Breasts Sagging After Weight Loss. Do I Need Breast Augmentation Redone?

I am 44 years old, 5'1", 125lbs and had my augmentation done 5 years ago with 350cc's moderate profile under the muscle. Since then I have lost approximately 25lbs. and breasts have become very saggy with no fullness on the top. I am considering getting them redone, but I am worried that I need a lift as well. My main concern is having more fullness and cleavage. What are your thoughts?

Doctor Answers 16

Breast Lift For Sagging Breasts After Weight Loss Often Best Option

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Thank you for your question. Weight loss has reduced the volume of your breast tissue and since the skin envelope is the same, the remaining breast and implant has sagged.

A breast Lift plus possibly a larger implant is likely your best option.

Be sure to see a Board Certified Plastic Surgeon who is experienced in Breast Lift Surgery.

Re: Breast sagging after weightloss - augmentation or lift?

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Unfortunately we do not have a lateral photograph to see the degree of glandular ptosis you may have off of the implants; also it would be important to know if the superior fill was symmetric. If that is the case then by just pinching the inferior tissue beneath the nipple areola you can visualize what a lift would accomplish. If you feel you need to be larger then you would need to replace the prosthesis. My rule of thumb is that if you are happy with the size and the prosthesis are in good position, then you do not need to do anything to the prosthesis and go ahead with a straight vertical mastopexy with a small inferior tissue excision. This would remove the droop, tighten the inferior aspect of the breast and place the nipple areola more appropriately over the prosthesis. As women age, and in your case with the weight loss, they tend not to want a larger size since it will give the appearance of being a bit heavier. So if the prosthesis are well positioned you do not necessarily need to change them unless it is your wish to be larger.

Breast lift or high profile implants

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If you're looking for fullness in the upper pole, then a breast lift would be more suitable. For minor to moderate sagging, breast augmentation with perhaps a different implant projection may help. A higher profile can give you better fullness.

Ronald Levine, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 25 reviews

Breast lift may be necessary

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Generally, if you have lost a lot of weight then a breast lift would be the most suitable solution, since your breasts are affected by lax tissues. This would give you a perkier contour.

Breast lift

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Aesthetically it looks like you have a natural ptotic breast shape. One cannot comment on how ptotic this is without further photos or an examination, but it is important to realise that with any revisionary procedure where breast tissue is lifted it will always be prone to the  tissue dropping with time. 
It is possible to perform a mastopexy implant to give the increased fullness and cleavage that you desire and there are pros and cons of this. Timing is also an important consideration as one would ideally like to limit the number of operations you have in a lifetime. I would tend not to recommend larger implants on there own without a lift unless you accepted that you will need a mastopexy at some point.
There are pros and cons of a one stage and two stage mastopexy implant and you would need to consult with a PS to make an informed decision if this is the route you wish to follow. 

Gary L. Ross, MBChB, FRCS
Manchester Plastic Surgeon
5.0 out of 5 stars 177 reviews

Breasts redone after weight loss?

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I am not sure a lift is what you need because you may not have breast sag (nipple position lowered). Just removing more skin and expecting the skin to act like a bra and not descend over time is unrealistic given that skin has a natural property to expand. You could go with a larger implant but truly a physical exam is required to know that for certain.

Sagging breasts after weight loss

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A direct examination should be performed to determine the exact nature of your complaint. If there is adequate volume or excess skin or both?  A simple solution would be a larger implant if appropriate or a breast lift maybe needed possibly with a new implant if there is excessive skin.  Sometimes Strattice BPS (by LifeCell) is used to hold the implant up under the chest muscles as a sling then the breast lift is performed. It is very important to have a stable weight before having any surgical procedure.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
4.8 out of 5 stars 116 reviews

Breast Lifting after Weight Loss?

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Thank you for the question.

It is not possible to give you good advice without direct examination.

However, based on your description of weight loss and the resulting "saggy"  appearance  of the breasts,  it is very likely that you will benefit from breast lifting surgery.

It would be in your best interest to meet with board certified plastic surgeons well-versed in revisionary breast surgery.

For prospective patients interested in breast surgery,  it is always best to be at a long-term stable weight before proceeding with these operations.

Best wishes.

Breast lift

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With the weight loss, you most likely deflated a bit, and from the photos it looks like you need a breast lift.

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

Breast augmentation

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Breast sagging as a result of weight loss can be addressed 3 ways. First we must determine if you breast volume is still adequate. If you want more volume than a larger implant would be necessary. If the volume is good than a breast lift would be appropriate. Sometime both larger implatns and a breast lift are necessary.

David L. Abramson, MD
New York 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.