Trying to avoid scarring - Will a lift be necessary? (Photos)

Question

I really don’t want scarring from a lift, is there anyway around this? I used to be a 32ddd, lost 40 lbs and now a deflated d cup. just wondering my options. My first consult the dr said i need a lift. Looking for other professional opinions

Gregory A. Buford, MD, FACS · Answer

Although it is challenging to answer your question without an in-person examination, from the photos you sent and the comment you made about weight loss I would highly suggest that you pursue a breast lift.

Some Plastic Surgeons will try and get around this by placing a very large implant.  However, given the fact that your tissue has already been stretched and is effectively compromised, this added weight and volume will only accelerate the drooping of your breasts over time.

I would suggest either getting the correct surgery (breast lift with implants) or holding on surgery altogether.  Trying to get away with a result by performing the wrong surgery will simply result in a suboptimal outcome and more costs in the long run.

I hope that helps and wish you the very best in your surgical journey!

Mert Demirel, MD · Answer

From the photos and your history of weight loss, you do appear to have deflation and loose skin. In this situation, a lift is usually the most effective way to improve breast position and shape.
Unfortunately, there is no true scarless way to lift a sagging breast. Implants can add volume, but they do not remove loose skin or raise the nipple enough when the breast is deflated. In some cases, implants alone can make the breast look heavier or create a “waterfall” appearance, where the implant sits higher and the natural tissue hangs below.
A smaller scar lift, such as a donut or periareolar lift, only works for very mild sagging. If there is moderate skin laxity, a vertical or anchor lift is usually more predictable. The trade-off is more scar, but also a better and longer-lasting shape.
If you strongly want to avoid scars, you could consider delaying surgery, using supportive bras, or accepting a smaller improvement with implants or fat grafting, but these will not truly correct the sagging.
My advice would be not to choose the shortest scar if it will not solve the problem. A well-planned lift scar usually fades over time, while an under-corrected breast shape can remain disappointing. An in-person exam will confirm which lift pattern is necessary.

Semih Yildiz, MD, FEBOPRAS · Answer

The photos show significant deflation, breast asymmetry, loose skin, and nipples positioned at or below the breast folds. To move the nipples upward and tighten this amount of skin, a breast lift is likely needed. There is no scar-free procedure that can remove the extra skin and reliably create a higher breast shape.

An implant alone can restore volume, but it will not lift the nipple position. With the existing tissue laxity, the breast may hang from the implant and produce a waterfall or Snoopy appearance, particularly if a large implant is used. Fat grafting can add modest volume but also cannot correct the skin envelope or nipple position.

Your options may include a lift alone, a lift with a small implant if upper-pole fullness is desired, or a lift using your own tissue for internal reshaping. The scar pattern could be around the areola, vertical, or anchor-shaped depending on measurements; photographs cannot determine the shortest safe pattern. Ask a board-certified plastic surgeon to show you examples of healed scars in patients with similar skin and weight loss. Scar care can improve maturation, but choosing less scar than the anatomy requires can compromise shape and durability.

Gianfranco Frojo, MD · Answer

Yes, you would definitely want to address the soft tissue envelope. In your particular scneario, you have some severe soft tissue laxity that would rqeuire a lift. This will be also be shown/determined by your soft tissue measurements. The breasts will determine what is needed and will guide your surgeon as well to select the proper implant and mastopexy (breast lift).

Ted Eisenberg, DO, FACOS, FAACS · Answer

Do I need a breast lift? You might not need one. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Gary M. Horndeski, MD · Answer

Many women do not like breast lifts because of the vertical scars associated with the traditional techniques. For that reason, an alternative was developed called the Bellesoma. 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.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

John LoMonaco, MD, FACS · Answer

Congrats on your weight loss !  Your breast is composed of fat and tissue, and depending on your age, MOST of the breast can be made up of fat. So when your body fat goes away, so does your breast tissue. This leaves a lot of loose skin which I see in your photos.  Simply adding an implant will get you size again, but it tends to stretch this damaged skin even further and the breasts often sit way too low.
It also means extra weight on your neck/back/shoulders.

A short-scar lift with a modest sized implant would benefit you the most, and yes its a trade of scar for a better shape withoutr an oversized implant. Get a few opinions from surgeons experienced with plastics after weight loss...it's a different ballgame that just a standard mommy makeover.

Mark T. Boschert, MD · Answer

Whether you need a lift or not, is really dependent upon your goals and expectations, and your anatomy. From the front it does appear as though you would needa lift, however, from the side it does appear that your nipples are above your fold and that you potentially could get away without doing a lift. The only way to really is to do an exam and have you try on some implants to figure out what size you are looking to accomplish.
 Best of luck, Dr. Mark Boschert, Renaissance Plastic Surgery, Saint Charles, Missouri

Trying to avoid scarring - Will a lift be necessary? (Photos)

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