Loss of breast gland post pregnancy - what are my options to correct this and will it happen again?

It is important to remember that post op results are vulnerable to fluctuations in weight as seen in pregnancy/breastfeeding. While the degree of change is difficult to predict, there is likely to be an evolution of results,.

With regards to your specific question, a second pregnancy will likely change things further (how much change is a mystery?).

Rippling is best countered by submuscular placement.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

It is possible that you will have some additional involution following your next pregnancy. While no solution is absolutely perfect, you can speak with your surgeon about moving to a more cohesive silicone implant. Although these implants are not as soft (i.e. not as natural feeling) they will ripple less than traditional implants. This is often a good solution for women like yourself that do not have much fat to transfer.

Loss of breast gland tissue and volume after pregnancy is a common concern for many women. The hormonal changes during pregnancy and breastfeeding can lead to significant changes in breast size, shape, and tissue composition. If you are looking to correct this loss, there are several options available, each with its own benefits and considerations. Here’s a comprehensive overview of your options and what to expect in the future:

Correction Options
Breast Augmentation with Implants

Description: Silicone or saline implants can be used to restore volume and shape.
Pros: Can achieve a significant increase in size and desired shape; long-lasting results.
Cons: Involves surgery with associated risks and recovery time; potential need for future surgeries for maintenance or replacement.
Suitability: Good for women seeking a considerable increase in breast size and volume.
Fat Transfer Breast Augmentation

Description: Fat is harvested from another area of your body (such as the abdomen or thighs) via liposuction and then injected into the breasts.
Pros: Uses your own tissue, reducing the risk of allergic reactions; more natural look and feel.
Cons: Less predictable in terms of final volume increase; multiple procedures may be necessary to achieve desired results.
Suitability: Ideal for those looking for a modest increase in breast size and who have sufficient donor fat.
Breast Lift (Mastopexy)

Description: Removes excess skin and tightens surrounding tissue to lift and reshape sagging breasts.
Pros: Improves breast shape and firmness; can be combined with implants or fat transfer for added volume.
Cons: Involves surgery with scarring and recovery time.
Suitability: Best for women with significant sagging or drooping of the breasts post-pregnancy.
Combination Procedures

Description: Combining a breast lift with either implants or fat transfer to both lift and add volume.
Pros: Addresses multiple concerns in one procedure; comprehensive improvement in breast appearance.
Cons: More complex surgery with longer recovery time.
Suitability: Suitable for women needing both lift and volume restoration.
Considerations for Future Pregnancies
Recurrence: Pregnancy and breastfeeding can again cause changes in breast size and shape. While the structural integrity provided by a lift or the volume from implants might offer some resistance, it is possible that future pregnancies will affect the results.
Timing: If you plan on having more children, you might consider waiting until after your final pregnancy to undergo corrective procedures to avoid potential changes.
Breastfeeding: Discuss with your surgeon how each procedure might impact your ability to breastfeed in the future. Some procedures, like implants, are less likely to interfere with breastfeeding than extensive lifts or reductions.
Consultation with a Plastic Surgeon
Personalized Assessment: A board-certified plastic surgeon will evaluate your current breast anatomy, tissue quality, and your aesthetic goals.
Customized Plan: The surgeon will help develop a plan tailored to your needs, whether it involves augmentation, lifting, or a combination approach.
Realistic Expectations: Understanding the potential outcomes and limitations is crucial. Your surgeon will provide a clear picture of what to expect from the procedure(s).
Summary
Correcting the loss of breast gland tissue post-pregnancy can be effectively achieved through various surgical options, including implants, fat transfer, lifts, or combinations thereof. While future pregnancies can impact the results, choosing the right procedure tailored to your specific needs and timing it appropriately can help achieve and maintain the desired breast appearance. Consulting with a skilled plastic surgeon is essential to explore your options and create a plan that aligns with your goals and lifestyle.

It is difficult to accurately predict the impact of future pregnancies on your breasts. If you are unable to have any more fat transfer, then you could consider changing the implant plane (placing the implants under the muscle) to provide additional tissue over the implant or switch the implant to one with a more cohesive silicone gel to reduce the risk of the implant rippling.

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Dear Fabulous588716,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

It is hard to predict the changes in your breast if you become pregnant again but for the rippling I would suggest going back into the pocket and removing a very small amount of the capsule (as it can get imprinted from the wrinkles in the implant), and replace it with some Strattice. I know you said you didn't have any fat but I can usually find a small amount of fat in these situations (and not much is needed) to also add.

First, your breasts will probably do what they did in your first pregnancy with each pregnancy in the future. For rippling, I suggest placing the implants behind the muscle for better coverage and do not go larger. If you have saline implants, change to gel.

There is no way to accurately predict how future pregnancies and/or breastfeeding will impact your breasts. One option to consider is to place the implants behind the muscle. This helps to camouflage the upper outer portion of the implants which is particularly helpful in those patients whose tissues are thin.

Unfortunately, as we age and get past the pregnancy years breast gland tissue tends to become a trophic, especially in thinner patients. This ultimately results in sagging skin and if implants are in place rippling is noticeable. That said you have several options. One is to do fat grafting and replace the implant with a gummy bear implant that has less rippling. A second option is to take the implants out of the plane and into the muscular pocket and perform some type of breast lift.