Repeat Breast Lift after further Weight Loss?
Thank you for the question.
Unfortunately without examination or viewing pictures is not possible to give you precise advice. The “extent” of the procedure necessary to revise your previous breast lift will depend on your physical examination and the degree of ptosis ( drooping) that is present after your recent weight loss. The position of the nipple/areola complexes in relation to the inframammary folds will be key.
Wow! Losing 40 lbs is great and doing a revision to lift the breasts is relatively easy to do if you already had a reduction.
Revision breast lift surgery
A second breast lift surgery depends on your ultimate goals, the surgical techniques used to maintain the shape of your breasts, and the quality of your skin. In our practice, we typically employ a surgical techniques that help re-create and reinforce the shape of the breast mound. This is so that the shape of the breast mound does not rely on the overlying skin which will ultimately stretch out. If you have good support of the breast mound and good-quality skin, a revision breast lift may not be necessary. However, if you've experienced drooping of your breast or the skin stretched out you would benefit from a revision breast lift.
Revision breast lift can be simple.
Remember that I have not examined you. But sometimes a breast lift can be revised and the breasts made perkier just through the vertical scar, leaving the nipple scars and the scars in the folds alone.
Your options for redo breast lift
Congratulations on your weight loss. I suspect the breast reduction helped you achieve that result. Your desire for a "perkier" similar sized breast is very understandable and plastic surgery can help.
You would need an in-person consultation with an experienced breast surgeon to get an individualized opinion, but here are some general guidelines. If the loss of breast size has caused your breast to maintain its shape, but only loose volume, then augmentation with an implant might be the simplest solution. If the change you experienced has caused the breast to sag down (lower nipple or more loose skin under the breast) that some re-tightening of the skin would be helpful. In addition, placing an implant during lift (mastopexy) could improve projection and upper pole fullness.www.expertplasticsurgeon.com/html/breast-lift-reduction.html
They would not get smaller from a second lift procedure, only better shaped. Your surgeon, after the assessment, could tell you how extensive your procedure would be compared to the reduction you had earlier.
So it appears that you had a breast reduction. Commonly what happens over time with this is that you get what we call bottoming out. This is where the lower pole of the breast tissue or the area under the nipple/areola become fuller and stretch out. What can be done is one of two things:
1) either repeat the breast lift part which includes redoing the incisions and raising the skin and tightening or
2) performing an IMF mastopexy. This involves removing an ellipse of skin from the lower pole of your breast, incision situated along the horizontal scar that you have now. This will in essence decrease the lower pole fullness and the bottoming out you may have.
Redoing a lift involves opening up all the old incisions.
To achieve the best result, you will likely need to have all the previous incisions opened again. Otherwise, when one area is tightened, it may make the other areas misshapen. You may also want to consider placement of an implant under your breasts to increase projection. If this is all you need, it can be done through a relatively small incision without opening everything up again. Good luck with your surgery.
My bet is that you probably would be best served with an breast augmentation.
It is always best to have achieved your ideal body weight prior to any body sculpturing procedure and this is especially true for reduction mamoplasty. What I would recommend at this time is to see your surgeon or another that you prefer and determine the position of your nipple areolar complex. If this is in the right position and it probably is if it was put in the right place before you lost the weight, then simply filling out the deflated breast with an implant will give you a great result. I would recommend textured silicone gel under the breast for the best, most natural looking result. If the nipple areolar complex is not in the right place then you have another issue that needs to be addressed.
Generally in order to repeat a mastopexy you need yo redo all the incisions. The recovery is typically simpler than the first time though. Another way of becoming "perkier" is to place a breast implant in to replace volume you may have lost in the weight loss. It all depends on what you look like and we don't have a photo for reference.
If I understand you correctly, you'd like perkier, lifted breasts without a drop in volume. This can be accomplished in 1 of 2 ways. The first is repeat mastopexy. How extensive the procedure is depends on how much needs to be done. If the areolas are pointing downward, virtually the entire old incision (or at least the portion around the areola and the vertical portion) would need to be re-incised. The horizontal incision may or may not need to be recut, depending on how much excess breast skin you have and how the pedicle (tissue supporting the blood supply to the nipple and areola) was designed at your last procedure.
The other possibility, depending on your desire to restore volume preferentially to the upper pole of the breast, is placement of a breast implant. This sounds somewhat paradoxical, given that you recently underwent a breast reduction, but if you lost a significant amont of volume from the upper breast with your 40 lb. wt loss, this may be the only way to restore it.
I recommend consultation with a board-certified plastic surgeon, particularly one with experience in secondary breast lifts/reductions. Hope this helps. Best of luck.