Implants for Sagging Breasts with Crepey Skin?

Question

My breasts are saggy (from massive weight loss) with loose and really unattractive crepe-like appearance. I have lost a lot of weight (about 50 kilos) and have loose skin all over my body. I am considering a full Tummy Tuck rather than a body lift as I don't want the wrap-around scar. I would also like to have implants to address loose and crepey breast skin, but don't want my breast too large. Should I consider having breast implants? Could a small implant be effective? What are some things for me to consider, as this is a bit different than just wanting larger breasts?

Michael Law, MD · Answer

Congratulations on your weight loss.

	When there is laxity of the breast skin that makes the breasts appear somewhat droopy, the addition of a breast implant of moderate size can 'fill up' the excess skin and create the appearance of a breast lift (although this is not truly a breast lift or 'mastopexy'). This is often a situation that exists after pregnancy and lactation, or following significant weight loss.

	In patients with more advanced drooping of the breasts, particularly when the nipples are pointing downwards instead of slightly upwards, a mastopexy (breast lift) needs to be combined with the breast augmentation surgery to tighten the skin envelope of the breasts, in order to produce a result that is truly youthful and aesthetically ideal. This procedure is called an augmentation mastopexy and the results of this operation can be dramatic and absolutely transforming

Jed H. Horowitz, MD, FACS · Answer

Including a Breast Lift with the Implants actually may beneficial. #BreastImplants without a #BreastLift can become a mistake. Many  patients who reflect back on the decision wich they had added a lift to their augmentation. Most breasts will look larger and more droopy with solely implants. They will sag more and sooner, due to the sudden and excess weight. At times it's possible for a “Snoopy” breast or double bubble to develop as a result.Additionally, an implant with lift may be useful to re-position the nipples which may have been affected by ptosis or drooping. One of the primary intentions of a Breast Lift (#Mastopexy) is to improve the shape and position of the breast without reducing their size. It is used especially for breasts which sag or droop (#ptosis).

Raffy Karamanoukian, MD, FACS · Answer

The ultimate improvement in breast shape will relate to how well the lax skin will accomodate the breast implant and change in volume. In some cases, a breast lift will be required to recontour the skin around the implant.

Vincent N. Zubowicz, MD · Answer

I you have lost breast volume from weight loss and want it restored, a breast augmentation might fill up the skin adequately to avoid a lift. This is something that you will discuss with your surgeon. However, If you don't want to be bigger, have a breast lift only. Don't have implants placed making you a size you don't want to be to camouflage some loose skin.

David L. Kaufman, MD FACS · Answer

Hi Melei,
First off, congratulations on your weight loss!  You've got a lot to be proud of.   After weight loss, it's pretty common to have volume loss and dropping of your breasts.  Replacing the volume with an implant, and lifting the breast itself is usually the way to go.  The implant provides volume and allows the surgeon to place it where it is needed.  Sometimes small implants placed to provide superior pole fullness is what meets the goal... othertimes larger implants with broad bases are better to achieve your goals.  Breasts are unique and in the weight loss patient, this is absolutely the case.
About 50% of my practice is dedicated to weight loss patients.  And in that group of patients, the breasts are a relatively challenging component of the overall picture - because many patients have lost much of their skin elasticity.  Seek a few opinions and find the surgeon that is right for you.
I hope this helps.  Good luck on your next step!

David Bogue, MD · Answer

First of all, congratulations on your weight loss. A truly impressive feat. The only negative for most folks is that they find how stretched out their skin is. The natural recoil of the skin is gone, much like stretching out a spring. Also, striae or stretch marks are common from the rapid expansion that occurred during the weight gain. What this leaves is what you describe: Lax skin with a crepe like appearance.

	Rejuvenation of the breasts after massive weight loss is significantly different than a breast augmentation. Implants by themselves are rarely the solution. Most times, some sort of lift is required which will remove large amounts of the excess skin. What the implants will do is provide a scaffold for the mastopexy (lift). They establish the desired size of the breasts and the skin and nipple placement are molded around them.

	These procedures can be very challenging. I recommend that you see a board certified plastic surgeon with a lot of experience in body contouring following massive weight loss. It is important to know that revisions and "tucks" are the rule, not the exception, following massive weight loss rejuvenation procedures. Again, congratulations on your accomplishment and best of luck with surgery!

Tom J. Pousti, MD · Answer

Congratulations on your significant weight loss! It is difficult to determine which procedure would be best for your circumstance. A photo would have been very helpful. However, based on the information you provided, you would probably benefit from a breast augmentation and lift (mastopexy) to give you a longer-lasting result. Depending on the severity and complexity of the case, usually patients who have lost a significant amount of weight, need to lift the nipple-areola complex to improve the saggy look. An implant alone may not be beneficial in your case. As you know, depending on the location of your nipple-areola complex, the incision type will be determined. There are 3 different types of incisions used to lift the areola: the "donut", "lollipop", and an "anchor". I would advice you to consult with a board certified plastic surgeon to determine the best and safest possible options for you to achieve the look you want. Good luck to you!

John P. Di Saia, MD · Answer

Hello,
The extreme excesses in skin and the loose nature of that skin make breast improvements after extreme weight loss almost invariably implantation plus an involved breast lift. There is no need for large implants just enough to give some mass to the breasts.

Steven Wallach, MD · Answer

Poor skin quality after weight loss can impact any procedure that is performed. It sounds more than likely that you will need implants and a breast lift.  But, without examining you it would be hard to tell.
I do this procedure all the time and it is interesting to me that each patient is very different. Some women just need implants, some need only a lift, and others need both. I would have to say that the majority usually need an implant and a lift.  A small implant can be used to give a very natural result.

Edward S. Lee, MD · Answer

Congratulations on your weight loss.  As if that wasn't hard enough, now you've got all this extra skin to take care of.    The excess skin you have after your weight loss remains crepey and deflated looking.  Breast ptosis (sagging, crepey breasts) after massive weight loss is a common problem.  Your breasts, I assume, were much larger before your weight loss.  Now, they sit flatter on your chest and droop.
Some of the key points are how much they have "settled" and what is the position of your nipple-areola complex.  A youthful, aesthetic-appearing breast has the nipple pretty much at the most projected portion of the breast, i.e. where your breast projects out the most from your chest.  If you put an implant in, but your nipple is at the bottom of the breast, than you're going to have a larger breast that doesn't look better.  It'll just be larger.
So, in order to get the best result, you often need to reshape your breast tissues.  Unfortunately this often means more scars.    An implant can help to replace some of the volume that you've lost.  This will stretch out some of the loose skin.  But it sounds like you don't want to be as large as you were before your weight loss.  So, it's unlikely that you'll fill up all of the loose skin.    You might do well with a combination of an implant and a mastopexy (breast lift).
A mastopexy can be done with an incision that just goes around your areola, a lollipop shaped incision that goes around the areola and then vertically down the underside of your breast, or an anchor or inverted T shaped incision.    You should ask your surgeon about these options and which one they feel is right for you.  Good luck to you.  You're well on your way to a fantastic transformation.

Implants for Sagging Breasts with Crepey Skin?

Answers (16)

More Breast Implants Questions

Right Breast Implant Sits Higher Than the Other

How Can You Tell if Your Breast Implants Bottom Out?

Bad Breast Implant Results. What Are my Rights?

50 Too Old for Breast Implants?

How Common is a Silicone Allergy with Silicone Breast Implants?

Do Breast Implants Cause Stretch Marks?

WE SEND PRETTY
EMAILS