Breast Revision + Possible Lipo: Should I Address Back/Abdominal Fat During Surgery or Lose Weight First? (Photos)

Based off your photos - there's limitation to our opinions since we can not see any of your breast / breast scar / IMF / breast native footprint without a bra / bikini on, therefore will only be able to give opinion on possibilities. There is the noted weight gain as you stated with still an athletic tone (increase in internal fat greater than external - aka visceral fat). Breast density likely has increased some as well with the weight gain but again hard to tell from the limited photos. There are a few options for your concerns - 1. (In my practice) Weight loss by yourself with good exercise / weight lifting / diet is always a must prior to any body contouring procedure - whether its many areas, few areas, fat vs skinny candidate. Reason is when you lose weight slowly yourself, your skin has the ability to retract as the fat cells decrease in size vs when you do liposuction on some areas where there is skin looseness - the skin likely will be loose after liposuction as well. (Different parts of the body will have different skin qualities). 2. The breast revision would be based off your desired look; from the sounds of it, your preop stage - you likely had spacing in between your breasts therefore creating a cleavage look without bra / bikini post augmentation is difficult or sometimes not possible. Internal bra can be added to help, fat grafting to your inner breast can help, but having a cleavage look when you didn't have it prior to surgery is difficult. (Again, without a consultation or photos to see your anatomy is difficult to give proper opinions).3. Have you thought about a fat transfer to both the breast and the buttock? What I would recommend is you lose some weight to bring down your internal fat gain - and then do liposuction on your abdomen, flanks. and mid back to lower back to use for transfer for cleavage fat grafting and for buttock fat grafting (both of which can be enough volume for a natural result) + or - internal bra, and + / - skin tightening during the procedure (J plasma, bodytite, etc). Hope this helps, seek out surgeons who also have experience in body contouring as well as fat grafting to achieve these combo procedures with the closest possible results to your desires. Good luck.