My breast fat is bumpy and lacking volume with pores and have major excess skin problem after mastopexy, suggestions?

Thank you for sharing your question.  A mastopexy is generally a good way to treat the droopiness of the breasts after significant weight loss. However the breast also loses volume which can be addressed by an augmentation with an implant.  You can discuss an augmentation with a Board Certified Plastic Surgeon to choose the right type of implant and placement that would best fit your desires.

Hi zom99,

Determining whether you need simply a breast implant versus a breast lift or both can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position.

Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just breast augmentation depending on the size of the implant the patient wants. I often use an implant when I perform a breast lift because it provides more upper breast fullness after the lift.

These two surgeries can be done at the same time and this may be optimal as the risks can be minimized. 

My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift).

Most importantly, it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, it is actually breast tissue that is being brought together to support the breast and hence improves longevity.

In addition, upper pole fullness is achieved with appropriate implant selection but more importantly, submuscular placement, and precise pocket dissection. The submuscular placement allows the muscle to cover the top part of the implant which allows the upper pole to appear fuller. Keeping away from the lateral chest during pocket dissection allows the implant to remain higher and prevents it from falling off to the side.

You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

Hello dear!!
Thanks you for your question. It is my pleasure to help you with your concerns.
You can be your own best version, and you can definitely achieve amazing results with plastic surgery.  For an improvement in your breast and to give them fullness, I recommend small implants.I suggest you to make an appointment with a board certified plastic surgeon for a good evaluation and to talk about your goals.
I hope this is helpful.  Good luck :)