Would weight loss after breast lift to correct grade 3 ptosis result in "perky sagging"? Not ideal but don't want to delay more.

Question

I'm 26 and have wanted a breast lift since I was 14. I have been sedentary from a chronic illness, and as I'm slowly reconditioning (think I can lose 25lbs), I no longer feel confident that I'd reach my previous "goal weight" for years (-45lbs). As I would be elated to have uplifted breasts, and given that I have squidward level ptosis, if I lost 15-20lbs after getting a breast lift, would my breast sag occur in a more "normal" way rather than in the tuberous downward shape I currently have?

Brian Biggerstaff, MD · Answer

lisailor, thank you for your good question. 
You are correct in your thinking that the most optimal result would be if you had all of your anticipated weight loss prior to mastopexy. However, if you do not think that goal is not realistically attainable (or in a reasonable timeframe), it would not be unreasonable to loose what weight you can now and go ahead with the lift. If you do loose more weight afterward, you likely will experience some new ptosis but I suspect it would be much milder than your current grade 3 ptosis, and would still represent a significant improvement from your current breasts. A popular quote in plastic surgery is, 'we can set back time, but we cannot stop the clock...' Meaning everyone who has a mastopexy will eventually develop new ptosis over time because surgery does not stop the aging process or gravity.Keep in mind that individuals will loose weight differently (ie one patient who has 20 lb weight loss may have 10 lb loss from the breasts while another may not loose much at all from the breast but loose most from the abdomen, etc), so it is difficult to predict exactly what the result would be. Also keep in mind that you can always get revision surgery in the future if necessary to re-lift or fine-tune your result. Long story short, if you have severe ptosis that is really bothering you and you cannot realistically get to your optimal weight for a projected amount of time, than it would be reasonable to proceed with mastopexy and that your result, even if you lost more weight afterward, would probably represent an improvement.

Kenneth Hughes, MD · Answer

If your breasts are composed of a lot of fatty tissue, your breast size will fluctuate with weight gain or loss. Think back to when you lost or gained weight in the past. Did the weight loss affect your breast size and volume? I always recommend that patients be at a maintainable weight before getting cosmetic surgery but I realize that you cannot achieve a goal of 45 lb weight loss before having the breast lift.

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs or told us your bra size. However, the technique I recommend is 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. If weight is lost or gained, you will lose or gain volume but not sag.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

Breast lift longevity depends of many things like breast size, skin elasticity/support, quality of breast tissue (harder breast tissue, longer result), weight oscillations, etc. Without in person evaluation and discussion about available options would be hard to give you a meaningful advise. In person consultation is recommended. Good luck.

Don W. Griffin, MD · Answer

The answer to your question really depends on how much your breast volume changes with weight loss/gain. some women experience significant changes in their breast volume with fluctuations in their weight while others don't have much change in their breast size with weight fluctuations. If your breast size tends to change with weight gain/loss, you should delay your surgery until you are at a stable weight that you know you can maintain. If you have the surgery, then lose more weight, your breasts will get smaller and will lose a lot of their perkiness because you tend to lose volume in the upper breast. Alternatively, if your breast size doesn't fluctuate with weight change, you may not change much if you have the surgery now, then lose weight later, but there is no guarantee.

Daniel Barrett, MD · Answer

Dear lisailor,
generally speaking, you want to reach your goal weight before you consider a tummy tuck, otherwise your results will be suboptimal if you continue to lose weight after the surgery.If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ted Eisenberg, DO, FACOS, FAACS · Answer

When you lose weight, it not only reduces the size of your waist and thighs, but it might also reduce the size of your breasts –sometimes dramatically – leaving you with saggy breasts and stretched skin. If you are planning to lose 10 percent or more of your body weight, it makes sense to wait until you have reached your goal before you surgery, in order to know your true starting size.
Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author.  RealSelf Distinguished Hall of Fame Inductee

Connie Hiers, MD, FACS · Answer

It would be best to achieve the weight loss you want prior to the breast lift.  Then, hopefully, you will maintain your lift.

Ed Breazeale, Jr., MD · Answer

Hello and thank you for your question. To get the best long term results, you would want to lose the weight prior to getting the surgery done. It is ideal to be within 5-10lbs of goal weight, but more than that can alter the results of your surgery. Weight loss can have a large effect on the volume of the breasts as well as how much drop (ptosis) you may get even if the lift done before. The lift itself will help with the tuberous shape you have now, but again I would recommend to lose the weight on the front end so that you hopefully do not have to repeat the procedure again. As always, it is recommended that you see a board certified plastic surgeon and they can help lead you with your next steps. Good luck on your journey!

Robert L. Kraft, MD, FACS · Answer

If you have third degree ptosis since adolescence and then lose a significant amount of weight after surgery, your breasts will likely sag again and negate much of the benefit, it would be best to achieve a stable weight prior to the procedure.

Would weight loss after breast lift to correct grade 3 ptosis result in "perky sagging"? Not ideal but don't want to delay more.

Answers (11)

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