Deflated breasts and loose skin after weight loss. I do not want a lift. Am I a candidate for breast implants? (Photos)

Unfortunately, weight loss can negatively affect your breasts with loss of volume and sagging skin- deflation.

Best results would be implants to restore volume and lift to tighten skin for perkier breasts. Trade off is scars.

You can do only implants- either above the muscle or dual plane- which will improve sagging to a degree, if you don’t mind some breast drooping over the implants. Usually, slightly larger implants give better results.

An exam and consultation with a plastic surgeon is recommended to discuss your options and expectations.

Implants are centred behind the nipples, therefore without a lift your implants would sit rather low on your chest and give you a “rocks in socks” look. For this reason, a lift is recommended.

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision.
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.
A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure. Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based on your photos, nipple position appears to be preserved. With careful implant selection, you can likely avoid the excess scar burden of a lift.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon (ABPS). Patient should discuss their concerns with their physicians in order to make an educated decision.

Dear Gregarious670292,

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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question.
In your situation, a breast lift would likely provide the best improvement if a perkier and more youthful shape is desired. While implants can restore volume, they also add weight, which may increase or make existing sagging and asymmetry more noticeable over time.
With proper scar care and follow-up, scars from a lift can fade beautifully and usually become far less visible as healing progresses.
I hope this helps clarify your options. A detailed evaluation with your surgeon will determine the most suitable plan for your goals and anatomy.
— Güray Yeşiladalı, MD

Thank you for sharing your concerns so openly. It’s very common to notice changes in breast shape and skin quality after weight loss, and it can feel discouraging when the breasts appear deflated or the skin does not recover as expected, especially at a young age.
You are correct that a mastopexy (breast lift) is the most definitive way to address loose skin and reposition the breast tissue. However, I understand your hesitation regarding scars, and it is reasonable to explore alternatives if you are not comfortable with that option.
For select patients, a small breast implant can provide subtle restoration of upper pole volume and improve overall shape without significantly increasing breast size. The goal is not enlargement, but rather a return of gentle fullness and roundness to counteract the “deflated” appearance. While an implant alone does not correct skin laxity, the added support can create the appearance of a more lifted contour.
Additionally, there are techniques such as the use of internal support materials (often referred to as an “internal bra”) that can reinforce the breast structure from within. These can help provide longer-lasting support and improve positioning, particularly in patients with reduced skin elasticity.
Ultimately, the right approach depends on your anatomy, degree of skin laxity, and aesthetic goals. A consultation would allow careful assessment, and a discussion of whether implant-based augmentation, internal support, or other techniques would best achieve your desired outcome while respecting your preference to avoid lift scars.
Warm regards,Dr. Sibel Atalay, MDBoard-Certified Plastic Surgeon

Thanks for your question! Unfortunately, if you want them perkier and more youthful, you'll have to commit to a breast lift. That being said, with the right scar care, the scars can fade beautifully. Best of luck if you decide down that road!

Ideally you need a lift along with an implant. You can try an implant alone and convert it to a lift later if you wish

Many women do not want a breast lift because of the vertical scars associated with the traditional techniques. For that reason, an alternative was developed called 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 or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

From your photographs, it seems you would not be a good candidate for simply getting breast implants. I think it might look awkward on your chest. I would need to do a careful examination, but your options probably include a breast lift, plus or minus a small implant, or do nothing. You may consider seeing a board certified plastic surgeon to get the most accurate advice.