Going for a staged lift and then (maybe) augmentation after 6 months. (Photo)

I have a TT & BL scheduled for April 6th. We didn't want to try a lift and augmentation together. My PS said it would be best to stage mine. I've lost 120 lbs from 267-144. I asked her how much boobs I will have left after the BL and she said "none". I guess because my skin is so stretched? I've seen people with cuts to underneath the arm (inserted pic) Why would that happen? Will I look like a boy? Just nipples left? I'm suppose to get the anchor. How will there be any fat left for a boob?

Doctor Answers 8

Breast Lift following Weight Loss

Congratulations on your weight loss.  Most massive weight loss patients will need a full Wise pattern mastopexy (anchor scar) or even a spiral mastopexy.  The inserted picture shows the extended scar of the spiral mastopexy.  This technique can be used to remove excess tissue from the side of your chest and rotate it into your breast to improve volume to your breasts at the same time as removing the excess skin and fat which is typical in this area after massive weight loss. I agree with your decision to stage this procedure as you may wind up with larger breasts than you initially think after rotating the tissue and tightening the skin.  But all of these decisions are best made by an in person consultation with a Board Certified Plastic Surgeon.  If the volume is not enough for you, an implant can be inserted six months after your first surgery to achieve additional volume.

Baton Rouge Plastic Surgeon
4.9 out of 5 stars 14 reviews

Breast lift

This is a procedure that I often do together. I know that some surgeons prefer to do it in 2 stages however I think that you have a lot of skin that can be filled up easily with an augmentation at the same time. If you do them at the same time typically the scars will be smaller. The other picture you pose maybe someone who needed to have it done in 2 stages.

sometimes the addition of longer scars can also be extended up through the arm to remove the excess arm skin this would be a combination of brachioplasty and mastopexy along with breast augmentation. These are very common procedures to do together, we do a lot of them in our practice for people who have had massive weight loss.

Good luck!

Mark T. Boschert, MD
Saint Louis Plastic Surgeon
4.9 out of 5 stars 30 reviews

Going for a staged lift and then (maybe) augmentation after 6 months

Congratulations on your massive weight loss!

You appear to have some breast tissue -i don't think you will be completely flat. Re/your question about incision length- usually the more excess skin a patient has- the longer the incision will be extended laterally to remove all of the excess skin. Doing this procedures in two stages is a good idea.

Thomas Trevisani, Sr., MD
Orlando Plastic Surgeon
4.9 out of 5 stars 63 reviews

Mommy Makeover and Augmentation Mastopexy

The Mommy Makeover is a combination of procedures to bring a woman’s body back to the way she looked prior to pregnancy. Most commonly some variation of a #TummyTuck and #BreastSurgery are performed. Additional procedures can include liposuction, umbilical hernia repair.  The most common #breastprocedures include #mastopexy or #breastlift, #breastaugmentation, or #breastreduction. The intentional result 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) as a result of aging, weight loss, pregnancy, or breastfeeding. However, many women report more satisfaction if an implant is used at the time of #mastopexy. The implants further shape their breasts, restoring superior fullness or volume which may be decreased over time.In regards to implants alone, this is usually said to be mistake by patients reflecting back at the decision. 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.All surgical procedures carry some degree of #risk. Always discuss your issues and concerns with the Plastic Surgeon during and following your consultation. Information that you read online may not apply to your personal situation.Make sure your surgeon is boarded by the American Board of Plastic Surgeons.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Staged lift is not required in your case

Thank you for your question and photos.
Please take a look at my before and after gallery to view a patient with your dimensions, excess skin, and degree of sagginess who underwent the Ultimate Breast Lift method without implants. It is hard to believe, but you actually have enough tissue to create upper pole fullness (without the extra expense, risks and complications associated with breast implants) if the UBL technique is used. The vertical incision component has also bee completely eliminated with this technique. The video below is an example of this technique.
I hope this helps.
Best wishes,

Gary Horndeski M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

Staged breast lift with implants after 120 pound weight loss

Thank you for your question about your staged breast lift and implants.

  • First, congratulations on your weight loss - what an achievement. Good for you.
  • The long scar in the posted photo was to reduce excess skin on the side of the chest with the breast lift.
  • Your surgeon is the best person to trust in doing this in stages -
  • When done in one stage, revisions are often needed.
  • At least in the photos, this does not appear necessary for you - 
  • You have very little breast volume - your breast volume is large gone from weight loss -
  • If your surgeon, based on an examination, tells you there will be no volume after surgery, then plan on that being the temporary result - until you have your implants.
  • You are likely to have a bit more than just nipples, depending on the surgical approach.
  • An incision is the crease seems the right approach, because of the needs to remove excess skin.

Always consult a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Great questions

Thanks for the questions.  Congrats on the weight loss, it is so difficult and you did it.  In terms of your questions, waiting on the augmentation is great if you are ok with that.  It gives us as surgeons more control over the final outcome.  I agree that after your lift you will have very little breast tissue.  If you have ANY fat left, one consideration would be trying some fat grafting at the time of the breast lift to at least give some additional volume.  Unfortunately, patients like you usually don't have much fat available.  The scar under the armpit is probably not something you need.  That extension is often used if there is considerable loose skin in the armpit area that needs to be removed.  

Good Luck

"The above answer has been given without seeing this patient and cannot be substituted for actual in-person examination and medical advice; it is only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Brian Arslanian, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 26 reviews

One stage or two

i think you will get the best result with two stages. You have a lot of loose skin and trying to tighten and add volume to the breast at the same time can compromise one or the other procedure. Filling your breast will require a lot of volume that coukd make your breasts more likely to sag in the future. The safest plan would be to do a lift to improve the shape of the breast and at a second stage make that improved shaped breast larger.
Doing this in one stage is not wrong, but more difficult to get a long lasting result.
Congratulations on your weight loss! 

Patricia A. McGuire, MD
Saint Louis Plastic Surgeon
4.4 out of 5 stars 8 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.