Would a small implant 150-200cc correct my sagging from weightloss? (photos)

Question

I have lost 50lbs. I have had onebreast fat transfer. Immediately afterwards, following 350cc transferred, my breasts were up in the air and looking spectacular. Sadly about 60% of the fat died and these are my breasts now. Would getting a small implant such as 150-200 give me a lift? I just want to fill out the skin that was full once before. I’m 29.

Bora Ok, MD · Answer

Hi from Istanbul! Considering your situation, my recommendation would be a periareolar breast lift rather than just an implant surgery. This method is likely to improve sagging by approximately 2 cm and would help delay sagging in the future. Opting for this could provide a more lasting solution to maintaining the uplifted appearance you desire. Best of luck!

John L. Burns Jr., MD · Answer

in general a smaller implant with a lower profile will appear more natural.  I'd suggest doing 3D breast implant imaging to see exactly what a particular implant would look like on you.

Wayne I. Yamahata, MD · Answer

This is a somewhat complex question. Implants provide volume but very little lift. Your photos suggest you do not have a great deal of sagging, so implants alone may suffice. You've stated that you lost 60% of the 350cc of the fat that was transferred. The math would suggest that you've lost 210cc of volume. You likely also had some swelling after surgery so the volume you lost was probably even greater. Finally, the changes in the breast when using implants is not exactly the same as placing the same volume of fat so there is some guesswork involved. Discuss this thoroughly with your surgeon as he or she can provide the best estimate based on experience. Your surgeon may also want to consider having multiple implants available and using sizers during the surgery,

Chul Hwan Seul, MD, PhD · Answer

If we choose an implant of the right size, we anticipate a significant improvement in both sagging and the overall appearance. However, it appears that implants in the range of 150-200cc might not provide the desired outcome. It would likely be more beneficial to consider implants in the range of approximately 250cc for a more effective solution.

Daniel Barrett, MD · Answer

Dear anongaghah,
determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Georges J. Samaha, MD · Answer

Hi, a few points. 
- Fat transfer to breast: Fat does not have vessels (arteries, and veins) carry O2 and dispose of CO2 to survive. Fat cells get O2 by diffusion from neighboring structures (muscle, skin...). So when you inject a large volume of fat, the middle of the fat does not get enough O2. O2 will supply the periphery but will not reach the center of the fat deposited. That's why 40+% of it dies. 
- A small implant will fill in your upper pole and give you the cleavage and fullness you are looking for. Talk to your surgeon about a dual plane placement of the implant. Hard to tell from not examining you, but sometimes you would need a vertical mastopexy to lift up your areola and nipple through an incision around the nipple. Don't do the anchor scar. You don't need it. 
Hope that helps. Goodluck.

Garrett Wegerif, MD · Answer

Yes a small implant would help fill out the skin envelope and have a more reliable result than fat grafting because the implant size remains constant unlike fat grafting. Determining the size of the implant that would work best really depends on your chest/breast measurements. Going too small may cause a waterfall deformity where the breast tissue is sagging off of the implant. The implant technique is also an important consideration when there is a small degree of ptosis (sagging). A dual plane submuscular or subfascial placement of the implant would help minimize the risk of waterfall deformity. You should consult with a surgeon to get accurate measurements and help guide you in an appropriately sized implant. Best of luck and congratulations on your weight loss journey!

Ronald J. Edelson, MD · Answer

I think it would be reasonable to have a small implant placed. I would recommend about 250 or 275cc. Otherwise it’s not even worth having anything done

Gerald Minniti, MD, FACS · Answer

You will need to be evaluated in person as photos are  unhelpful. In general, implants don't lift, and breast tissue sagging after weight loss can have poor elasticity leading to an unnatural appearance with a breast implant if there is sufficient sag. This is what needs to be determined.

Aaron Gilson, DO · Answer

If your goal is to fill out and increase the overall volume of the breast, then a small implant or breast augmentation can certainly do that. However, implants alone do not alter "sag", but instead increase volume. A discussion with a trained plastic surgeon may help guide your decisions. Best of luck!

Would a small implant 150-200cc correct my sagging from weightloss? (photos)

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