Distant, severely pendulous breasts on a large ribcage-- what procedure could help?

A breast lift will restore shape and symmetry so that should definitely be your first step. Once you are at your target weight, you will be in a better position to select implants of the size you want.

First, congrats on the weight loss. I would have you at your goal weight for 6 months prior to any surgery. This allows for everything to settle out and give a better long term result. At that point, I would do a 2 stage surgery. First, I would do a breast lift (mastopexy). I would allow this to heal for 6 months to 1 year. Then, in the second stage, I would place an implant. I know that's a long time to get to the final result but wouldn't want to risk something unsatisfactory just to speed things along. I would not do the implant at the same time as the lift as it may cause wound healing issues and possible nipple death!

As always, be sure to research who performs your surgery to ensure the best likelihood of a positive result

A lift can reshape your breasts to make them less pendulous and perkier. Augmentation with implants can also help increase size and further improve roundness. It would be best to define what “normal and youthful” is, so you can better describe your goals to your surgeon. That way, your surgeon can then determine which treatment(s) would be most suitable.

Congrats on your weight loss!
After massive weight loss, it is not uncommon for the breasts to sag. A breast lift, repositions the nipple and breast tissue. Depending on patients desire of cup size, breast implants and/ or fat grafting may be performed with a breast lift to restore volume and help shape the breast. Internal bra or a mesh slings also can be used to help keep the breasts lifted.

The technique I recommend is a lift using 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. Implants are not lifetime devices. 8% fail within the first year and 30% fail within six years. Fat transfers are permanent and incorporated into the body.

Best Wishes,

Gary Horndeski, M.D.

In your case the best procedure to provide shape/fullness and also lift the breasts to a more ideal location would be a combination of a lollipop lift with an augmentation in a dual plane pocket. Because of the thin tissues and poor elasticity in weight loss patients I would also suggest considering having internal support placed. My personal preference is an alloderm sling but different surgeons will have different ideas as to what works best in their hands so consult with a couple in your area. Best of luck!

I recommend an in person evaluation by a plastic surgeon to be measured and discuss your goals. 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

Congratulations, you saved your own life. When you are ready, you would be a candidate for a breast lift with or without an implant. Be sure you go to a very experienced surgeon who is known for breast surgery.

Hello, thank you for your question. It seems like you can benefit from a breast lift with implants. A breast augmentation and a breast lift work hand and hand to enhance the overall shape and size of a woman’s breasts. These procedures are ideal for increasing the size of the breasts while restoring balance and youthfulness to a woman’s bust. Schedule an email, Skype or in-person consultation with a board certified plastic surgeon for proper evaluation.

You need a full lift and probably an implant to give you the best result. There are many different procedures to accomplish this. Just don’t go very large with implant. About 400 cc max