Will getting a Breast Lift first help me achieve my desired look? (photos)

Thank you for your question regarding what to do with sagging breasts after weight loss. A thorough history and consultation will be in order. I would specifically want to know how much weight you lose and if you have numerous stretch marks throughout your breast. It appears from your photos that you do not have significant stretch marks. Nonetheless, your weight loss is of concern. Weight loss tells the plastic surgeon how elastic your skin is. If you had lost over 100 lbs, the elasticity of your skin has been stretched almost to the max.

Nonetheless, I would suggest a mastopexy. This would be an anchor mastopexy with an incision around the areola, down the front of the breast, and underneath the breast. This will definitely lift the breast. At the same time, I would also suggest a smooth-walled implant. This can be placed either on top or under the pectoralis major muscle. If there is a concern for skin drop after the surgery, as your previous consultation mentioned, then I would suggest a dermal mesh be placed. There are several companies now which provide internal mesh which helps to support the implant. Over several months this mesh dissolves and is replaced by your own naturally formed scar tissue within your breast. This leads to a solid lift for years to come and the implant and lift will not significantly drop. I would seek consultation from several other plastic surgeons before you give up on breast surgery. In my opinion, I would go for it. Specifically, I would suggest an anchor mastopexy, breast augmentation with silicone implants, an insertion of mesh. Thank you for your question regarding what to do with sagging breasts after weight loss.

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

I would suggest doing the lift first. I think you have plenty of volume and would do well with a lift. Adding implant adds weight to you now stretched out tissue and tends to stretch and sag with time.

Hi Graceful 431279,
In looking at your situation, I think you are a fantastic candidate for breast lift only with superior pole autoaugmentation. You certainly have enough breast tissue to fill out the upper pole and by just moving your breast tissue up you will have a perky C+/D- breast size. We have also been adding fat grafting as an adjunct to fill out the cleavage if desired as well as an internal lower pole support in form of a sling as well to secure the breast position. At Cosmoplastic Surgery, we have used the "Naturabra" technique that allows for your own breast tissue to act as an internal bra that supports the lifted breast while filling out the superior pole. We just reported our results of the past 18 years of over 700 breast lift cases at the 100th anniversary meeting of the American Association of Plastic Surgeons in San Diego in April 2022.