Is It Normal to Appear Flat After a Breast Lift?

Breast lift (mastopexy) surgery typically involves only skin removal and putting your existing breast volume in a higher, tighter skin brassiere. Even for very large droopy breasts where the patient wants to maintain her size and simply get her own breast volume to a more youthful and uplifted position on her chest wall, I will generally remove no more than an ounce of skin per breast (I always weigh and record the amount removed on the patient's chart). Perhaps your surgeon did this as well, as it certainly seems as if you had a "cosmetic" reduction rather than a lift.

Since both a full Wise (anchor) mastopexy (breast lift) and Wise-pattern breast reduction utilize the same incisions, the amount of tissue removed is not defined by the incision pattern chosen, only by the choice and judgement of your surgeon.

It certainly sounds as if you surgeon removed more than just skin in performing your "breast lift" and perhaps it is because there was some difficulty in safely closing your incisions with all of your tissue remaining. But that is a function of the design your surgeon chose, and experience with this procedure tends to reduce these concerns. If your surgeon is talking about "adding" implants at this stage of your recovery and newfound dissatisfaction, I suspect she may have felt the need to remove tissue in order to perform a proper closure, decreasing your size more than you prefer.

I'd ask your surgeon frankly about the cost for redo surgery, but I personally continue to be dismayed that patients don't ask this (and surgeons often don't discuss this openly) BEFORE surgery. Providing implants at no or reduced cost is not the only financial issue, as there are still operating room, anesthesia, and possible professional fees to discuss! Good luck, and understand that your surgeon always TRIES to do what the patient wants, but sometimes anatomy and other factors may change that plan. Best wishes!

First of all, it is not uncommon to have a flat or square appearing breast after a wise-pattern or anchor-pattern breast lift. I will inform my patients of this possibility pre-operatively. Secondly, A breast lift alone should not reduce your size by 2 cups. You may see a very slight (maybe a half cup at the most) reduction due to skin tightening and compacting of breast tissue. I often suggest a small implant with a breast lift to give patients that "fuller/perkier" look. I would encourage you to discuss your concerns with your surgeon and I'm sure you will come to an agreement about future surgery and costs.

 

Without seeing before and after photos, it is impossible to give you specific advice.  In many cases, patients need both an implant and a lift to achieve the best results.  Many surgeons do the lift as a first stage and then implants as a second stage surgery or visa-versa.  However, it is also possible to do both procedures at the same time.

 

Good Luck.