Breast Plastic Surgery After Extreme Weight Loss – An Uplifting Experience

For almost all patients with extreme weight loss, reshaping of the female breast requires a mastopexy or breast lift. This procedure is primarily about reshaping the breast by removing excess skin, moving the nipple to a higher position, and reshaping the breast mound. The skin of the breast is much like a bra, it provides support and shape. When one loses a lot of weight, the skin stretches and the leather bra is no longer able to support the weight of the breast. This results in breast ptosis in which the amount of loose skin exceeds the volume of breast tissue it supports. As a result, the breast develops a lot of sagging.

By definition, sagging of the breast means that the skin must be removed to move the nipple to a higher position. The degree of breast ptosis or drooping (the position of the nipple in relation to the inframammary fold) determines the amount of skin that must be removed, as well as the location and length of incisions (scars) needed to do so. One concept to understand about a breast lift is that the lifted breast will likely look slightly smaller (about ½ cup size) and will not maintain upper pole fullness long term.

While there are different types of breast lifts, from small to large, most patients with extreme weight loss require a full or extended breast lift. The full breast lift that I am referring to is also known as the anchor technique. This method of breast lift gets its name from the anchor-shaped scar it leaves on the breast. This technique creates vertical and horizontal breast scars. (an inverted T) Think of this operation like making a cone out of a piece of paper. Cutting a wedge and bringing it together creates the brisket cone. This is very similar to the anchor breast lift technique. Although this approach creates a large amount of breast scarring, half of the scar is along the inframammary fold, thus being hidden.

Such a complete breast lift will not make the breast bigger, but rather it will be lifted in a better shape. For this reason, many patients may want or require more breast volume so that the lifted breast is fuller as well. As a result, many breast lift patients require an implant to create more volume. The combination of these two procedures is called mastopexy with implants or breast augmentation with lift.

Lifting and implanting a sagging breast is often required after someone has lost a lot of weight. This is a tedious and very artistic procedure in which it is difficult to achieve good symmetry between the two breasts. For this reason, anyone considering this combined breast procedure must accept the risks of the possible need for revision surgery.