I'm looking into a mastopexy with implants and a tummy tuck. What would your recommendations be? What are my options? (photo)

I am unhappy with breast vol in the upper pole(I can see my pec muscle as my breast tissue has dropped)& low nipple position. I prefer the gentle slope toward the nipple and fullness in the lower pole. Would a sub muscular round implant give me the fullness in the upper pole I need or would an anatomical implant be a better choice bc of the look I am wishing to achieve?What size of implant should I be expecting and what are the limitations?Appreciate any advice or recommendations. TY in advance.

Doctor Answers 10

Considering the various options for mommy makeover.

I think you get an excellent result. The mastopexy is clearly indicated. I'm not certain I would recommend a more expensive shape implants since conventional implants should do quite well. I personally put the implants below the pectoralis muscle when I do a mastopexy concurrently. This is for blood supply reasons but this opinion is not shared by all plastic surgeons.


Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

MMO

I do not like to use anatomical Implants for only one reason, if this implant rotates, you will end having an uneven look and  I can get the same Natural Result with a round implant in a dual plane placement. So my recommendation is  to go for the round Implant and choose a surgeon that knows how to properly do a dual plane.

You are in an excellent weight, congratulations, and you should expect a marvelous result from this MMO.

Best of Luck, 

Luis Eduardo Redondo, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 17 reviews

Breast augmentation with lift and full tummy tuck

I think you correctly answered your own question. Congratulations on your decision to undergo this life altering procedure. Based on your pictures, my opinion is that a round smooth silicone implant along with a lift in which the scar is either only around the areola or the "lollipop" or circumvertical lift will give you the result you are seeking. The measurements of your breast will help me delineate if the implant should be placed under or over the muscle. Based on the pictures, it is likely that you do not have enough soft tissue support in the upper pole and so likely the implant would have to be placed under the muscle. Anatomic implants , in my opinion, are not any better in recreating a soft upper pole than a round implant. These implants are at a higher risk for rotation which would require surgery to fix. Also these implants are textured, not smooth, which can cause many other issues. Best wishes

Regards 

Ravi Somayazula, DO
Sugar Land Plastic Surgeon
4.8 out of 5 stars 52 reviews

Mommy Makeover

Libby,
Thank you for your question. Clinically  it can be impossible to tell the difference between round or shaped implants. Personally I would tell you that I would use a submuscular  moderate plus style implant. With all implants there are trade offs. Shaped implants typically cost more than round implants. Also, they can rotate if the don't become adherent to the breast.  You will get an excellent result with either implant. Your choice for a lift would be either a lollipop  or inverted T of incision. Both are good choices.  Tummy tucks are either a full or mini. A full tummy tuck allows full tightening of the abdominal muscles. While a mini typically tightening is below the belly button.  It is difficult to tell how  much skin laxity that you have without an exam.  My guess is that you would benefit from a full tummy tuck. A full tummy tuck will give you flatter abdomen with tighter skin but requires an incision around the belly button. The mini tummy tuck only affects the lower part of your tummy. While you don't have a scar around the belly button The shape will change with skin tension if left  attatched or will move lower on your abdomen if detached. I think the choice of an abdominal procedure ultimately depends on your goals.  Good luck!

Dr Rast

Jon E. Rast, MD
Kansas City Plastic Surgeon
5.0 out of 5 stars 28 reviews

Mini Tummy Tuck - Am I A Candidate?

Thank you for your question. Based upon your description, it sounds like you are an excellent candidate for mommy makeover surgery. The lower abdominal skin excision and muscle tightening could give you an excellent contour as well as improve the tone of the anterior abdominal wall. The breasts could benefit from a lift +/- an implant. Please see a board certified plastic surgeon for an in-person examination to discuss the specific details of the procedures. Ask to see before and after photos to get an idea of what can be achieved. Hope this helps!

Lancashire Lass MM

Thanks for the question and pics.  You are slender with minimal infraumbilical skin laxity, so I think that a #mini TT, (keeping the umbilicus attached, repairing the infraumbilical musculofascial laxity, redraping and excising the suprapubic skin excess should restore your abdominal contour.  Your breasts would benefit from a #short scar mastopexy ("lollipop" pattern) as well as one of the shaped anatomical silicone gel implants, which will provide a subtle fullness and transition from the area below the clavicle with a gentle slope.  The other #advantages of the shaped anatomical implants include 1) ability to be placed in the subfascial plane; 2) low rate of capsular contracture (average 3.8% vs 2-25% for smooth silicone); 3) form stability (i.e. "stay where they are put"); 4) their lower pole arc supports the lower pole fullness and often decreases the length of a mastopexy.  That being said, not all PS are fans. I have a relatively short experience, however the patients who have been best served are those who value a "natural" look.  Consult with a variety of PS and stick by your aesthetic goals. Good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 56 reviews

I'm looking into a mastopexy with implants and a tummy tuck.

Thanks for including good photos with your question. You are going to get a very nice result with your surgery, and you will be getting answers that vary in what to do because every plastic surgeon has developed their own way to get good results. For you, a breast lift is essential. I personally would lean towards an anchor scar because it will give you, in my hands, a more attractive round and full lower pole of the breast along with a round silicone subpectoral implant using dual plane positioning. Many people would look at your abdomen and feel not much skin can come off, and it does take an exam to be sure, but I suspect a full TT with a very low scar and muscle tightening will get the best results as we find when the abdominal skin  is properly loosened at the time of surgery and then closed with progressive advancement sutures, it is almost always possible to remove all the skin from the belly button to the lower pubic area. Just be sure you find a surgeon who is both experienced and artistic as the two do not necessarily go together. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

I'm looking into a mastopexy with implants and a tummy tuck

Dear Libby

Choosing to make this type of change is exciting. You are a great candidate for a vertical mastopexy with breast augmentation. In my experience, a round submuscular implant does a nice job with upper pole fullness and natural slope. In most patient a M+ implant can achieve that well. Implant sizing is best done in person based on your chest width and shape and a detailed discussion of relevant issues. With a thin skin/breast envelope, do not go too large.
A full abdominoplasty with fascia tightening will work very well for you.  This procedure would tighten your skin and improve your waistline.
Look for an experienced and properly trained plastic surgeon certified by the American board of Plastic surgery. see more than one consult and make a well informed decision.

Afshin Parhiscar, MD
Bay Area Plastic Surgeon
4.9 out of 5 stars 49 reviews

I'm looking into a mastopexy with implants and a tummy tuck. What would your recommendations be? What are my options?

You appear to be an excellent candidate for a mommy makeover. Its sounds like the natural shaped silicone implants under the muscle will give you the look you describe in your answer. The sizes of the implants are also very natural and are based on there width of your breast. You won't be too big or too small if you choose that style. Best of luck to you!!

Terry E. Restivo, DO
Napa Physician
5.0 out of 5 stars 4 reviews

I'm looking into a mastopexy with implants and a tummy tuck. What would your recommendations be? What are my options? (photo)

Thank you for your question and photographs. I think you would be an excellent mommy makeover candidate to address your two major areas - breasts and stomach. Unfortunately implants will only help fill the volume of your breasts that you have lost but will not raise your nipple. Only a breast lift can do this while also removing excess breast skin and elevating your natural breast tissue over an implant. An anatomical implant will supply you with a gentle slope from your upper chest to nipple but implant size will depend on key chest measurements to ensure appropriate implant fit.  As far as your stomach, a full tummy tuck would help remove the most amount of excess skin and adipose tissue while allowing tightening of your muscles to help further enhance your results. be sure to see a board certified plastic surgeon for an in-person consultation and discussion of your desired results.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

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.