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Is a breast lift surgery with implants a good idea for saggy DD breasts?

Q:

Recently I lost 20 kg and lost a lot of weight in my breasts.  Now I have loose skin causing my breasts to sag.  When they are in a bra they look fine and sit normally.  However, when the bra comes off they sag down.  I want to get a breast lift with implants to get that full look (I want them to look full and sit up roundly if that makes sense).  Would it be better to get a breast reduction to get rid of the fat in my breasts and then get implants to fill in all the loose skin?

A:

Anticipate you must drop at least two cup sizes with a Breast Reduction.  A mastopexy which is a cosmetic surgery procedure allows you to actually pick your final breast cup size.  But again with most mastopexies, patients are going to drop at least 1/2 to 1 cup size. If your breasts are truly very saggy, then I would recommend a major mastopexy first.  If you are unhappy with the final fullness or size, a breast augmentation can later be performed with a much lower complication rate.  Consider a consult with one of the many members of the ASAPS to address your concerns.  They are experts in Breast Surgery.

Best,

 

Gary R. Culbertson, MD, FACS

A:

If you "look fine" in a bra, you do not need a breast implant. all you need is a breast lift to put your breasts back to where your bra holds them. It is OK to also augment the breasts if you would like to be larger than you are in a bra, but from your description, this is probably not the case. It is never correct to replace normal breast tissue with an implant. Since you are considering an implant, I would never remove any breast tissue before inserting the implant.

A:

From the description of your expected result, "full and sitting up roundly", you will be most satisfied with a combination lift and augmentation. When doing the lift breast tissue does not usually need to be removed but it can depending on your presentation. The goal of the implant is simply to restore volume to the upper pole of the breast which generally speaking can't be done with lifting alone. Seek out a board certified plastic surgeon to show you photos of lifts alone and lifts with implants. This will help you understand the difference and chose the procedure which is best for you. All the best.

A:

I would recommend that you have a breast uplift (vertical lift with the  Elizabeth Hall-Findley, MD approach).  After the breast uplift wait 6 to 12 months and see how you like the results.   Since your breasts are DD you may likely be very pleased and not need bother with implants.  There is nothing as good as you natural breast tissue so you would never want to have you fat removed and replaced by implants.  Breasts Implants are ok but never as good as you own tissue.  I would bet that the uplift alone will be a pleaser for you.  If not and you choose larger, it is very easy to place  implants in 6 to 12 months.  If you find you just want a little more fullness in 6 to 12 months you may also choose to try fat transfer to your breasts.  The fat transfer procedures have become very popular and far more reliable in 2012 than in past years.   Doing uplift and implants together is a complex combination that leads to revision in 3/4  of the cases so best to stage but some do together as do I in selected cases.   Thanks,  Dr Commons

A:

I would recommend that you have a breast uplift (vertical lift with the  Elizabeth Hall-Findley, MD approach).  After the breast uplift wait 6 to 12 months and see how you like the results.   Since your breasts are DD you may likely be very pleased and not need bother with implants.  There is nothing as good as your natural breast tissue so you would never want to have your fat removed and replaced by implants.  Breasts Implants are ok but never as good as you own tissue.  I would bet that the uplift alone will be a pleaser for you.  If not and you choose larger, it is very easy to place  implants in 6 to 12 months.  If you find you just want a little more fullness in 6 to 12 months you may also choose to try fat transfer to your breasts.  The fat transfer procedures have become very popular and far more reliable in 2012 than in past years.   Doing uplift and implants together is a complex combination that leads to revision in 3/4  of the cases so best to stage but some do together as do I in selected cases.   Thanks,  Dr Commons

A:

Tayla,

Based on your stated goal of being "full and sit up," you are probably seeking a mastopexy. If you want a fuller look than you have now, then breast implants may be in order. Depending on the scope of the mastopexy, you may want to consider performing the lift and augmentation in stages. Consult with 3 - 4 experienced and expert board certified plastic surgeons to explore your options.  

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