Breast lift combined with augmentation after massive weight loss?

I have posted pics before showing my breasts after losing 100lbs. I heard different doctors giving different advice (which I expect), but I want to ask this question directly. With significantly sagging breasts, is it safe and doable to perform a lift and augmentation at the same time? Why and why not please. Thank you.

Doctor Answers 5

Breast lift combined with augmentation after massive weight loss?

Hello dear, thanks for your question and provided information as well.. The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but  also help bras and swimsuits fit more comfortably and attractively. By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast, Actually the perkiness on a person or another, depends on patients skin and breast tissue..

Dominican Republic Plastic Surgeon
4.5 out of 5 stars 396 reviews

Breast Lift Combined with Augmentation?

So here is as direct an answer as possible. It is certainly possible to combine both a lift and an augmentation in the same operation, but the question is, is it a good idea for you. And the answer is, it depends.............Depends on what? It depends on the degree of sagging or ptosis, the quality of your tissues, the size of the desired implant etc. In the case of the major weight loss patient who typically have a lot of sagging or ptosis, the chance of getting a really nice result that is long lasting by doing the surgery in a single operation is extremely remote, even in the hands of the very best surgeons.
There are too many moving parts and the operations tend to work against each other. By trying to combine them in a single operation you end compromising either one or both of the procedures. This results in unsatisfactory outcomes which require revisions to achieve something that is even remotely attractive. There are studies which show that the revision rate for the combined procedure is 30% or higher, and this if for all patients. For the major weight loss patient with significant sagging, the revision rate would approach 100%. So you have to ask yourself, is your priority to have the surgery in a single operation and hope that despite the odds your surgery turns out well, or do you prefer to get the best possible outcome that minimizes risks and gives you an attractive and durable outcome.

Braden C. Stridde, MD
Kirkland Plastic Surgeon
4.8 out of 5 stars 52 reviews

It is always doable to do a lift and augmentaton at the same time

but there is a minority of surgeons who feel that you're better served by doing the lift first and then the augmentation second.  I personally allow my patients to choose and when you lose a lot of weight, your procedure would be more like a breast reconstruction using your own deepithelialized inferior based flaps to provide more coverage to your implant and help maintain your current fold.  I would not think of any other way to do your lift as all of the other ways will surely bottom out with time.

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

Breast lift combined with augmentation after massive weight loss?

I have posted answers to some of your previous posts. Let me see if I can answer this one as well. 
The short answer is yes, it is "doable" to perform a lift and an augmentation at the same time. However, would it be considered advisable by me to someone in your current situation? My answer would be no. Based on your previous pictures and depending on your goals, here is what I would suggest to you. Start with the lift. Use your own tissue and re-arrange that tissue to create a smaller breast envelope at a less ptotic position on your chest. Often time this results in an overall "smaller" breast, but in a different position, the volume can be very different to your appearance and patients are often very happy. If after that, you are unhappy with the overall size, then go back and place a modest implant to get you where you want to be in terms of size.  
While it is possible to do both at the same time, it is very difficult to get right and often the chance of another operation for revisions ins as high as 20-30%. In addition, combining the procedures puts you at increased risks for complications such as wound healing problems or infections. Furthermore, patients with massive weight loss have permanent stretching of the skin and the poor skin quality that lead to the initial problem continues after surgery and this can lead to a poor result long term. To avoid this, it might be advisable to provide some type of soft tissue support to the breast lift to improve long term results. You should discuss this with the ABPS certified surgeon of your choice.
Hope this helps!

Dallas Buchanan, MD
Spokane Plastic Surgeon
5.0 out of 5 stars 30 reviews

Breast lift combined with augmentation after massive weight loss?

You're not going to like this answer, but it is sometimes safe for some patients and not for others. There are a great many variables, but the risk of losing one or both nipple/areola complexes from vascular necrosis is not worth pushing the risk factor. The answer for you specifically will depend not on photos but on your physical exam and consultation to determine specific goals. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

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.