Steven Vath, MD

Thank you for your question. Given the degree of your breast ptosis (sagging) I would advise that you undergo a full (anchor) breast lift with augmentation to achieve the best result.

A breast implant will simply make what you already have larger. I would absolutely recommend that you undergo a breast lift with augmentation. A breast lift will restore a youthful, perky breast shape and position. and the implant will give the upper pole fullness that you want.

Muscle repair is an integral part of a tummy tuck, and should therefore be included at no extra charge.

Given the physicality of your occupation, you should plan on a minimum of 2 weeks off from work. I would also recommend starting back after the 2 weeks with working 1/2 days if possible. If you have the flexibility to take 3 weeks off, that would probably be best.In answer to your other question, taking the stairs at your home should not be a problem.Best of luck!

You are referring to a rare lymphoma called Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) that the FDA reports is related to textured breast implants. This is a rare and treatable type of T-Cell lymphoma that can develop around breast implants. BIA-ALCL is not the more commonly diagnosed cancer of the breast tissue itself. The FDA as well as the Institute of Medicine (IOM) maintain that breast implants do not impair breast health or cause breast cancer, and scientific evidence continues to support that FDA-approved breast implants have a reasonable assurance of safety and effectiveness according to a joint statement issued by the American Society of Plastic Surgeons (ASPS) and The American Society for Aesthetic Plastic Surgery (ASAPS). Breast implant associated-ALCL is very rare, and if it occurs, is highly treatable in the majority of patients. With all that being said, I make sure to address ALCL in my consultations with patients. If having this, albeit very low, risk is not something they are willing to take on, I recommend a smooth breast implant. A very natural and aesthetically pleasing result can be obtained with these implants.

You are still very early in the healing process and it is not at all uncommon for the breasts to "drop" or relax at different rates. You won't see the end result of your breast augmentation until at least 4 months  post-op (and up to 6-7 months), so try not to stress about it.Cheers!

First off, in answer to your question, it is not uncommon for a patient of your age with a breast size of DD to experience sagging. You are a great candidate for a breast lift. A breast lift, or mastopexy, will lift the breast and nipple restoring a youthful, perky breast shape and position. The areolae are also usually reduced during a breast lift. Women after a breast lift generally feel that their breasts are slightly smaller even though no breast tissue has been removed. Only skin is removed during a lift; however, because the breasts no longer "hang," they look and feel smaller to the patient.If you would like to significantly decrease your breast size, a reduction would be advised. A reduction does everything a lift does and removes breast tissue as well.Best of luck.

You are at an acceptable BMI to undergo surgery now. I do caution you that if you are intending to lose 15+ pounds, to go ahead and do that prior to surgery for the best possible result.Best of luck!

I routinely perform breast lift and tummy tuck procedures at the same time. As long as the patient is in good overall health, there is no reason at all to separate the operations. The pros to doing them together are:

• Only one anesthesia event
• Only one recovery period
• Typically cheaper (for instance, in my practice, I offer a discount off the surgeon's fee when procedures are combined)

Hello and thank you for your question. If I saw you in for a consultation, I would definitely recommend that you have a breast lift to get the best aesthetic result. Breast implants do NOT lift breasts or assist in lifting breasts. Commonly, it is assumed that implants alone, without a lift, will raise breasts and achieve a more youthful appearing shape. Many women hope for this implant-alone option to avoid the scars incurred with a lift. But implants do not restore an attractive shape to sagging breasts: only a breast lift can do that. Implants alone will successfully fill out deflated breasts that do not drop below the breast creases. Deflated A-cup breasts after pregnancy often fit this scenario for an implant-only solution. Otherwise, when breasts truly sag, implants can be added to a lift procedure to boost upper fullness and overall size.