Sagging, Uneven Breasts After Weight Loss - Surgical Options?

I lost 50 pounds this year and am concerned now that my breasts are not even, and they sag. what procedures would be recommended that cause the least amount of scarring? I am not concerned with breast size, but i would like more fulness up top. PLEASE HELP!

Doctor Answers 19

Option for saggy and uneven breasts after weight loss

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Congratulations on your weight loss!!

There is a new procedure called the Ultimate Breast Lift that provides upper pole fullness without implants and with the added benefit of NO VERTICAL SCAR. It was developed after it was noted that women who had large implants to 'lift' their breasts were highly disappointed and unhappy.  The 1957 anchor technique and subsequent 'vertical lifts'  leave women equally dissatisfied and unhappy. The Ultimate Breast Lift  is an extremely complex technique using engineering principles which require extensive knowledge in mathematics to perform. Breasts look natural and because the scars are well hidden, there are no issues with scarring. It's worth looking into.

Best wishes,

Dr. H

Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Surgical Options for Sagging, Uneven Breasts After Weight Loss

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An ideal #candidate for a #BreastLift (#Mastopexy) surgery are women who have #sagging breasts due to past pregnancies and #breastfeeding; both which increase breast #ptosis. Also, when many women lose #weight, their breasts lose weight as well. There may also be some sagging of their breasts due to the weight change. These women are potential candidates for a breast lift.
A #mastopexy or breast lift operation is designed to improve the shape and position of the breast without reducing their size. Those with breast #sagging or #ptosis experience improvements with the surgery. Also, the procedure can also be combined with a minor breast reduction to reduce the breast width if desired as well. It's during this procedure, the nipple and areolae can be corrected, if necessary, to the desired size and at the correct height.Those with #uneven or #asymmetrical breasts are candidates for #BreastLifts. They are among a category of candidates with #DevelopmentalBreastProblems. This includes women with one breast is lower than the other, those with tuberous breast deformity. Women with asymmetric or enlarged nipples or areolae (pigmented areas around nipples) also may be candidates for a breast lift or a modification of a lift. #Asymmetric breast can be adjusted by adding or removing volume. One side can be tightened more or less than another.I prefer the “lollipop” technique or “donut lift” to avoid more significant scarring, rather than the majority of surgeons in the United States that use an anchor pattern lift.Some patients will achieve a better result by increased the fullness often lost with child-bearing, with the addition of an #implant with the mastopexy, known as Augmentation Mastopexy. In regards to implants alone, this is usually said to be mistake by patients reflecting back at the decision. Most breasts will look larger and more droopy with solely implants. They will sag more and sooner, due to the sudden and excess weight. At times it's possible for a “Snoopy” breast or double bubble to develop as a result.  All in all, an elevated, more youthful breast can be a satisfying result for the patient.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Breast lift with short scar

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You can try a short scar breast lift (scar around the areola and vertically down to the breast fold). That may be sufficient to lift your breasts and give you more upper pole fullness.

Uneven Breasts After Weight Loss

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Congratulations on your weigh loss. You appear to be a candidate for a breast lift. Consult with 3 board certified plastic surgeons to understand your options and choose the surgeon/surgical plan that best meets your needs/objectives.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Asymmetric breasts

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Everyone has two breasts that are not equal or asymmetric.  An important part of breast enhancement surgery is to try to make the breasts more equal.  In this situation, the best choice would be a mastopexy or breast lift. 

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 82 reviews

Breasts sagging and uneven after 50 lbs weight loss

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First, congratulations on your weight loss.  Also thanks for sending in photos.  It appears, (without a proper exam), that you would be a good candidate for a breast augmentation, (to achieve upper pole fullness), and a lift.  Please seek out a board certified plastic surgeon.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

Breast augmentation and mastopexy

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Thank you for the question and picture.

 I think you will benefit from  breast augmentation and mastopexy surgery.There are a variety of different mastopexy procedures that are available depending on the patient's specific needs and goals. I would recommend consultation with well experienced board-certified plastic surgeons for direct examination. This consultation will allow you to get the best advice in your specific situation.

In order to achieve “more formless on top” breast implants will be helpful. It will bevery important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.

You should also be aware that the  breast augmentation/ mastopexy procedure can be done in a single or 2 staged fashion.There are good plastic surgeons who will insist on doing the procedures separately and there are good plastic surgeons who can produce excellent outcomes in a single stage.

The combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increase with breast augmentation / mastopexy surgery done at the same time.
I'sn my opinion, the decision  to do the operation in a single or two  staged fashion becomes a judgment call made by a surgeon after direct examination of the patient.  For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or  whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).
Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks  are greater with a 1 stage  procedure and the patient does have a higher  likelihood of needing revisionary surgery.
I hope this helps.


Treating Sagging, Uneven Breasts After Weight Loss

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It seems as if you will require a breast lift to tighten the loose skin and perhaps an augmentation to restore your volume. The amount of scar formation will depend on how much loose skin is actually required to be removed from your breast. That has to be determined by a discussion with your surgeon. Sometimes only an incision around the nipple is required and sometimes it needs to be extended down the breast. However, most patients that have undergone this procedure still feel like they have improvement and that the scars, while not invisible, are a small price to pay for the overall improvement in appearance.

Deason Dunagan, MD
Huntsville Plastic Surgeon

The Solution for Sagging Breasts after Weight Loss: Mastopexy Augmentation

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After weight loss, your breast skin just like skin in other areas of your body may not rebound as well, leaving you with areas of sagging. You have done great with the weight loss but your question is not uncommon: I have put in the effort with weight loss now what can I do with this new problem? Fortunately, with the breast the answer would be a breast lift which will reshape the breast and reposition the nipple combined with or a delayed insertion of a breast implant. Unfortunately a breast lift does entail scarring which, if performed correctly can be minimized. Avoid the periareolar lift and or the larger implant by some surgeons because you will end up exactly in the same position with enlarged areola. The implant will give you more breast volume in the upper part of the breast and breast lift will reshape the breast around the implant. 

I hope this helps.

Dr. Trussler

Andrew P. Trussler, MD
Austin Plastic Surgeon
4.9 out of 5 stars 52 reviews

Sagging breasts after weight loss

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There are numerous options for this surgery.  Essentially you will require an implant and then some procedure to place the nipple in the proper position.  I prefer a larger implant to build on, as long as the larger breast size is acceptable to you.  Once you have more volume the placement of the nipple is somewhat easier and less scarring will result.  Without an implant the proper placement of the nipple will require more incisions, and hence more scars.


Tal Raine MD

Talmage J. Raine, MD, FACS
Chicago 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.