Will skin tightening reduce my breast size?

Question

Hi, I had a BA and BU TT and MR in December so just over 6 months ago. I’m having revision as one of my implants hasn’t dropped into place and is still high. I can feel it under my muscle. My surgeon wants to do skin tightening under each breast when he adjusts the pocket. I like the size of the breast that’s dropped into shape and I’m worried skin tightening will make them smaller. I’m wondering whether to increase the implant size also to 425 whilst I’m having revision to make up for the potential decrease. I originally had 355cc dual plane. Round motiva. Do you think skin tightening will decrease the size and make them look smaller?

Semih Yildiz, MD, FEPOBRAS · Answer

Skin tightening under the breast does not reduce the volume of the implant itself. What it can do is tighten the lower breast envelope, improve support, adjust the fold, or remove a small amount of excess skin. Because the skin envelope becomes snugger, the breast can sometimes look a little firmer, rounder, or slightly less droopy, but it should not create the same kind of size decrease as changing to a smaller implant.

If you like the size of the breast that has settled, I would be cautious about increasing implant size only to compensate for skin tightening. Moving from 355 cc to 425 cc is a noticeable but not huge increase, and it may add width, projection, and weight. In a revision where the pocket and implant position need correction, a larger implant can sometimes make control of the pocket and lower pole more difficult, depending on your tissue support and breast measurements.

The key is to ask your surgeon exactly what "skin tightening" means in your case: a small lower-pole skin excision, fold adjustment, capsulorrhaphy/internal support, or a lift-type revision. Ask to compare expected shape with the same implant versus a larger implant. If your goal is to keep the size you like, pocket correction with the same implant size may be enough, but your surgeon can only confirm this after examining your skin, capsule, and breast base width.

Arthur Dean Jabs, MD, PhD, FACS · Answer

Removing skin from a mastopexy has very little effect on cup size. It does improve the shape of the breast though. It is best to think of the breast shape as being due to the volume (breast tissue and fat) and the bra (the skin).

Hope this helps

Dr. J

Hope this helps

Dr. J

Jeffrey M. Darrow, MD · Answer

The modalities which tighten the skin only do so to a very small extent. The skin will not tighten enough to appreciably make your breast look different and as you are not decreasing the volume of your breasts, they will not look smaller. Armed with this knowledge, you can save yourself the money of upsizing your implants. Best wishes.

Yasemin Aydinli, MD · Answer

Tightening the lower-pole skin envelope removes skin, not breast tissue or implant volume, so your actual size stays the same &mdash; the breast may look slightly more compact and lifted rather than smaller. Since you like your current size, tell your surgeon explicitly so the tailoring stays conservative. This adjustment usually improves implant position control after pocket revision. One important detail to consider: performing revision surgery while keeping the same implant can increase the risk of infection and capsular contracture, since the implant is re-exposed and handled during pocket work. It is worth discussing with your surgeon whether exchanging the implant for a new one of the same size at the same session would be the safer choice.

Will skin tightening reduce my breast size?

Answers (4)

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