I am a 21 year old struggling with breasts after weight loss. As a professional, what would your approach be for me? (Photos)

After a 60lb loss, my breasts went from a 38D to a very unfilled 34B. I am currently an active duty service member and live an active lifestyle. I like my smaller breasts, anything bigger than a c would get in the way, but I'd like more fullness in my upper pole that I haven't had since the loss. I was wondering if a mastopexy w/ gummy bear implants and periareolar and sub imframammary scars would be obtainable,how costly would it be, and souls the implant be placed above or under the muscle?

Doctor Answers 11

With weight loss, breasts will lose volume

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as you have.  But congratulations on your weight loss!  Awesome job!  Make sure you found the happy place where your routine and diet can be continued indefinitely so you can maintain your weight where it is.  As for your breasts, only an augmentation would be recommended with the risk of having a small double bubble but you really don't need the costs, risks, and scarring of a lift at this time... and if anyone insists, I would question their motives and get a second opinion.

Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Struggling with breasts after weight loss.

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Thank you for the question Congratulations on your successful weight loss.  Based on your history, photographs, and described goals, I think that you will be a good candidate for breast augmentation/mastopexy surgery.  Key to success will be: careful selection of your plastic surgeon and careful communication of your goals.

There are pros and cons to the placement of breast implants in the “sub muscular” position versus the "sub glandular position”.    I will try to outline some of the differences here;  you may find the attached link helpful as well. I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes). The submuscular positioning  also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position. On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle)  that can be seen with breast implants placed in these sub muscular position.     

 I hope this, and the attached link, helps. Best wishes for an outcome that you will be very pleased with.

Breast Lift with Implants Provides Intended Result

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A #mastopexy or breast lift operation is designed to improve the shape and position of the breast swithout reducing their size. It is used for #breasts which sag or droop (ptosis). Sagging of the breasts may occur with normal development for some women, or as part of the aging process. Pregnancy, breast-feeding and weight loss are other conditions which increase breast ptosis. Some patients will have a better shape to their breast such as increased superior fullness if an #implant is used at the time of mastopexy. This is called an #Augmentation/Mastopexy.  The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height. 

#FatGrafting is another option to using #breastimplants and requires a small amount of liposuction to obtain the fat which is the prepared and transferred to the breast. 

A hybrid operation may use both an implant and fat to provide the best contours of the lifted breast.

I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.

Implants with no lift is usually a mistake. Most breasts will look larger and droopier.  They will sag more and sooner because of the excess weight.  The shape will usually not be satisfactory. There will sometimes be a “Snoopy” breast or double bubble.

If the nipples are in a fairly high position on the breast or “glandular” ptosis or drooping, an implant may be useful.

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

Implants candidate, some advices:

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Thanks for the question. I recommend you to use microtexturized highly cohesive silicone implant ("gummy bear" implants), with high projection, and 550ml will be excelent on you, to fill the breasts properly, under the muscle.

Kind regards

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 372 reviews

What are my options for breast reshaping after a 60 pound weight loss?

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From the pictures that you provided, I would recommend a straightforward sub muscular placement of Inspira gel breast implants through an inframammary incision.  I don't think you need a lift and am not a big fan of the gummy bear implants.  In my experience, I am able to achieve nice upper pole volume without the issues associated with the gummy bears.  

I hope that helps!  Please let us know if we can be of assistance here.  Would love to work with you!

-Gregory A. Buford MD FACS

Breast options after 60lb weight loss.

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Hello, a mastopexy with gummy bear implants is one potential option to improve your breast fullness and nipple position.  Without a proper assessment including measurements it is not possible to provide specific details, but if you seek one or more consultations the surgeons should be able to discuss the pros and cons of the different breast lift procedures and implant types.

I am a 21 year old struggling with breasts after weight loss.

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Obviously it really takes a consultation and exam to be sure, but from the photos I think a subpectoral dual plane silicone breast augment will get you to your goal. I doubt a lift of any kind will be necessary if you choose your surgeon wisely. And thank you very much for your service to our country.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Augmentation Mastopexy

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You will need to be evaluated by ABPS certified/ASAPS member surgeons that specialize in all forms of breast surgery, not just implants. It is likely you'll benefit from a proper breast lift. Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Correction of Breasts after Weight Loss in Active Person

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Congratulations on your significant weight loss. Unfortunately, breast deflation like you have had is quite common. You appear to need a small implant and lift to achieve your objectives. Because of the need to lift the breast and your active lifestyle I would never consider a sub-glandular implant. To overcome the increased risk of capsular contracture with smooth implants placed sub-glandularly, the implants need to be textured. When done properly, these provide a very natural appearing and feeling breast and avoid the problems of sub-muscular implants in someone like you. You do need to make sure the plastic surgeon you see is board certified and experienced in use of textured implants. 

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Breast lift with implant

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Hello and thank you for your question.  Congratulations on your weight loss.  The best advice you can receive is from an in-person consultation.  With that being said, based on your photographs, the best shape and contour could be achieved with an implant and a breast lift.   A breast lift with an implant can result in a very nice shape if good technique is used.  The size of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 174 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.