Losing a significant amount of weight is an achievement that deserves recognition. However, many individuals find that losing a significant amount of weight leaves loose skin behind, especially in the chest area. A common side effect of major weight loss is sagging skin. For many women who have lost a substantial amount of weight, the joy of reaching their goal size is dampened by the realization that their breasts have lost volume and shape. Though it is a natural result of weight loss, the change in breast shape and lift can cause emotional distress for some women. Fortunately, today's advanced mastopexy, augmentation, and masto-augmentation techniques allow for dramatic, rejuvenating enhancement of your breasts post-weight loss. Breast reshaping should be integral to an upper body lift.
The Impact of Weight Loss on Breast Appearance
Breasts change dramatically after massive weight loss. The reduced volume of fat results in poor shape, projection, and skin elasticity. Most breasts resemble a pancake, with distorted and ptotic nipples. After massive weight loss, breasts have poor shape, projection, and skin elasticity. The nipples are distorted and ptotic. Significant weight loss often deflates the breasts due to fat loss. The excess skin on the breasts can be frustrating after working so hard to achieve significant weight loss results.
When a significant amount of weight is lost following breast surgery, it impacts several aspects of the final cosmetic outcome. First, the breast skin becomes looser and begins to sag, causing the breasts to lose optimal shape and lift even if an implant technique was used. Additionally, areas adjacent to the breasts, such as the chest, back, abdomen, and sides, can lose tissue fullness. This results in visible transition lines and an unnatural appearance between the thin adjacent areas and the fullness of the breasts. Ultimately, breast surgery achieves its most natural, aesthetic outcome when post-surgery weight is stable. Losing 20 pounds or more after breast surgery can cause deflation and sagging that negatively impacts the desired lifted shape. Weight loss doesn't just reduce fat-it also changes your skin's elasticity. If your breasts have lost volume and now sit lower, a breast lift (mastopexy) may be needed to remove excess skin and reshape the breasts for a firmer, more youthful look.
Understanding Breast Lift Procedures (Mastopexy)
A mastopexy, or breast lift, can be a good option for reshaping the breasts after major weight loss. A breast lift is a surgical procedure that tightens the skin on your chest to lift and reposition sagging breasts. A breast lift removes excess skin from your chest, which repositions your breasts. It also repositions your areolas, giving your breasts a perkier appearance. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. To restore a better breast shape following pregnancy & breastfeeding. Pregnancy can bring some unwelcome changes to the breasts, often leaving them stretched and sagging. To improve breast contour after significant weight loss. Losing weight often means losing breast volume. To enjoy a beautiful, perky breast shape for the first time. A small but growing number of breast lift patients have had drooping breasts since their teens.
During a mastopexy procedure, the surgeon will make strategic incisions around the areola and vertically down to the breast crease, allowing the skin envelope to be shifted and tightened. Excess, loose skin that is contributing to breast sagging and a deflated appearance is trimmed away once optimal positioning and lift height are achieved. The remaining skin is then sutured into place, forcing the breast mound to take on a more projected and youthful position on the chest wall with enhanced cleavage.
Read also: Losing Weight, Changing Breast Size
Incision Techniques
Cosmetic surgeons use a variety of incision techniques for breast lift surgery; the exact technique used will vary based on a patient’s existing breast tissue, the amount of excess skin to be removed, and her personal goals.
Crescent Lift: Cosmetic surgeons may use the “crescent lift” technique for women who have a very small amount of sagging to correct. This involves a small incision running halfway around the top half of the edge of the areola.
Peri-areolar Lift: Women who are experiencing mild sagging, yet still will benefit from a breast lift, are often good candidates for a peri-areolar lift. This involves a circular incision running around the edge of the areola, and like the crescent lift, is commonly performed in conjunction with breast augmentation. This lift can also be effective in helping reduce areola size.
Vertical Lift: This type of breast lift is commonly used, as it allows a cosmetic surgeon to remove excess skin and reshape the entire breast with modest, easily hidden scars.
Anchor Lift: If you have considerable sagging, pendulous breasts, an anchor lift, which allows a cosmetic surgeon to remove a significant amount of excess skin and sagging tissues, may yield the best results. This technique involves 3 incisions: one around the edge of the areola, one vertically from the bottom of the areola to the breast crease, and one along the inframammary fold, hidden in the breast crease. Your cosmetic surgeon may also use this technique if you are having a breast reduction with lift.
Read also: Comprehensive Guide: Carnivore Chicken
Breast Augmentation with Implants
Breast augmentation using implants is an excellent option to restore both volume and shape for deflated breasts after weight loss. As its name implies, a breast lift is a surgical procedure that tightens the skin on your chest to lift and reposition sagging breasts. If your breasts never had the amount of volume that you wanted, a breast augmentation may be the answer.
During an augmentation, the plastic surgeon carefully creates pockets either under or within the pectoral muscle to accommodate the breast implants. Breast implants come in a variety of sizes and profiles to customize to the patient's dimensions and aesthetic goals. Once surgically positioned underneath the breast tissue, the implants provide increased projection and fullness centrally beneath the nipples for optimal cleavage enhancement. In terms of shape, round implants improve your breasts’ shape. Fortunately, with breast implants, you can choose a size that most suits you. Breast implant sizes are measured in ccs. Furthermore, both saline and silicone implants are safe. However, of both implants, silicone implants are more natural to touch. You have to discuss with the surgeon to know what works for you.
Implant Fill
When the implant becomes the dominant volume of the breast, gel fill is preferred. It is softer and more cohesive than saline. Lax breast tissue is unlikely to adequately support a saline-filled implant, resulting in rippling.
Masto-Augmentation: A Combined Approach
The most comprehensive approach to rebuilding sagging breasts post-weight loss is a masto-augmentation - concurrently performing a breast lift (mastopexy) and breast augmentation. With this dual procedure, the restoration process addresses both breast volume and excess skin laxity at the same time. If you may also choose to get a breast lift and an augmentation at the same time.
The surgery begins with augmenting the breasts using the chosen implant sizes to increase fullness and cup dimension. The implants stretch the skin envelope to create a subtle breast mound. A mastopexy is then meticulously executed, trimming away the extra, loose skin before it is shifted and tightened into a lifted position secured with sutures.
Read also: Breast Lift Surgery
Fat Grafting
Fat grafting procedures achieve the most natural results because they involve the transfer of fat from one part of your body to another. A fat transfer breast augmentation corrects asymmetry while providing a moderate breast volume enlargement. The ideal candidate for a fat grafting breast augmentation are women seeking only modest enhancements to their breasts and looking for alternatives to breast implants. So, if you want to increase your breast volume just a little bit, it is best to discuss this with Dr. Joe to be sure you qualify for the procedure. Breast lifts and fat transfer breast augmentation are the most natural since they don’t involve prosthetic implants.
Addressing the Torso Deformity
Breast reshaping is best performed within the context of the torso deformity. Midtorso rolls of skin and fat may lie beneath and lateral. We incorporate reshaping of the breasts into the upper body lift. The upper lift consists of raising the IMF, a reverse abdominoplasty, excision of the midtorso back rolls, and reshaping the breasts. A total body lift consists of an upper body lift combined with a lower body lift and circumferential abdominoplasty. Due to the magnitude of the case, the total body lift is usually a two-staged procedure.
Upper Body Lift
More often the breasts are reshaped during an upper body lift. This lift is a reverse abdominoplasty that ends along the inframammary fold scar of the Wise-pattern mastopexy and extends laterally along the back roll. The upper body lift is a reverse abdominoplasty that ends along the IMF scar of the Wise-pattern mastopexy and extends laterally with excision of the back rolls.
Inferolateral Breast Spiral Flap Technique
When the breasts need enlarged, nearby tissue is used for augmentation. The inferolateral breast spiral flap technique has been devised for that purpose. Augmentation will be from de-epithelialized inferior and lateral flaps of skin. Augmentation of the superior pole of the breast will be provided by a de-epithelialized lateral extension of the central breast pedicle that includes the lateral 50% of the back roll. For the right breast, a clockwise spiral of inferior, lateral, and breast de-epithelialized flap is made. On the left, the composite flap spirals counterclockwise.
The Importance of Inframammary Fold (IMF) Construction
Proper inframammary fold construction is pivotal to the upper body lift. Proper IMF construction is pivotal to the upper body lift. It contributes to breast shape and position. It hides the anterior scar of the reverse abdominoplasty under the breasts. It allows for maximum removal of redundant and lax midtorso skin flaps by a secure fixation to the chest wall. Although the new IMF establishes the end of the reverse abdominoplasty, its positioning focuses on the breast. Secure fixation is essential. The IMFs we have created approximate the SFS to muscular fascia, and despite considerable tension caused by the reverse abdominoplasty, they barely drift. The anterior thoracic SFS is well defined with sparse fat. We minimize injury to the SFS by scalpel incision. The suprafascial undermining goes to the coastal margin or beyond. We place interrupted, large braided, permanent sutures with generous vertical bites using tapered needles from just lateral to the sternum to the anterior axillary line. We tug on each suture is ensure secure placement. By forceful upward push on the reverse abdominoplasty flap, tension is…
Considerations for Weight Stability
The number one rule before going into breast surgery? Your weight should be stable for at least three to six months before your procedure. Fluctuating weight can impact your surgical results - if you lose more weight after surgery, your breasts could continue to shrink or sag. If you gain weight, your breast size may increase unpredictably, altering your results.
Recovery After Breast Lift Surgery
Recovery from breast reduction and lift after weight loss should be manageable if you closely follow your surgeon’s advice and take proper care of yourself.
- Swelling, bruising, and soreness for the first week
- The need to wear a surgical bra for support
- Downtime from exercise and strenuous activities for a couple of weeks
- One week off work, depending on physical activity on the job
- The need to keep your upper body elevated
- A few follow-up appointments with your surgeon
During your breast lift recovery time you can expect discomfort and redness around incisions post-breast lift. Numbness in nipples, areolae, and breast skin may persist for about six weeks. After the procedure, it is best to follow the surgeon’s instructions for fast recovery. Furthermore, sleeping on your back, drinking plenty of water, and keeping your breasts above water are best. Submerging your breasts may lead to infection. In addition, avoid smoking and alcohol, as they can delay wound healing and cause dehydration.
Scars
Unfortunately, almost all surgical procedures involving the breasts come with scars. You will have visible scars immediately after the breast augmentation procedure. Nevertheless, the scars should fade within 12 months. You can reduce the appearance of these scars by following your surgeon’s post-operative instructions and using pressure bandages or silicone sheeting.
Long-Term Results and Expectations
Expect your mastopexy results to endure for about a decade, possibly 15 to 20 years if done at a younger age. Having a breast lift is similar to resetting the clock for sagging. Your breasts will still undergo natural changes due to the aging process, although with proper care you should not experience your previous level of sagging for many years. However, it is important to understand that certain life events, such as future pregnancy or weight fluctuations can negatively affect your results.
Insurance Coverage
Many patients are concerned about whether breast reduction and lift after weight loss are covered by insurance. The answer depends on your individual plan and the medical necessity of the procedure.
Insurance often covers breast reduction if it’s needed to relieve physical symptoms like chronic pain, skin irritation, or posture problems. You may need to provide your insurance company with documentation from your primary care doctor or a physical therapist, showing how symptoms impact your daily life.
In most cases, however, a breast lift (mastopexy) is considered cosmetic and is not usually covered by insurance alone. Sometimes, however, if the lift is performed alongside a medically necessary reduction, portions of the surgery may be included in the coverage.
Finding a Qualified Surgeon
If you’re considering breast lift surgery, choosing a cosmetic surgeon is the most important decision you’ll make. When you visit potential surgeons, ask how frequently he/she performs breast lift surgery and how many total procedures that surgeon has performed. Make sure your cosmetic surgeon is board certified; this ensures that he or she is specifically trained and experienced in cosmetic surgery and that your procedure will take place in an accredited facility, which is essential for your safety. Finally, don’t choose a cosmetic surgeon based on price alone.