5 Wks PO BA/BL and They Are Still UGLY As Ever? (photo)

I had ba/bl 6/20/12 silicone unders 400cc w/donut lift. I was to get a full lift but once in there he decided all that was needed was the donut lift. WLS lost 130 lbs. I had very saggy breast 38C. I was told to give it more time that I will see changes in the months to come. I just havent seen any yet, they are still square flat looking and it doesnt even look like a got a lift! Do you think I'll see better results or is this going to be it??

Doctor Answers 7

5 Wks PO BA/BL

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Five weeks is still early to say that there will be no further changes in your appearance. 

As an on line respondant to your question, it is not possible to know what your expectations may have been. 

I do see enlargement, and I do see nipples and areolae that appear to be well positioned in the after photos. I think your surgeon did the right thing in limited the lift to a donut lift. There are a variety of goals after a lift, the primary one being that the bottom of the areola be even with or slightly above the breast fold, and it looks like that is where they are.

If you still feel too flat, you will need to discuss with your surgeon the possibility of using larger implants. 

Thanks for your question, best wishes.

Seattle Plastic Surgeon

5 Wks PO BA/BL and They Are Still UGLY As Ever? (photo)

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It is early yet to tell the full effects of your implants with respect to them dropping. Massive weight loss does pose special challenges in that the skin envelope is usually quite lax and you would require more of a lift than you had. I do not feel that your surgeon did the wrong thing by limiting your lift if he or she felt that was best for you. It is possible that you will need larger implants and even more extensive of a lift. Being that said this is the hardest surgery that we do and almost always back in the old days these surgeries were split into two operations because of the difficulty to obtain symmetry. As our knowledge and techniques have evolved they have become very good operations to perform in one setting. But, and there is always a but, I tell all of my patients that this can be done almost always in one operation however, in their mind they should think of it as a two stage procedure. What I mean by this is that the revision rates are so high for augmentation/mastopexy surgeries such that if you wind up needing that second surgery there were no surprises. Your situation is very common.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 54 reviews

Results At 5 Weeks Post-op Of A BA/BL

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I am sorry that you are not happy with your results.

The main point to address is your excess skin as a result of your massive weight loss.

Comparing your "before" to your "after" pictures, you have good increase in the size of your breast with some lift.

At this point, you are still in recovery mode and you should be a little more patient so the end results can be established before you make any decision.

In case you remain unsatisfied once you fully recover, then a more aggressive lift could be considered such as the lollipop lift.

Communicating with your surgeon is essential during your recovery process as he/she knows the full details of your procedure.

I hope this helps and the best of luck to you.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

Breast augmentation revision

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The look of the end result of breast implant surgery is dependent on the skin envelope and what is inside that envelope. Your history of massive weight loss and posted photos are indicative of significant extra skin on the breast (a large envelope). In placing breast implants in such cases one has to balance the envelope size with the implant size. For a larger envelope smaller implant mismatch you will have to remove more breast skin (decrease envelope size). The drawback to that is more skin scar.

Since your current implant size does not fill the envelope you will have to increase implant size and/or remove additional skin envelope. The envelope shown in your photos may shrink a bit as the swelling of surgery resolves but 2 or 3 months after surgery most of that should be gone. You will then have to decide if you want larger implants and/or more breast skin removed. If you operate before all the swelling has resolved you could make it worse.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

5 Wks PO BA/BL and They Are Still UGLY As Ever?

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Sorry to say either to small implant or in correct lifting choice. Or both. Best to discuss with your chosen PS or seek second opinions. I might suggest a redo lift like a L-shaped. 

Ugly as ever after breast implants and lift

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Your breast is indeed fuller after the augmentation, and five weeks is ususally not enough time for a submuscular implant the shape into the breast well. Weight loss poses special challenges as the expanded skin envelope often requires a rather large implant to fill it out. You will have to wait six months before you can rally judge your results.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Volume versus shape

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It would seem that more volume, more projection, and better breast tissue tightening wold create an aesthetically more pleasing result.  You will, however, have to decide what your ultimate goal is.  The good news is that the purse-string lift (donut lift) did not burn any bridges so to speak and a circumvertical breast lift (lollipop) can be done at your revision surgery should you so choose.  You will have to consider carefully the implant that will give you the result you seek.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 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.