5’7, 190lb after 80lb weight loss, want an hourglass shape & can I get implants without a lift? (Photos)

I would begin with your breasts using 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. At the same time, a brachioplasty can be done to remove the excess arm skin & fat. After this has been completed, you can consider a tummy tuck with mesh, if you are not planning future pregnancies. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight. After this is done, you can consider a posterior lift.

Best Wishes,

Gary Horndeski, M.D.

I recommend doing liposuction and a full Abdominoplasty to help get more of an hourglass shape. As for your breasts, I do not recommend implants without a lift. A lift could give you perky, full breasts. With the breast lift, the scarring isn’t terrible after everything heals, and you could choose to put in implants or have fat from your liposuctioned areas transferred to your breasts. During the mastopexy, or breast lift, we can also make your nipples smaller or leave them the same size you have if you prefer. Would love to see you for a consultation to go over things in more detail here at Smith Plastic Surgery.

Thank you for your question regarding how to maintain an hourglass shape after significant weight loss, and whether you can undergo breast augmentation without a breast lift. Congratulations on your successful weight loss journey.

Analyzing your current shape, the curves you have due to excess skin and fat above your waistline and over your hips give you an hourglass figure. A tummy tuck may lead to the loss of some of these curves due to the removal of excess skin and fat.

In regards to your breasts, I would recommend a combination of breast augmentation with a lift. If we were to only place a breast implant, it could result in what we call a 'snoopy dog' deformity, where the breast tissue hangs over the implant, leading to an unnatural appearance. A breast lift, likely an anchor lift, would be needed to achieve the best results.

Therefore, my recommendation would be an extended tummy tuck, possibly even a 360 circumferential lower body lift, to address the abdomen, hips, and buttocks. This could be combined with an anchor mastopexy (breast lift) and breast augmentation.

If you're not satisfied with the curves obtained after a body lift, you may want to consider a procedure to enhance the hourglass figure, sometimes known as a vertical torsoplasty. This procedure, however, cannot be performed concurrently with a tummy tuck or body lift as it compromises the blood supply to the anterior abdominal flap. Instead, this hourglassing procedure can be done approximately 4-6 months after a tummy tuck or a body lift. During this procedure, an incision is made from your armpit down your sides to your hips, and an elliptical area of skin and fat is removed. This results in the elimination of fat from your bra line and accentuation of your hourglass figure.

Please note, this would require two separate surgeries, but the results should be worth the wait. As always, these suggestions should be tailored to your specific circumstances and desires, in discussion with your plastic surgeon.

Sincerely,
Dr. Katzen