Losing a significant amount of weight is an incredible accomplishment. Whether you reached your goal through diet and exercise, medication-assisted weight loss or bariatric surgery, the health benefits can be life-changing. Many people feel more energetic, healthier and more confident after losing weight.
However, one aspect of weight loss that often comes as an unwelcome surprise is the effect it can have on your breasts.
Many women discover that while their body shape has improved, their breasts may now appear smaller, flatter, deflated or saggy. They have lost much of their previous fullness and youthful shape.
If this sounds familiar, you may be wondering whether a breast lift, breast augmentation or a combination of both could help restore a more attractive breast appearance.
And make you much happier!
Understanding your options is the first step toward determining what may be right for you.
Why Do Breasts Sag After Weight Loss?
Breasts are composed primarily of fatty tissue, glandular tissue, supporting ligaments and skin. When a woman gains weight, the breasts often increase in size because additional fat is deposited within them.
Unfortunately, when that weight is later lost, the breast skin and supporting tissues do not always shrink back to their original shape.
As a result, several changes can occur:
- Loss of breast volume
- Deflated or “empty” appearing breasts
- Excess loose skin
- Drooping or sagging breasts
- Nipples that point downward
- Loss of upper breast fullness
- Breast asymmetry becomes more noticeable
The larger the weight loss, the more significant these changes may be. Women who have lost 50, 75, 100 pounds or more often experience substantial breast deflation and sagging.
While exercise can strengthen the chest muscles beneath the breasts, it cannot tighten stretched skin or restore lost breast volume. Consequently, surgery it the only effective option that can address these concerns.
What Is a Breast Lift?
A breast lift, also known as a mastopexy, is a surgical procedure designed to elevate and reshape sagging breasts. During a breast lift, excess skin is removed and the remaining breast tissue is reshaped and elevated on the chest wall to create a firmer, more youthful contour. The nipples and areolas are repositioned higher on the breast to a more natural location. Depending on the degree of sagging and stretching, the areola may also be reduced in size.
The goal of a mastopexy is to lift and rejuvenate the breasts. It does not directly address breast size. In reality, this procedure actually results in a reduction in breast size due to tissue removal and compaction though it may not always seem that way.
The results from this procedure can be extremely positive and satisfying, physically and emotionally.
Signs That a Breast Lift May Be Right for You
A breast lift may be an excellent option if:
- Your breasts sag or hang lower than they once did
- Your nipples point downward
- The nipples sit below the breast crease
- You have excess loose breast skin
- Your breasts appear flattened or elongated
- You are generally satisfied with your breast size but dislike their shape
For women who still have adequate breast volume after weight loss, a breast lift alone may provide all the improvement they desire.
By repositioning and reshaping the breast tissue, a mastopexy can often create a firmer, perkier, and more youthful appearance without increasing breast size.
What a Breast Lift Cannot Do
One common misconception is that a breast lift will restore lost fullness. While a breast lift can dramatically improve breast shape and position, it cannot replace volume that has been lost through weight loss or create greater volume where these is none.
For women who have significant volume loss or want to have larger breasts, a breast lift alone will not achieve their desired outcome.
This is where breast implants are beneficial.
When Are Breast Implants Helpful?
Breast implants are designed to increase breast volume and improve fullness. They can be useful after major weight loss when the breasts have become deflated and lack upper pole fullness—the fullness seen in the upper portion of the breast above the nipple. Of course, they are also helpful in increasing overall breast size when this is the desired goal.
Implants can help:
- Restore lost volume
- Increase breast size
- Improve upper breast fullness
- Enhance cleavage
- Improve breast symmetry
- Create a fuller breast contour
However, implants alone do not correct significant breast sagging.
This is a very important concept to understand and one where there is a lot of misinformation about.
Why Breast Implants Alone Often Are Not the Answer
Some women hope that simply placing larger implants will lift sagging breasts. Unfortunately, this approach often leads to disappointing, even disastrous, results.
An implant can add volume but it cannot remove excess skin or reposition breast tissue hanging down or droopy nipples.
When significant sagging exists, implant-only surgery may result in breasts that are larger but still droopy and even deformed or bizarre in appearance. In addition, by using disproportionately large implants in attempt to compensate for excess skin and drooping, this places additional stress on already stretched tissues, resulting potentially in severe sagging and irreversible thinning of the tissues.
For these reasons, experienced plastic surgeons will recommend combining a breast lift with a breast augmentation when both sagging and volume loss are present.
When Is a Breast Lift with Implants the Best Choice?
A combination mastopexy-augmentation procedure addresses both major concerns that commonly occur after weight loss:
- Sagging breast tissue
- Loss of breast volume or desire for larger breasts
By combining the procedures, the breasts can be lifted, reshaped and restored to a fuller, desired size during a single operation.
Women often choose this option when they:
- Have lost significant breast volume
- Feel their breasts look deflated
- Desire larger breasts
- Have noticeable sagging
- Want upper breast fullness restored
- Desire the most comprehensive rejuvenation
The results can be breasts that are fuller, firmer and more youthful in appearance and feel.
Timing Matters: When Should You Have Surgery?
One of the most important factors in achieving long-lasting results is ensuring that your weight has stabilized before surgery and that you are either at your target weight or as close to it as you can reasonably get.
If substantial weight loss continues after a breast lift or breast augmentation, additional stretching and sagging may occur.
Most plastic surgeons recommend that patients:
- Reach their goal weight first
- Maintain a stable weight for several months
- Establish healthy lifestyle habits
- Be in good overall health
For patients who have undergone bariatric surgery, this often means waiting until weight fluctuations have largely stabilized.
Patience at this stage can significantly improve both the appearance and longevity of your results.
What About Future Pregnancies?
Women considering future pregnancies should discuss their plans with their plastic surgeon. Pregnancy can once again enlarge the breasts and stretch the skin, potentially reversing some of the benefits achieved through surgery.
While there is no absolute rule, many women choose to postpone cosmetic breast surgery until they have completed their families.
Choosing the Right Plastic Surgeon
Breast lift surgery is a relatively complex procedure that should be meticulously tailored to each individual patient’s needs and situation. Because every woman’s anatomy and goals are different, there is no one-size-fits-all solution.
Achieving superior results requires both technical expertise and an artistic eye.
Consulting with a reputable plastic surgeon certified by the American Board of Plastic Surgery and who is experienced in cosmetic breast surgery is one of the most important decisions you can make.
During your consultation, together you can determine whether a breast lift alone, a breast augmentation alone or a combination procedure, mastopexy-augmentation, would provide you with the results that you are seeking.
Final Thoughts
Major weight loss can be a very rewarding achievement of yours. However, it often leaves behind changes to the breasts nothing short of surgery will effectively address.
A breast lift can restore a more youthful position and shape to sagging breasts. Breast implants can restore lost volume and fullness. For many women who have experienced substantial weight loss, combining both procedures offers the most complete breast rejuvenation.
The best procedure is not necessarily the simplest or less expensive one—it is the one that appropriately addresses your specific concerns and goals.
By understanding your options and consulting with an experienced plastic surgeon, you can make an informed decision and enjoy results that complement the hard work and dedication that went into your weight-loss journey.
If you are interested in scheduling a complimentary consultation with me, Dr. Steven Turkeltaub, you can do so by contacting the Arizona Center for Aesthetic Plastic Surgery either by calling (480) 451-3000 or by email.
Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona