Lost 100lb and Now Want Tummy Tuck Breast Augmentation, How Many CCs To Go From B to DD-DDD Cup?

I lost 100 lbs-diet/TONS of exercise (275to175/5'3/27y). Everything tightened but under my arms, breast skin, and lower abominals. I have 30 lbs more to loose. But my breasts are completely deflated (not sagging), abdomen hangs-just skin. I want a tummy tuck and augmentation, augmen 1st.(Go from B? to full DD-DDD). My goal is VERY large/full breasts-don't mind semi-fake looking but I DONT want to look that stretched-skin porn look. Do I have to loose the lbs first? What cc should I get?

Doctor Answers 10

Implant Size to move from B to DD cup after weight loss

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Congratulations on the weight loss. You may want to be within 20 pounds of your target and long term stable weight for optimal results.

The size of the implants are based on a combination of a patient's goals and objectives and her anatomy. In order to provide a natural looking augmentation, the surgeon needs to evaluate many factors including soft tissue coverage, skin laxity, chest wall width, breast imprint width, the shape of the breasts and relative level of constriction to ensure that the breast implants are appropriate for your body. Consult in person with 3 experienced and expert board certified plastic surgeons to understand your options.

West Palm Beach Plastic Surgeon
4.5 out of 5 stars 55 reviews

Massive weigth loss and breast augmentation

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Given that you lost a lot of weight, by the way which is terrific(!), implants can help fill you out. Remember though that your skin has been stretched alot and is probably  not of the best quality. A very large implant, may not be work well with poor skin quality.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Implant sizes for a mastopexy augmentation following massive weight loss

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You have largely succeeded in the difficult first part - losing over 100lbs. Now for the personal rewards for your perseverance - cosmetic improvements.

You will need not only an augmentation but also a breast lift (mastopexy). In order to determine the most appropriate implant size for you, a detailed physical examination would be mandatory. Because your tissue has been severely damaged by the massive weight gain then loss, it would be an imprudent choice to go with very large breast implants. Your skin would thin out and stretch extremely rapidly and you would then have to deal with these consequences. It would be better to look at a "C" or a "D" cup size. The implant sizes that might help you meet this goal could be determined during your consultation with a board certified plastic surgeon.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 31 reviews

Breast augmentation and weight loss

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Well done on losing the weight! Massive weight loss patients are the most difficult group in which to achieve good results from breast augmentation. As others here have said, this is because of the large amount of excess skin usually with poor elasticity after weight loss. It's also because the inframammary fold height is often dropped. If it is at least 1.5 inches above your rib margin when you're standing up, then the results will be better. Here are a couple of tips: 1. Don't get too too skinny. Weight loss patients look at their best at the upper end of their recommended bmi not at the lower. So stay just a little chubby. 2. Go to a surgeon with extensive experience in breast rehabilitation after mwl for advice. There is a long learning curve for surgeons in learning how to achieve consistent results in mwl patients, and your request is a really difficult one. Well done and good luck.

Plastic surgery post massive weight loss

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Congratulations on your weight loss! Many patients who have experienced a significant amount of weight loss opt for breast augmentation with mastopexy (breast lift) and a tummy tuck procedure to improve body contours. It would be in your best interest to consult with a board certified plastic surgeon to discuss the best and safest options for you. I ask my patients to reach their ideal weight prior to proceeding with surgery to avoid additional surgery and ensure the best results possible. It is difficult to determine how many cc’s you should get pre-operatively. Every surgeon utilizes a different technique to determine implant size and profile to be used. Clear communication with your plastic surgeon is important in achieving the desired goals of the patient.  I like to communicate with patients with “goal” pictures.  During surgery, I use temporary sizers to determine the size/profile that will give the patient the look she is looking for. Trying to predict the size of the implant preoperatively is not ideal.  I think it is too much responsibility for the patient to choose the size of the implant.  Ideally, the surgeon would make that determination once he/she is in the operating room with sizers in and examining the patient in the upright and supine position.  There are many variables that come into play when choosing the correct implant size (how much breast tissue the patient currently has, the shape of the chest wall (concave vs. convex), etc…If a breast lift is indicated (as is often the case after 100 pound weight loss) a single or 2 stage procedure may be recommended.

Breast Augmentation After Massive Weight Loss

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After massive weight loss, choosing a breast implant size just based on the cup size you want is a bad idea.First, figure out the correst procedure.If the breasts are just deflated without sagging, which means the nipples are at or above the breast fold and point outwards, a breast augmentation alone will work; otherwise you may need a breast lift. In almost all cases of total deflation after massive weight loss, the breast skin and tissues have lost much of their elasticity. Large breast implants to get to a DD or DDD cup size may fit but in the long run would create more sagging. Pick an implant size under the guidance of a board certified plastic surgeon and choose one that will fill out but not stretch the skin, and forget about cup size. Also, silicone implants weigh less than the same size saline and would probably be a better choice.

Joseph Fata, MD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 105 reviews

Excess skin after weight loss

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For safety reasons I do not like to do too much surgery on a patient at one time. Those patients who have lost a lot of weight (over 100 lb) tend to have remaining excess skin in the abdominal, love handles & inner thigh areas. Some also have extra hanging skin in the upper arm area &/or chest. There may also be remaining significant amounts of fat in some areas. Clearly operating on all these areas at one time would be too much surgery. I prefer to tackle the largest area first i.e. the abdomen & love handles by performing an abdominoplasty - tummy tuck & outer thigh & buttock lift or belt lipectomy. This is a lengthy procedure by itself that I perform in the hospital if the resection is extensive. The patient stays in the hospital for 1 to 2 days. A one month preparation is required during which time the patient donates their own blood for re-transfusion during surgery at the hospital via the Red Cross. I have found this allows for a much quicker uneventful recovery.

The abdominoplasty - tummy tuck & outer thigh & buttock lift involves the removal of a circumferential section of skin that lies under what is normally covered by underwear or a bathing suit. The remaining scar lies across the lower abdomen and just above the buttocks on the back. It is designed to be hidden by a bikini type brief. Given the weight loss you describe it is unlikely that an abdominoplasty alone will suffice. You will most likely need an an abdominoplasty extended onto the back or the belt lipectomy.

6 or more months later 1 or 2 of the following - chest, inner thighs, upper arms - can be addressed as well as any liposuction or touch ups that may be needed on the first procedure.  Without seeing it is impossible to say whether you need a lift with breast implants or even if it is advisable to do both at the same time. However if the abdominal and back skin resection is extensive the breasts should definitely be done at a separate operation for safety reasons. You should also do the abdomen first so that the design of the breast surgery can be adjusted for the pull of the abdominal tightening. If you do the breasts first the abdominal tightening can distort the breasts.

Touch ups are minor revisions performed on previous operative sites to achieve the best look possible such as liposuction or scar revision. This procedure(s) is performed in my office operating room & no overnight stay is required. 6 or more months later a final procedure is performed on any remaining problem areas if desired by the patient. In most cases only 2 or 3 procedures are required. Photos of patients on whom I have performed the procedures can be found on my website.

It is not necessary that you lose the additional weight as long as you are not currently morbidly obese (over 100 pounds above ideal body weight) and as long as your weight has been stable for about 6 months. Also be sure to get a medical clearance from you internist to ensure you are in the best condition before surgery. That should include a nutrition work up.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Breast Augmentation and Tummy Tuck after Weight Loss

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Congratulations on your weight loss!  Body contouring after massive weight loss is an excellent way to restore volume to your breasts and remove all of the excess skin from your abdomen.  Usually, a breast lift is required with breast implants and you can be a DD-DDD cup size if your skin allow it.  Because you want to be on the bigger side, you may need the lift first and then the implants to prevent excessive scarring.  For the tummy tuck, the abdominal muscles are tightened along with removing the excess skin.  Both procedures can be done at the same time to only give you one recovery time.  Having said all of this, I could give you a better idea of what you'll need to achieve your aesthetic if you provide me with pictures or come in for a consultation.  Again, great job on your weight loss!

After weight loss.

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i would suggest completing your weight loss process. implant size is very difficult to suggest without pictures and examination. keep in mind that the larger your implzants the more likely to have problems.  congrats and good luck

Jonathan Saunders, MD
Newark Plastic Surgeon

Be carefull what you wish for....

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The larger the implant the more it weighs. The more it weighs the higher the complication/malposition rate. Massive weight loss patients have compromised skin elasticity which makes augmentation less predictable. Get two or three opinions from experienced breast surgeons before proceeding. Good luck!

Marcel Daniels, MD
Long Beach Plastic Surgeon

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.