I did a tummy tuck after losing 100 pds and am now wanting to lift my breasts. I was a 40E before and always had larger breast even before becoming over weight. I am currently a 32DDD but very very saggy & gave a lot of stretch marks on my yapper breast. I do not want to be under a D as I don't have a tiny frame. I am on the fence with implants. How much size do you typically lose with a lift? can upper volume be restored with a lift alone when the skin has been stretched from weight issues?
How Much Cup Size Do You Lose with a Breast Lift?
Doctor Answers 28
Breast Lifts Do Not Reduce The Size Of The Breasts
In theory, one should not lose any breast volume with a lift as no breast tissue is removed. Only skin is removed and tightened and the nipple moved upward in a breast lift. But there is often a perception that the breast does seem smaller as the surface area of the total breast is reduced through the skin removal. What most women expect from a breast lift is to have not only an uplifted breast but one with more upper pole fullness as well. While this most certainly occurs early after a breast lift, the settling of the breast after surgery will cause some loss of upper pole fullness. That is the role that a breast implant plays in many breast lift surgeries, to get and maintain upper pole fullness. Given the size of your existing breasts and the amount of lifting that will be required, it is understandable why you would be on the fence about the need for implants in your lift. When in doubt, do the lift without the implants first. Let the six month results determine whether implants would really be beneficial.
Breast lift and cup size
In a Mastopexy your size remains the same. If some reduction (in order not to leave you looking boxy) is needed you may lose a bit of volume. Both ways your top (upper pole) will look empty. That's why an implant or a fat transfer is what is often needed. Lifting is easy. Making you look perky, not just lifted is hard. A board certified plastic surgeon, not just any cosmetic surgeon, may be the one to see. What you are asking for is easy but the artistry and experience of the surgeon will determine your outcome.You question is brilliant, by the way.
Cup size change with breast lift?
Congratulations on your weight loss.
It is hard to promise or predict final cup size after breast surgery. With breast lifting, even though no breast tissue is removed, the breast shape and position are changed. This change in position and shape may result in a different cup size or a different level of filling the cup of a bra. For example, a breast that sits lower on the chest wall may require a larger cup size bra than the same volume breast sitting higher on the chest wall.
Therefore you should not base your goals or the success of your operation based on a cup size which may vary depending on who makes the bra.
I do not think you will reliably restore “upper volume” without the use of implants.
It is very 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" means different things to different people and therefore prove unhelpful.
By the way, the most common regret after this operation, is “I wish I was bigger”.
Also you should consider the question of whether to do the breast augmentation/ mastopexy in a one stage or two stage fashion. This is not a question agreed-upon by all plastic surgeons. 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.
In 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.
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The tighter the lift, the more your cup size goes down. Need implants.
It sounds like you are thinking the right thoughts. Don't believe a plastic surgeon who says he can restore your upper pole fullness using a lift without implants. If you want upper pole fullness, you need implants (breast tissue is too malleable to stay perky). Period. But you also need an aggressive lift using the vertical technique and greatly reducing the amount of tissue in the lower poles. A lift alone reduces your cup size; if it does not, then it won't be effective. You need to reduce breast tissue to have an effective lift. The vertical technique is most effective, provides better shape, and less scarring. Look at plenty of before and after photos for yourself. Avoid disappointment by knowing the facts.
Breast lift and cup size
A breast augmentation is designed to add volume to the breast while a breast lift is designed to allow shaping of the breast. In theory, little to no volume should be lost when a breast lift is performed. Each plastic surgeon performs their breast lift procedure a little different so ask plenty of questions and ask to see before and after photos of patients that have a similar body and breast shape as you do before surgery.
All the best,
Dr Remus Repta
Mastopexy and size reduction
You certainly provoked a lot of comments with your question. You are asking a lot from a mastopexy given the size and volume of your breasts. Consider a small reduction along with the mastopexy and a year later if you feel you want further upper pole fullness it would be relatively simple to put in a small to moderate size implant. Chances are you will not feel the need for that and simplify your life avoiding the implant.
Breast lift with implants or without?
I think that you are asking 2 questions that need to be answered separately - do you want to decrease the size of your breasts to a D, or would you rather stay at about a DDD cup size? Would you be opposed to being bigger? A mastopexy or breast lift alone will not decrease your cup size by that much unless you also have breast tissue removed. The other question to address is how important upper pole or upper breast fullness is to you. Without an implant, the upper part of your breast will not stay full and round over time, as breast tissue has a natural tendency to drop - particularly after large weight loss. If it is very important for you to have fullness on top, you need to consider an implant. Then your plastic surgeon will need to decide if you need breast tissue to be removed in order to accomodate in increase in size that an implant gives. Breast lifts with implants are more complicated procedures than either one alone, so make sure that you are treated by a qualified plastic surgeon who has experience with combined procedures. Some surgeons stage the procedures, which is a perfectly acceptable way to approach this.
Breast lift does not have to make your breasts smaller
Thank you for the photo. As you can see from the previous answers, there are two camps. Surgoens who suggest a vertical lift (I'm in this group) and surgeons who suggest the traditional wise pattern or inverted "T" incision. Both give you very good results and each surgeon will do the procedure they learned best and feel comfortable with. In my opinion, the vertical lift allows the surgeon to make the breast any size you want, give you a better shape, more projection and better upper pole fullness. Your breast foot print is a little low on your chest and no matter how high any surgeon will promise you fullness, in the long run the breasts will settle where the foot print is. After your lift, if you desire more fullness in the superior chest area, fat grafting is an option. I would wait at least six months after your lift, before deciding on this. I do not add implants with a lift.
Breast volume loss after breast lift? NO!
Your breasts have excess skin containing a decreased volume of tissue. (Congratulations on the weight loss!) Thus, a breast lift is designed to create a new skin brassiere, tailoring the skin to contain the same volume in a tighter, higher, and perkier package!
I routinely weigh the skin I remove during the course of breast lift (mastopexy) surgery, and even for breasts larger than yours (and assuming the patient wants to retain the same volume breast in a less-saggy skin "container"), this amounts to no more than 30 grams of skin (1 ounce). Since you do not want to go smaller, only skin removal is done to lift and tighten your present breast volume, but if a woman wants smaller breasts in addition to her lift, then any amount of additional tissue can be removed, including different amounts from each breast to even-out asymmetrical or non-matching breasts. If you presently fill a DDD bra, you do not need implants, just skin tightening. I do suspect that you have D-volume breasts in a DDD skin amount, but proper bra size is what fits and looks good, not a letter on a label.
I believe that with breasts such as your photos show, a one-dimensional (vertical or lollipop) skin tightening lift will yield too-long scars that possibly cross the inframammary crease, and a boxy or flattened-bottom breast shape that will take months to start to look normal. I believe you would be best served by a Wise-pattern (anchor) mastopexy, which adds a crease scar (nearly imperceptible if skillfully closed) to an appropriate-length vertical scar. This provides skin shaping in two dimensions rather than just one, for an immediately-better and just-as-long-lasting result over time. For an example of a vertical lift (plus implants) that did not go well until I performed the "proper" skin tailoring incisions, see the photos below. Also click on the link (go to the photogallery) to see breast lift plus augmentation examples, and breast reduction examples (all these patients have the same skin incision pattern, whether skin only or skin plus tissue is removed). Best wishes!