Please Help. Been Told Some Many Things from Different Doctors (photo)

I am 24 years old and looking to get a breast uplift from a weight loss of 7 stone. I want young perky breast that are full as I have always had a large chest. I have been to a few different doctors. This is where the problem is. Too start some have said they can do the lollipop, others say anchor. Then some are saying implants will give me the look I want, others are saying no that I don't need them, and lastly others are saying that they wont do the lift with the implant? Please help me!

Doctor Answers 8

Breast Lifting/Augmentation Concerns?

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Thank you for the question and pictures.

it is not unusual to get different opinions/advice from different plastic surgeons. Some things should be unanimously  agreed upon: 

1. You will benefit from breast lifting ( exact technique may differ from one plastic surgeon to another). I would suggest that you do your due diligence and pick the plastic surgeon who can show you lots of good quality work ( and ask him/her  to help you achieve your goals using whatever technique he/she feels will work best). In my opinion, based on the degree of ptosis present a full ( anchor) mastopexy would work best.

2. Breast implants will be necessary IF  you want larger breasts and/or more volume superiorly (upper pole fullness).  Again, I would suggest that you pick your plastic surgeon first ( based on due diligence researching the physician's  training and experience...).   Then, communicate your goals with the plastic surgeon ( I prefer the use of “goal” pictures)  and ask your plastic surgeon if breast implants will be necessary to achieve those goals.

3. Whether the breast lift and augmentation should be done the same time  is not a question agreed-upon by all plastic surgeons. There are good plastic surgeons who will insist on doing the procedures separately and there are good plastic surgeons who can produce excellent outcomes in a single stage.

The combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increase with breast augmentation / mastopexy surgery done at the same time.

In my opinion, the decision  to do the operation in a single or two  staged fashion becomes a judgment call made by a surgeon after direct examination of the patient.  For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or  whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure in one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).

Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks  are greater with a 1 stage  procedure and the patient does have a higher  likelihood of needing revisionary surgery.

I hope this helps.

Breast lift at 24

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Thank you for your question and the photos. Whether you have implants placed or not, you will likely need all three incisions to appropriately remove the excess skin for a breast lift. To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.  I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Severe mammary ptosis following weight loss

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is a challenging problem.  Much of what is done depends on what your desires and needs are.  If you are done breast feeding or breast feeding is not an issue for you, then consider a reduction with an implant for volume.  If you wish to avoid an implant completely and are happy with your current volume, a Rubin mastopexy will probably suffice.  If you try to lift your breast tissue and use an implant, it is likely you will have your native tissue hang over the implant, imparting an odd look.  As my colleagues have stated, a vertical lift is inadequate in your situation.  You should discuss all of these alternatives with your chosen surgeon.  You also have to understand it is likely you will lose nipple sensation during your procedure.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

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Breast lifting and augmentation procedures

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As Dr. Pousti has nicely outlined, you need a major lift, only an anchor in my opinion will really tailor out your substantially excess, poorly elastic skin and hold the breasts up better over the long term.  As for an implant to make you bigger and/or fuller please realize that the "perky upper pole fullness look" is not something your body will likely be able to achieve because in weight loss patients the tissues have lost their elastic strength and will never regain it.  So trying to go really big and full will not work.  The implants will settle south and look matronly.

I personally agree with him that if you have good tissue (not in a weight loss patient) and want a moderate implant, a one stage approach is best doing the lift and aug simultaneously.  But in the weight loss situation, I have decided no longer to offer that and always do it in two stages now because there are too many complications with implant malposition issues in this setting.

Lift and augmentation

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You have a common shape afer significant weight loss.  It looks like you need a lift and an augmentation and certainly the two can be done together.  As for lollipop incision vs "T" incision it is best determined by exam in person. It depends upon the quality of the skin, laxity fo the tissues, movement of  the nipple, etc..  Hard to say from your photos.  Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Multiple breast options for lift and implants

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When you have a consultation you need to make your self clear as to what you want.  Your goals will direct a lot of the plans and solutions that your surgeons come up with.  You have a lot of different options depending on what you want as a final result. 

You need a breast lift and this can be done a couple of different ways but you should know the reasons and consequences of each one..  An implant would give you a nice look but you will need to decide what size is right for you and the type of implant.  Some surgeons do not like doing a lift and implants at the same time but others do it regularly.  If you want to do a lift with implants then find a surgeon that does it.

Now that you have heard all of the possibilities you need to decide what you want and choose a plastic surgeon that will do that for you.

Best Wishes

Dr. Peterson

Marcus L. Peterson, MD
Saint George Plastic Surgeon

Breast Lift

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From your pictures, you are definitely a candidate for a breast lift.  With the amount of ptosis present, I believe you will achieve a better long term shape with a full lift over a lollipop pattern.  If your breast volume in your bra is adequate now, a lift alone may suffice.  Although I don't always do a two-stage procedure, I would recommend the lift first, then implants later if your volume is not enough for you.

Please Help. Been Told Some Many Things from Different Doctors (photo

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Thanks for the posted photos. You might consider a full lift as operation first see how you appear after 3 months. Than if you want larger breasts have implant. Regards 

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.