Implants for Sagging Breasts with Crepey Skin?

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?

Doctor Answers 16

Implants can help

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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.

Englewood Plastic Surgeon

Breast Implants After Large Weight Loss

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Your description of drooping with crepey skin suggests that you may be best served with a combination of breast lift and breast augmentation (implants).

The implants can restore lost volume and help to create more fullness in the upper chest.

The lift removes lax, saggy skin, repositions the breast and nipple to a more attractive position on the chest, and produces a more pleasing shape.

Your plastic surgeon will be able to guide you after examination of your specific situation.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 46 reviews

Breast Rejuvenation Following Massive Weight Loss

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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

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

This is part of the post weight loss routine

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Improving your abdominal contour and breast shape are both common procedures in the post weight loss patient. They share in common that they are tradeoffs of shape for scar and both usually produce nice results. An implant alone won't do it for you as you will need a simultaneous lift. This is more complicated in the weight loss patient because typically the inframammary crease (the crease below the breast) becomes very loose and ill-defined from weight gain. Make sure you go to a plastic surgeon who has a special interest in body contouring post weight loss.

Improving Sagging and Crepey Breast Skin

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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).

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Breast implantation with lax skin

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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. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Breast implants after massive weight loss

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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!

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Breast surgery after massive weight loss

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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!

A conservatively sized implant with or without a breast lift may work for you

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The answer to your question lies in the degree to which your breast hangs and in the amount of residual breast tissue you possess since your weight loss. If your droop is considered minimal then a conservatively sized implant alone can be used to fill up the empty skin and give you the look you desire. However, many times following a weight loss of the magnitude you have experienced, more then just an implant is required.

The amount of excess skin must be addressed with a breast lift procedure. In certain cases where there is adequate breast bulk the lift operation can reshape your breast without the need for an implant. However, it might still be necessary to introduce an implant plus the lift to obtain the best cosmetic result. Once again this implant can be of a conservative size to suit your taste. Your surgeon will be able to explain your options.

David A. Ross, MD (retired)
Chicago Plastic Surgeon

You probably need breast implants and a lift

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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.

John P. Di Saia, MD
Orange Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.