Deformed breasts. Do I need a lift on both sides? (Photo)

I have deformed breasts (sagging and asymetrical) I am 34, never had children, never will. Do I need a lift on both sides? I would also like to get implants eventually to help "fill" the loose/sagging skin. I am about 20-25Lbs overweight. Do I need to wait until after I have lost it to have a consult? Any advice greatly appreciated. My fiance has never seen me shirtless because of the deformity. I am in Toronto, Canada.

Doctor Answers 11

Reach stable weight first then consider surgery

Asymmetry of size and shape is normal, therefore I wouldn’t call your breasts “deformed". You may need a breast lift on both sides, and some excess tissue removed on the larger side to match the smaller side. If you would like larger breasts, implants may be placed (although this is up to you).

If you are currently in the process of losing weight, I would suggest you wait until you’ve reached your stable and ideal weight before proceeding with surgery. You’ll get longer lasting results that way.

Deformed breasts. Do I need a lift on both sides?

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 for the first 3 to 4 months! 

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 360 reviews

Breast Lift and Augmentation

Thank you for your question and sharing your photos. 
Based on the uploaded photos you are an excellent candidate for a breast lift and placing silicon gel implants to get a better shape. 
Questions about the size and projection have to be decided after a physical evaluation with your plastic surgeon. 

Rafael Lluberes Freites, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 10 reviews

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Do I need a lift on both sides?

You appear to be a good candidate for breast lift with possible implants if you desire more volume. Best to seek in person exam by an experienced Board Certified PS

Correction for your breasts

Hi,

You have breast asymmetry. There is no reason that you can't make this a whole lot more balanced.  There are several options available to you. The final decision is something your surgeon can help you to come up with.  There are pros and cons to each. Really though you could have a lift on one side, a bilateral lift, or an augmentation with a lift.  In the case of an augmentation you would most likely only need a lift on the one side.  If you are going to loose weight it is always best to get to a stable weight first.  Don't starve yourself for surgery only to put on weight later.  I tell my patients that I can give them a beautiful result for the long term better at a stable weight than if it were to change.

I would be happy to see you in person if you wish to discuss things further. Feel free to look at my web page to see if you think we would be a good fit.

Dr Rodger Shortt
Oakville Plastic Surgeon
Assistant Clinical Professor &
Director of Cosmetic Surgery Training,
McMaster University

Performing plastic surgery in Oakville, Mississauga, Georgetown, Milton, Burlington, and Hamilton.

Rodger Shortt, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 52 reviews

Deformed breasts. Do I need a lift on both sides?

Yes a breast lift and implants can give you a very nice result and correct the asymmetry of your breasts. You want to finish losing weight before having surgery. After surgery it is ok to gain weight but if you lose weight the breasts will sag again.

Please read below:

Deformed breasts. Do I need a lift on both sides?

Without examining you I cant be entirely sure but it looks like you would definitely benefit from one on the left and on the right you might consider one to slightly improve the shape as well as ensure the scars are symmetrical between the two breasts.The only way to know for sure is to book a consultation with a board-certified plastic surgeon near you. Best of luck! 

Mathew A. Plant, MD, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 21 reviews

A breast lift and implants would be beneficial

Looking at your photos, it looks like you need a lift on your left side to improve symmetry, and on the other side a lift would be useful not so much to lift your breast as to reshape it.  An in person consultation is the best way for you to get an expert advice.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 427 reviews

Deformed breasts. Do I need a lift on both sides?

 Thank you for the question and pictures.  Although I would disagree with you that your breasts are "deformed", you seem to be an excellent candidate for breast augmentation/lifting surgery; this operation is best done once you achieve your long-term stable weight.  Some general thoughts about this combination procedure may be helpful to you as you learn more:

Generally speaking, patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. In other words, 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 increased with breast augmentation / mastopexy surgery done at the same time. This revisionary rate may be as high (or higher) than 20%.
Personally, I find that the breast augmentation/lifting procedure to be one of the most challenging of the breast operations I perform, even compared to somewhat complex revisionary breast surgery. On the one hand, when performing breast augmentation/lifting surgery we are increasing the breast size with breast implants; on the other hand, we are reducing the breast “envelope” in order to achieve the breast lift. These two “forces” must be balanced as perfectly as possible in order to achieve the desired results. Removing too much skin/ breast tissue is problematic; removing too little breast skin/tissue can also be problematic. Remember also that patients presenting for breast lifting surgery and general have lost some skin elasticity/thickness making potential incision line healing problems and/or recurrent drooping/sagging important concerns to communicate.
To achieve a surgical result where the breast implant and breast tissue “come together” and behave like a single breast is one of my goals but can be difficult to achieve. Essentially, we are trying to create a breast implant/breast tissue interface that feels and behaves as naturally ( as a single unit) as possible. Generally speaking, making sure that the breast implant has some sub muscular and some sub glandular component ( dual plane) and tailoring the overlying skin/subcutaneous tissue/breast tissue as precisely as possible over the underlying breast implant is key.
Despite these efforts, breast implants are after all a foreign body that don't necessarily stay where we wish they would; therefore, breast implant related problems such as positioning ( too high, too low, lateral displacement etc.) can occur and may be a reason for returning to the operating room for revisionary breast surgery. I use a “tailor tacking” technique that allows a determination of what breast implant should be used to SAFELY produce the results the patient is looking for. This technique involves use of a temporary sizer and temporary “closure” of the overlying breast skin over the sizer. The use of the tailor tacking technique is very helpful. Breast lifting involves removal of skin ( and tightening of the breast skin envelope) while breast augmentation involves expansion of the breast skin envelope. These 2 forces are counteracting each other. Again, despite these efforts, breast implant and/or tissue/skin complications may arise causing minor or significant complications.
Generally speaking, it is difficult to achieve the “perfect” result with breast augmentation/lifting surgery, despite best efforts. Patients should be aware of the complexity of this combination procedure, achieve REALISTIC EXPECTATIONS prior to proceeding, and understand that additional surgery ( along with the additional recovery time, stress, expenses etc) may be necessary in the short or long-term. Patients should understand that the results of the procedure will not necessarily match aesthetically the results of patients who have undergone breast augmentation surgery only.
For example, some patients who wish to maintain long-term superior pole volume/"roundness" or "implanted look" may find that this result is not achieved after the initial breast augmentation/lifting operation.
An additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness). It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation. The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery, Including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia, lateral displacement etc).
Potential risks associated with breast augmentation/lifting surgery include infection, bleeding, incision line healing problems, loss/change of nipple/areola complex sensation, and blood flow related issues to causing skin or tissue necrosis. Poor scarring, pigment changes, areola/nipple asymmetry etc. are also potential problems. Again, patients may experience implant related problems such as encapsulation, leakage, displacement problems ( too high, bottoming out, lateral displacement, asymmetric positioning etc.), rippling/palpability of breast implants etc. Patients may also be dissatisfied with breast size, shape, and/or how the breast implants and overlying breast tissues “interface” with one another. Occasionally, a breast implant may even have to be removed and the patient will generally be “implant free” for several months at least. Obviously, this situation can be quite physically, emotionally, and psychosocially stressful to the patient involved.
Given the complexity of the combination breast augmentation/lifting operation and the greater risk of revisionary breast surgery needed, there are good plastic surgeons who will insist on doing the procedures separately. 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.
Having discussed some of the downsides and potential risks/complications associated with breast augmentation/lifting surgery, most patients (If properly selected and who are doing the operations at the right time of their lives psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry.
I hope that this summary of SOME of the issues surrounding breast augmentation/lifting surgery is helpful to you and other women considering this procedure in the future.
The attached link may also be helpful. Best wishes.

Breast Lift with Implants

Based on your photos you are an excellent candidate for breast lift with implants. If you plan to lose as much as 20 pounds, do that prior to your surgery. Consult with a board certified plastic surgeon who is highly experienced for a natural look.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 55 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.