What size implants can I get with severe sagging?

Question

I am 27 years old, 170cm tall and weight 72kg. I have lost 54kgs. I am due to have my surgeries in Thailand in 12 days time. I have booked in for the following: - Breast Lift with Augmentation 400+ cc (Round implant) - Extended Tummy tuck - Mons Pubis lift - Arm lift - Side lift - VASER Liposuction 2 area (on love handles and arms. My question is.. .I am nervous I will not get the big breasts I have paid for due to how saggy my breasts are. What results should I expect?

Gary M. Horndeski, MD · Answer

I recommend a breast lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. After 6 months, you can consider augmentation or fat transfers.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

Because of your tissue and skin having been so stretched from weight gain, they will not hold heavy implants. That size can be used, but your tissue may not support it well and may sag. I recommend going with a smaller size so you will look good for many years.

Camille Cash, MD · Answer

Congratulations on your impressive weight loss and upcoming surgery!  An examination and measurements of your breasts are needed to give specific implant recommendations.  Many surgeons have sample implants available for you to "try on" to give you an idea of how you may look after surgery.  I also use sizers during surgery to help get my patients as close to their desired look as possible while still making sure the implant size fits the breast space.  On a separate note, this is quite a bit of surgery at one time.  You may want to consider two stages.

Steven Schuster, MD, FACS · Answer

My dear Pookie, If the picture you show on the right is what your surgeon thinks you will look like in the end I really think he is joining you a disservice. You have a lot of drooping and the concern is not how big you can be but what result can I give you.  Starting with breasts the bigger you go the bigger the risk of wound healing problems and scars stretching.  The extended tummy tuck will be good for you but I am concerned that this is a lot of surgery.  If you live in Thailand at least you will be able to be followed by your doctor for several months, but if you are traveling home quite a distance I would not recommend doing this much surgery and going home.  Instead of worrying how big you will be ask how many surgeons will be operating to minimize time in the OR and what to do if you have a complication.  And I agree with you that you should be concerned that you may not be as big as your wish picture after all of these surgeries.

Mats Hagstrom, MD (license on probation) · Answer

Fundamentally speaking, there are generally two variables that determine cosmetic surgical outcomes.
The first is the patient candidacy for the procedure and the second is the choice of provider.
I generally do not recommend people travel along distances for elective surgical procedures, and usually recommend patients have multiple in person, consultations with local providers before scheduling surgery. The more extensive the procedure, the more important this becomes.
You’re scheduled to have a substantial amount of surgery for one session.
I see no need for you to have Liposuction since subcutaneous fat excess is nonexistent on your body.
A wraparound, tummy tuck and breast lift seem like the most important procedures.
I’m not sure if the second image provided is your wish picture but that patient is a very different candidate than your own candidacy for breast surgery.
Your results will not look like hers because your body doesn’t look like hers.
For breast augmentation surgery, implant selection is an important variable. Each provider will have their own way of guiding patients through implant selection.
Using excessively large implants for a mastopexy augmentation operation can increase the chance of complications.
The key to quality outcomes is always going to be based on patients having a clear understanding of their own candidacy for the procedures they have selected with the appropriate selection of providers.
To find the right provider I suggest patient schedule multiple in person consultations.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who had similar body characteristics to your own.
And experience provider should have no difficulty showing you to before, and after pictures of at least 50 previous patients.
 Being shown a handful of pre-selected images of representing the best results of a providers, career or patients who don’t look like you is insufficient to get a clear understanding of what average results are going to look like in the hands of that provider, what your results are likely to look like or how many of these procedures they’ve actually done.
There’s no correct number of consultations needed to find the right provider.
The more consultations you have the more likely you are to find the best provider.
Likewise, it is very important for patients to understand their own candidacy for the procedure.
Patients were excellent candidates for surgery have the potential of having excellent outcomes.
They also have the potential for having poor outcomes. If the procedure is not done well.
Patience were not excellent candidates do not have the potential for having excellent outcomes, regardless of who does the procedure.
 an in person consultation should help clarify your candidacy for a procedure, including what the procedure can or cannot accomplish.
At this point, I’m not sure if any of this information is useful for you since you have surgery scheduled in Thailand in 12 days.
There are talented and less talented providers in our communities.
That said, long-term follow-up care tends to be more important than most people realize.
With having extensive surgery, the chance of needing revisions or having complications becomes real.
Perhaps you are a Thailand native.
I wish you all the very best with your upcoming procedure.
Best,
Mats Hagstrom, MD

What size implants can I get with severe sagging?

Answers (5)

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