Perky Again! Breast Lift After Weight Loss

by Dr. Stewart Wang, Cosmetic Surgeon

“So you lost the weight, but what do you do with all that loose skin on your breasts?”

It’s no secret that more and more Americans are overweight. While the tried-and-true method of dieting and exercise has helped numerous people shed their unwanted poundage, some people are turning to drastic weight loss surgery such as bariatric gastric bypass surgery or lap-band surgeries.

No matter which route is taken, the substantial reduction of weight and fat loss are wonderful for one’s health and self image. Even reduction of metabolic diseases can be attributed to this type of dramatic weight loss.

While we congratulate ourselves with our weight loss accomplishment and look forward to a healthier lifestyle, there is a significant drawback that comes with this massive weight loss: sagging, stretched-out skin.

What happens to the sagging skin that is left behind after the fat is gone? The extra skin will not shrink back completely, therefore the only logical solution is to remove it. One of the most common areas affected is the breasts.

Typically the breasts have significant sagging regardless of their size. When it comes to rebuilding the breasts, there are several options to consider. Should one go for a breast implant, a breast lift, or a combination of the two?

The answer really depends on what the patient’s ultimate goal is. Is she looking to be perky and full? Or is she looking to just put the nipple back where it belongs? It takes a serious, lengthy consultation with a cosmetic surgeon to outline all the options available.

Let’s say for instance that the patient is not concerned about the lost breast volume. Her main concern would be placement of the breast and the nipple/areolar complex. In this case, we would recommend a breast lift. This would allow the plastic surgeon to remove excess skin and lift the nipple to the center of the breast mound.

Types of Breast Lift

• There are several types of breast lifts. The most minor lift – commonly known as the circle/donut breast lift – is usually used when there is a very minimal amount of excess skin to remove. The nipple/areolar complex can be lifted during this surgery; however, this surgery is reserved for minor adjustments. The only visible scar is a circle around the border of the areola. Over time, the scar fades and is not as visible.

• The next type of lift to consider would be the lollipop breast lift. This lift allows the surgeon to remove more skin and elevate the nipple higher. The scars are on the lower portion of the breast, and include a scar around the areolar border and a vertical scar running from the bottom of the areolar border down to the bottom of the breast. When the surgery is completed the final incision looks like a “lollipop:”

• The third type of lift would be the full “anchor” breast lift. This would be recommended for a patient with the most severe type of pendulous, sagging breasts. The incisions are the same as the lollipop lift, with an additional horizontal scar running along the bottom of the breast. Once again, the scars – although permanent – do heal and fade over time.

Breast Lift with Breast Augmentation

Finally we need to address the issue of lost breast volume. If the patient wishes to add volume to her depleted breasts, then she would need to undergo a breast lift with an implant augmentation, as pictured:

While adding an implant will definitely add to the fullness of the final breast shape, the implant itself is also an added weight which will pull the breast down over time. That’s why this is not a good time to insist on large, fake-looking implants.

The skin that has now been compromised with weight loss and loss of elasticity may not be able to hold up the weight of a such large implant. The incisions can be under a tremendous amount of pressure from the implant and this may hinder the healing process.

We highly encouraging our patients to choose an appropriately-sized breast implant that will be proportional to their new body. A wisely-chosen small to moderate size implant will likely improve the chances of an excellent recovery and longer-lasting, perky breasts.

As with any cosmetic or reconstructive plastic surgery, it is critical to consult with a qualified cosmetic surgeon who has the ability and experience to perform complex breast plastic surgeries. Discussing your issues and concerns with a licensed medical professional is a key first step in the rebuilding of your beautiful, youthful breasts.

(published April 26, 2012)

Stewart Wang, M.D., is a Board Certified Plastic Surgeon known for his skill, sensitivity and ability to artistically create beauty. Dr. Wang’s primary objective is to provide his patients with superb results and ultimate satisfaction. With offices in Upland, Alhambra and Arcadia, and patients from throughout the San Gabriel Valley, Dr. Wang is considered one of the leading cosmetic surgeons in Southern California. Visit his website, Wang Plastic Surgery, for more information or to schedule a consultation.