Breastfeeding and weight loss - Is an anchor lift my only option? (Photos)

Question

I had two breastfeeding kids and finally lost a significant amount of weight. I recently went in for a consultation and the doctor mentioned the only way for me to have a “lift” would be with an anchor lift. I’ve recently read that implants can also be placed instead of a lift. I’d be so greatful for any insight.

Donovan Rosas, MD · Answer

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision. 
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.   
A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure.  Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based upon your photos, you would likely benefit from an augmentation in conjunction with a lift. Ultimately, if you are uncomfortable with the scar burden the procedures can be staggered. The augmentation will not deliver a lift but the result may still be acceptable to you. If not, you can follow with a lift 6 months later.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon Patient should discuss their concerns with their physicians in order to make an educated decision.

Semih Yildiz, MD, FEPOBRAS · Answer

Implants and a breast lift solve different problems. Implants add volume, especially in the upper breast, but they do not remove extra skin or reliably raise the nipple and areola. From the photos, there appears to be significant deflation with stretched lower-pole skin and low nipple position, which is why an anchor lift was likely recommended.
An anchor lift allows the surgeon to remove skin both vertically and horizontally, reshape the lower breast, narrow the breast envelope, and raise the nipple to a more youthful position. A lollipop lift can work in some patients with less lower-pole excess, but when there is more skin laxity after breastfeeding and weight loss, an anchor pattern often gives better control of shape.
Implants can still be added if you want more volume, but they are not a substitute for a lift in this situation. Placing implants alone into loose skin can sometimes make the breast larger but still saggy, or create a bottom-heavy or waterfall look. Fat grafting can add modest fullness, but it also does not correct significant skin excess.
The tradeoff with an anchor lift is the scar pattern around the areola, down the breast, and along the fold. The benefit is that it gives the surgeon the most ability to reshape and lift the breast. An in-person exam can confirm whether a lollipop pattern is possible, but based on the photos, an anchor lift seems like a very reasonable recommendation.

Joel Patrick Maier, MD · Answer

I agree with your plastic surgeon. A proper breast lift with removal of the lower, heavy parts of the breast will provide the most durable, lifted and proportionately shaped breast. I would also recommend liposuction of the front bra roll/side breast area to help frame and define the breast shape. No need for an implant; if desired, best to place at a later date . . . I hope this helps. Thank you for the inquiry!

Leila Kasrai, MD, FRCSC · Answer

Implants can only lift the breasts a bit. Since your nipples are located below your breast fold, an anchor lift would most likely be recommended.

Ted Eisenberg, DO, FACOS, FAACS · Answer

lifting. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Gerald Minniti, MD, FACS · Answer

For you, implants cannot replace what you absolutely need: a breast lift. Your fears of scars making your breasts unattractive are unfounded when a breast surgery expert performs your surgery.

Guler Gamze Eren, MD · Answer

Hi from Istanbul!Thank you for your question.In your case breast lifting will be enough to support upper pole fullness and remove sagging skin tissue. According to your photos you may be suitable for anchor breast lifting surgery.Best luck!

Gary M. Horndeski, MD · Answer

The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Jeffrey M. Darrow, MD · Answer

Thank you for your photos. Without your arms raised, it appears you have a grade 2 ptosis, meaning a significant portion of the lower part of your breast, as well as your nipple, lies below the level of your fold underneath your breast. The correct position for your nipples is above the level of your fold. As the nipple/areola are moved upward to the normal position, the distance from your nipple to your fold will increase, leaving your breast tissue hanging below your fold, even though your nipple/areola are in the correct position.  The anchor incision is designed to shorten that distance, as the breast is lifted, by removal of a carefully measured amount of skin.  Adding implants only, will increase the weight of your breast and result in further descent of your breast.  The anchor incision is a time tested, predictable way to lift breasts and performed well, should have well camouflaged incision lines.  Best wishes.

Ronald J. Edelson, MD · Answer

There are some surgeons who would do a lollipop lift to avoid the extra scar. However I would do the full anchor lift

Breastfeeding and weight loss - Is an anchor lift my only option? (Photos)

Answers (19)

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