Deflated breasts after weight loss. Would implants or fat transfer help? (Photo)

Question

I am 28 years old with no children, 127lbs and 5’5”. I lost about 25 lbs very rapidly and my breasts are quite deflated when bent over or to the side. They aren’t very perky when standing but I really don’t like the breast lift scars and would only consider a lift after children/implant removal. Would implants or fat transfer help with them being deflated?

Joel Patrick Maier, MD · Answer

Fortunately, you do not have a lot of ptosis, very mild and I would not recommend a mastopexy. A natural augmentation with an appropriate sized saline implant or fat transfer would suffice to fill the upper pole volume and improve the overall shape. Thank you.

Chet Mays, MD · Answer

Thank you for your inquiry! You are a great candidate for a breast augmentation with implants. Adding implants will increase volume where you feel your breasts have deflated. I recommend consulting with a board certified plastic surgeon to create a surgical plan targeted towards your specific goals.

Daniel Barrett, MD · Answer

Dear Optimistic477163,
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

Alan Gonzalez, MD, FACS · Answer

Hello @Optimistic477163, thank you for your question. Breast implants and fat transfer could potentially help in your situation. However, the best choice depends on your individual goals and circumstances. Breast implants can increase breast volume and fullness. On the other hand, fat transfer can also add volume and avoid potential risks associated with implants.I understand your concern about scarring from a lift. My technique uses the BRALift technique with a minimal L-shaped scar. But, this is a personal decision. I recommend scheduling a consultation with a board-certified plastic surgeon. This will allow you to examine and discuss the best options for your specific case and goals. Best wishes! Alan Gonzalez MD, FACS.  American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science Member (IFATS), Colombian Society of Plastic Surgery member (SCCP).

Hilton Becker, MD · Answer

Fat grafting can be very effective in restoring volume to deflated breasts  provided that there is sufficient Fat to graft

Connie Hiers, MD, FACS · Answer

You would probably do best with implants and can achieve the size you want better and for longer term.

Mats Hagstrom, MD (license on probation) · Answer

Your condition is often referred to as pseudo ptosis. True breast ptosis describes the relationship of the nipple position in relationship to the inframammary fold. Based on your pictures, your nipples are still above your inframammary fold which gives technically equals grade 0 ptosis. 
Pseudo ptosis is the term for lack of volume in the upper half of the breast, when the nipple position is still not below the inframammary fold,
In addition, your breast diameter is slightly smaller, bordering on very slight tubular breasts. 
Both tubular breast, deformity and pseudo ptosis is best treated with implant augmentation. That transfer is good at increasing overall breast size by 1/2 cup, but does little to change the shape of the breast, and in the end your condition is more an issue of shape rather than of actual size. Such a transfer is not particularly good at restoring volume in the upper half of the breast. Grafted fat survives based on where the patient has the most abundant supply of host tissue, which in your case is the lower half of the breast.
There may be good reasons to not want to have implant augmentation but in regards to pure aesthetic outcomes implants are without question your best option.
I suggest having multiple in person, consultations with local board-certified plastic surgeons in your area. Ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of the previous patient who had breasts similar to your own.
An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. It may be challenging to find that many cases of patients who have the same breast shape, but a sufficiently talented and experience provider should be able to have examples of previous patients, who look very similar to what you do.
That is the best way to get a clear understanding of what a single procedure can, and cannot accomplish, and good likelihood of what your results will look like.
As a general rule of thumb patients, do not schedule enough consultations, and should be more selective when choosing providers.
Best,
Mats Hagstrom, MD

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.

Breast implants are the most reliable material to enlarge the breasts

Fat transplantation works but many patients need a second injection and you must have areas of significant fat excess to provide enough fat for an accepotable result. Be aware that removing fat from an area that does not have excess can leave visible depressed areas.

Deflated breasts after weight loss. Would implants or fat transfer help? (Photo)

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