Best Breast Implant For Weight Loss, Excess Breast Tissue?

I lost a lot of breast tissue after weight loss. What type of implant is best? I have recently lost a little weight and am now 114 lbs. I am healthy and feel great. But I have also lost breast mass as well, and went from a very large D to a small C. The skin on my chest is crepey but I don't have much saggin at at all, yet, thankfully. What type of breast implant would best suit me. If I want minimal scarring and a natural look and feel. Over, under? Gel, saline? It's all over whelming. I am a young topless dancer in desperate need of advice. Thank you.

Doctor Answers 5

Breast augmentation after weight loss

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There are often many possible answers to any given cosmetic surgery scenario or question. Having your picture is certainly helpful to giving you an answer without an in person consultation. I would say that you have maintained a nice breast shape after weight loss and couple that with your desire to have natural look and minimal scars, in addition to taking into consideration your profession, a breast augmentation with silicone implants placed through a small incision at the lower edge of the areola should be able to give you the look and feel you are looking for. I have performed many breast augmentations with silicone implants through this incision and this typically heals very well to the point that the incision is often difficult to see.

Good luck.

Breast Augmentation method with minimal scarring

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Dear Jain,

Many textbook chapters have been written on the topic your raised and obviously this space would not allow a complete explanation of the topic.

I will base my answer on your following description :" am now 114 lbs. I am healthy ...lost breast mass ...went from a very large D to a small C....The skin on my chest is crepey ...don't have much saggin at at all, a young topless dancer "

There is NO perfect breast implant. To get the best possible breast enhancement we have to match your particular breast and chest characteristics, to the breast implants that may be used in your circumstances. We also have to consider that unlike other women your occupation depends on the appearance of your breasts.

First, a few facts. Breasts (and faces) like people, have a lifetime and sag. Even if you take care of yourself, the breasts (and face) you have at age 20 will NOT be the breasts (and face) you will have at age 60. The heavier the breasts (the bigger the implants), the faster the sagging. (This factor needs to be considered in your case where few dancers continue dancing into their 40's - so a larger implant may be put in but may have to be exchanged or breasts be lifted earlier). All breasts implants will eventually leak and have to be replaced; this can happen anytime in 20 or so years.

In MY opinion the best incision (scar) to place a breast implant in is the periareolar scar (around the dark skin of the nipple). It often heals to the point of almost invisibility and unlike the other scars, it can be reused over and over again (to change implants and even, when needed, to lift your breasts).

As to "What type of breast implant would best suit me" - that would depend on how much breast (skin and fat) you have to cover the various size implants, the laxity of the breast skin (which in your case is not a problem), the width and slope of your chest wall and the position of the nipples vis a vis your under the breast fold.

Personally, gel filled implants FEEL more natural and are volume per volume lighter than saline implants. While placement over the muscle will give you more prominent, "out there" breasts, this will also be associated with faster sagging, more visible and palpable implant ripples and potentially more potential healing difficulties in the future should you decide to have a breasts lift (since the blood supply to the breasts skin is interrupted more). An UNDER the muscle placement, is associated with less visible and palpable ripples, potentially less OR less visible scarring around the implant (capsular contraction), less sagging BUT less breast prominence.

Your best bet is to consult with several board certified plastic surgeons and go with the one who spent the most time with you, answered all your questions completely and who you trust the most. THAT choice ultimately would get you the best augmented breasts you can have,

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Breast augmentation desire for natural look and feel

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Most patients and plastic surgeons are of the opinion that silicone filled implants have a more natural feel and less tendency to wrinkle or ripple than saline filled implants.

There are several considerations or "trade-offs" in the decision to go above or below the muscle. One of those which is not obvious from your photo, is the thickness of the tissue in the upper portion of the breast. You consulting plastic surgeon can go over the pros and cons of that decision after an exam. In general though, in many patients a more natural result may be achieved with placement of the device beneath the muscle.

Regarding the "naturalness" of the result, probably the factor that contributes most is the size of the implant. Your consulting plastic surgeon will measure your breast, chest and tissues and suggest a range that "fits" for you. If you choose to go larger one of the "trade-offs" may be a less natural appearance.

In most patients the scar around the areola or the short scar in the natural crease below the breast fades over time and either location may be appropriate.

John E. Gross, MD
Los Angeles Plastic Surgeon

Breast Implants and Lift

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Dear Jaindoe,

Thank you for your interest and inquiry. Please be advised that an 'in-office' consultation with full interview and physical examination is truly the best way to answer all your questions and concerns-particularly when one is considering an undertaking as important as surgery.

Some important questions to consider prior to breast augmentation surgery include your age, if you plan to have children and/or breastfeed in the future, have you had a mammogram, and is there any family history of breast cancer? Your picture is helpful. It appears you have lost volume in your breasts with your weightloss- particularly in the upper pole regions. Luckily, you do still have quite a significant amount of breast tissue and volume in the lower poles.

You do have what appears to be either Grade I or Grade II Breast Ptosis, which is just a fancy word for the degrees of "sagginess" of your breasts. In Grade I Ptosis, the nipple lies at the level of the inframammary fold, and in Grade II Ptosis, the nipple lies slightly lower. It is difficult to asess if you have any asymmetries of your breasts with only one view.

The decision of whether to get saline or silicone implants is one that I leave solely to the patient to decide. There are many significant differences--which is the topic of a rather in-depth discussion. You have enough breast tissue to 'camouflage' an implant and would likely be satisfied with either option.

Silicone implants these days are better devices, more cohesive, and many women choose this option because they believe the silicone to feel more natural and more like actual breast tissue. Silicone implants may be heavier on your chestwall--a consideration to keep in mind if you are very petite, thin, or have any issue regarding chronic neck, shoulder and/or upper back pains that you would not wish to aggravate or make worse.

The question of whether to place the implant over or under the pectoralis muscle is another in-depth discussion. The fact that you wish to minimize your scarring is an important factor. Due to this, and the fact that you desire a rather large-sized implant and breas, I'd recommend you get silicone breast implants placed in the subglandular position through a peri-areolar approach where the incision lies along the upper portion of the areola so that a small peri-areolar "lift" can be performed at the same time, through the same incision without creating any additional scars.

You must be informed, however, that if your breast skin is indeed thin and "crepey" as you describe, that you will indeed run the risk of getting "saggy" again in the future with aging and the weight of the implants pushing on the skin. Any future weight-gains and weight-losses can change the size and shape of your breasts.

Also, future pregnancies and breastfeeding will also likely alter the size and shape of your breasts. Thus, you should be prepared for some type of revisional breast surgery in the future to correct any shape changes and/or any commonly-known sequelae of breast implants such as future rupture, capsular contracture and/or deflations.

As you can tell by the length of my response, breast augmentation, particularly when coupled with a breast lift, is a rather complicated and very personalized decision regarding the implant type, size, surgical approach, type of mastopexy required and future sequelae and/or complications.

Suzanne M. Quardt, MD
Palm Springs Plastic Surgeon

Photos of breasts after weight loss

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You have large breasts with ptosis (sagging) which would benefit from a lift but this would cause significant scarring. Howver, given the amount of tissue you have, I might consider using silicone implants placed over the muscle. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 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.