patients will benefit from a breast lift after losing 100 lbs or more.  If you are a DDD-cup size, you will also benefit from a breast reduction.  Your insurance may cover a portion of the cost of surgery.

David Stoker, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 19 reviews

Breast Surgery Following Weight Loss

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Many patients present with sagging breasts which have lost volume following significant weight loss. Normally, the problem is a combination of loose sagging skin and diminished breast volume. In this situation, it is often necessary to perform a breast lift and a breast augmentation. Performance of a breast lift and breast augmentation at the same time is one of the more challenging procedures routinely performed by a plastic surgeon. In this situation, many different components of the breasts are changing at the same time. The size and shape of the breast is changing and the position of the nipple is changing. There is often some degree of preoperative unevenness or asymmetry creating more challenges during the course of this operation. Even though breast augmentation and breast lift surgery are performed at the same time, it should always be considered as two separate operations. Sometimes after healing has occurred, some residual asymmetry unevenness may be noted requiring a second operation to achieve the optimal result. Most often when augmentation and breast lift surgery are performed together, a second operation is not required. In the event however, that the second operation is required, it should not be interpreted as a failure of the first operation.

Some patients may elect to separate these two procedures from the beginning. If the breast lift is the most important of the two procedures then it can be done first. After adequate healing, a patient may return for placement of a breast implant to help restore volume.

Some patients have sufficient breast tissue to satisfy their postoperative goals. In this case, a breast lift in conjunction with redistribution of the breast tissue can lead to a satisfactory result.

It is very important if you are considering this type of surgery that you consult with a well-trained plastic surgeon experienced in all forms of breast surgery.

John J. Edney, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 49 reviews

BREAST SURGERY

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As you can see from the other answers this is not as straight forward as you would think. The most conservative approach would be a two stage operation with a lift in the first operation, wait 3 months and than adding an implant to the desired volume

Ryan Neinstein, MD, FRCSC
New York Plastic Surgeon
5.0 out of 5 stars 36 reviews

Breast Lift after Weight Loss

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If you are happy with your current volume, but simply want the volume back where it used to be, you may be an excellent candidate for a breast lift with auto-augmentation.
This is my primary method of breast lift in patients who do not require a breast implant.  This will provide natural results with suture resuspension of the breast tissue to the upper pole producing fullness/cleavage without tension on your skin.   This will minimize stretching of the skin longterm.  
Also, by avoiding the long horizontal scar, you will be able to show cleavage without visible scars and where swimsuits and bras that easily camouflage all your scars. 

This allows for a long lasting result because the breast tissue itself has been lifted, not just the surrounding skin.
I wish you a safe recovery and fabulous result!
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 35 reviews

Breast sagging after weight loss

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There are many different types of breast lift and each one is designed to take care of increasing degrees of breast sagging or ptosis.  Unfortunately there are no short cuts with breast lift surgery.  Many times the patients would prefer a lift with less incisions but it is not always possible.  A plastic surgeon will be able to examine you and select the correct operation to meet your expectations.  In you case with the amount of breast tissue below the inframammary crease you will need at least a vertical mastopexy and possibly an anchor type.  This will give you the beast result.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

Breast augmentation and mastopexy?

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Congratulations on your weight loss- you should be very proud of what you are accomplishing.

Given the information that you have provided and the goals of treating “sagging breasts” and wanting “very large breasts” it may be it in your best interest  to do the breast augmentation/mastopexy in a two-stage fashion.

Whether to do the  breast augmentation/mastopexy in a single stage or  II staged  manner is not a question agreed-upon by all plastic surgeons. There are good plastic surgeons who will insist on doing the procedures separately and there are good plastic surgeons who can produce excellent outcomes in a single stage.

The combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increase with breast augmentation / mastopexy surgery done at the same time.
In my opinion, the decision  to do the operation in a single or two  staged fashion becomes a judgment call made by a surgeon after direct examination of the patient.  For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or  whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).
Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks  are greater with a 1 stage  procedure and the patient does have a higher  likelihood of needing revisionary surgery.
I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 710 reviews

Breast lift and implants (augmentation mastopexy) following massive weight loss

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In Instances like this I often advise a two stage approach for several reasons but primarily because: 1) you are at a high rate for revisionary surgery and 2) the blood supply to the nipple is compromised by the very long and thin stalk of tissue providing vascularity. An implant placed at the same time could further compromise this delicate supply.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

Sagging Breasts After Weight Loss

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I see many patients that have diminished skin elasticity in the breasts while other areas of their bodies have good elasticity. In my experience, this tends to be genetic and also probably related to your weight loss. In the end the stretched out skin needs to be reduced with perhaps a majority of your breast tissue preserved which should lift your breast and make you slightly smaller but maintain some of the volume. Frequently a C cup can be attained which will give some longevity to your lift. If you only tighten skin and remove no tissue you'll still have lots of weight that will re-stretch the skin over next few years. Talk with a plastic surgeon who can examine you in person and make suggestions based on your specific anatomy.

Deason Dunagan, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 4 reviews

Getting the Sag out of the Breast: Breast Lift after Weight Loss

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Weight gain, pregnancy and genetics can all enlarge the size and weight of the breast. This places a tremendous amount of tension on the supportive tissues of the breast, including skin. When these stretch and fail, you are left with a sagging breast or breast ptosis coupled with things like stretch marks. After weight loss, these supportive structures sometimes do not bounce back. It sounds like you are large breasted, and what you should consider is a breast reduction which lifts the breast with the same incisions as a breast lift, as well reshaping and lightening the breast by removing breast tissue. I would recommend consulting with a plastic surgeon for this and consider to be at a stable weight which is realistic for about 3 months.

I hope this helps.

Dr. Trussler

Andrew P. Trussler, MD
Austin Plastic Surgeon
4.5 out of 5 stars 11 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.