After weight loss & breastfeeding, my breasts are deflated & sag a lot at only 22. Is there hope with a lift and implants?

I would like implants and possibly a lift, but I'm worried after seeing others results that it isn't high profile enough... I want nice full breasts and don't care for the natural look, is this possible with a good surgeon or are you doomed if you sag?

Doctor Answers 14

Breast augmentation/lifting surgery concerns...

Thank you for the question.  It is not possible to give you good/ specific advice without viewing photographs of your breasts and goal photographs as well.  Some general thoughts regarding breast augmentation/lifting surgery may be helpful to you however:
 Generally speaking, patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. In other words, 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 increased with breast augmentation / mastopexy surgery done at the same time. This revisionary rate may be as high (or higher) than 20%.
Personally, I find that the breast augmentation/lifting procedure to be one of the most challenging of the breast operations I perform, even compared to somewhat complex revisionary breast surgery. On the one hand, when performing breast augmentation/lifting surgery we are increasing the breast size with breast implants; on the other hand, we are reducing the breast “envelope” in order to achieve the breast lift. These two “forces” must be balanced as perfectly as possible in order to achieve the desired results. Removing too much skin/ breast tissue is problematic; removing too little breast skin/tissue can also be problematic. Remember also that patients presenting for breast lifting surgery and general have lost some skin elasticity/thickness making potential incision line healing problems and/or recurrent drooping/sagging important concerns to communicate.
To achieve a surgical result where the breast implant and breast tissue “come together” and behave like a single breast is one of my goals but can be difficult to achieve. Essentially, we are trying to create a breast implant/breast tissue interface that feels and behaves as naturally ( as a single unit) as possible. Generally speaking, making sure that the breast implant has some sub muscular and some sub glandular component ( dual plane) and tailoring the overlying skin/subcutaneous tissue/breast tissue as precisely as possible over the underlying breast implant is key.
Despite these efforts, breast implants are after all a foreign body that don't necessarily stay where we wish they would; therefore, breast implant related problems such as positioning ( too high, too low, lateral displacement etc.) can occur and may be a reason for returning to the operating room for revisionary breast surgery. I use a “tailor tacking” technique that allows a determination of what breast implant should be used to SAFELY produce the results the patient is looking for. This technique involves use of a temporary sizer and temporary “closure” of the overlying breast skin over the sizer. The use of the tailor tacking technique is very helpful. Breast lifting involves removal of skin ( and tightening of the breast skin envelope) while breast augmentation involves expansion of the breast skin envelope. These 2 forces are counteracting each other. Again, despite these efforts, breast implant and/or tissue/skin complications may arise causing minor or significant complications.
Generally speaking, it is difficult to achieve the “perfect” result with breast augmentation/lifting surgery, despite best efforts. Patients should be aware of the complexity of this combination procedure, achieve REALISTIC EXPECTATIONS prior to proceeding, and understand that additional surgery ( along with the additional recovery time, stress, expenses etc) may be necessary in the short or long-term. Patients should understand that the results of the procedure will not necessarily match aesthetically the results of patients who have undergone breast augmentation surgery only.
For example, some patients who wish to maintain long-term superior pole volume/"roundness" or "implanted look" may find that this result is not achieved after the initial breast augmentation/lifting operation.
An additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness). It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation. The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery, Including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia, lateral displacement etc).
Potential risks associated with breast augmentation/lifting surgery include infection, bleeding, incision line healing problems, loss/change of nipple/areola complex sensation, and blood flow related issues to causing skin or tissue necrosis. Poor scarring, pigment changes, areola/nipple asymmetry etc. are also potential problems. Again, patients may experience implant related problems such as encapsulation, leakage, displacement problems ( too high, bottoming out, lateral displacement, asymmetric positioning etc.), rippling/palpability of breast implants etc. Patients may also be dissatisfied with breast size, shape, and/or how the breast implants and overlying breast tissues “interface” with one another. Occasionally, a breast implant may even have to be removed and the patient will generally be “implant free” for several months at least. Obviously, this situation can be quite physically, emotionally, and psychosocially stressful to the patient involved.
Given the complexity of the combination breast augmentation/lifting operation and the greater risk of revisionary breast surgery needed, there are good plastic surgeons who will insist on doing the procedures separately. 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 in 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.
Having discussed some of the downsides and potential risks/complications associated with breast augmentation/lifting surgery, most patients (If properly selected and who are doing the operations at the right time of their lives psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry.
I hope that this summary of SOME of the issues surrounding breast augmentation/lifting surgery is helpful to you and other women considering this procedure in the future.
The attached link may also be helpful. Best wishes.

Weight loss / breast feeding: Lift with Implants

Thank you for your question. First I would say that you should be proud of your weight loss. As long as your expectations are realistic, I think that a mastopexy with implants will be the appropriate procedure to improve the shape and enhance the fullness of your breasts. Without photos, it is not possible to advice you more precisely. I would recommend to see at least 2 good plastic surgeons in your area and compare their advice. I am sure you will find the right one for you.

All the best.

Andrea Marando
Plastic and Cosmetic Surgeon
Manchester - London

Andrea Marando, MD
Manchester Plastic Surgeon
5.0 out of 5 stars 110 reviews

Get the results you want

Many moms, especially young moms, are not happy with the appearance of their breasts after pregnancy and breastfeeding. Luckily, breast lift with augmentation procedures can help you achieve your post-baby breasts, or the breasts you have always dreamed of. For patients who want high profile, full breasts (as opposed to more "natural looking") we can achieve this through choosing the proper implant shape and size. However, I would need to examine you in person to give you a realistic idea of what sort of results we could achieve for you. Good luck!

Jimmy S. Firouz, MD
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 16 reviews

Augmentation Mastopexy to Correct Ptosis from Weight Loss, Pregnancies and Breastfeeding

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.

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
5.0 out of 5 stars 94 reviews

Lift with implants

Achieving that "fake" look can be done by using appropriately sized implants as well as performing a concurrent breast lift.  Do your due diligence and locate a plastic surgeon that specializes in this combination procedure.
Good luck,
Ary Krau MD FACS

Ary Krau, MD, FACS
Miami Plastic Surgeon
4.8 out of 5 stars 269 reviews

Breast rejuvenation after breast feeding

Yes, it is possible to have a nice result after breast feeding with implants and/or a breast lift. It is best to schedule an in person consultation to examine you and review your options.  Without pictures or knowing more about your situation it is impossible to give you more advice.

Good Luck

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 72 reviews

Breast lift with implants

There are numerous options for proper implant projection, style , size to achieve the results you desire. 

An exam and consultation with a plastic surgeon is recommended to discuss your options and expectations. That will determine if you need a lift and which implants.

Breast lift with implant

Hello and thank you for your question. With good technique a breast lift with implants can result in a lifted, perky, and full breast shape. 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 67 reviews

Sagging breasts

Yes, if you said that you only wanted implants, I would say that if your breasts are significantly sagging then you would need a lift.  Many times a circumareola or lollipop lift can be used.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Breast Lift

A lot of the final results are based on your tissue dynamics.  I would recommend an in-office examination as well as a detailed discussion with a board certified Plastic Surgeon whom you feel comfortable with.

Best wishes!

Dr. Desai
Harvard Educated, Miami Beach and Beverly Hills Trained Double Board Certified 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.