For almost all extreme weight loss patients, reshaping the female breast requires a mastopexy or a breast lift. This procedure is mostly about reshaping the breast through 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, providing support and form. When one looses a lot of weight, the skin stretches and the skin bra is no longer able to support the weight of the breast. This results in breast ptosis where the amount of loose skin exceeds the volume of breast tissue that it is supporting. As a result, the breast develops a lot of sagging.
By definition, drooping of the breast means that skin has to be removed to move the nipple to a higher position. The degree of breast ptosis or sag (the position of the nipple relative to the inframammary fold) determines how much skin must be removed as well as the location and length of the incisions (scars) that are needed to do it. One concept to grasp about breast lifting is that the uplifted breast will likely appear somewhat smaller (a ½ cup size) and will not maintain upper pole fullness over the long-term.
While there are different types of breast lifts, from small to major ones, most extreme weight loss patients require a full or extended breast lift. The full breast lift to which I refer is also known as the anchor technique. This breast lift method gets its name from the anchor-shaped scar that it leaves on the breast. This technique creates vertical and horizontal breast scars. ( an upside-down T) Think of this operation working like making a cone out of a piece of paper. Cutting out a wedge and bringing it together creates the breast cone. This is very much like the anchor breast lift technique. While this approach creates a lot of breast scar, half of the scar lies along the inframammary fold so it is hidden.
Such a full breast lift will not make the breast bigger but uplifted with a better shape. For this reason, many patients may want or require more breast volume to make the uplifted breast 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 a mastopexy with implants or breast augmentation with a lift.
Lifting and implanting a saggy breast is frequently required after someone has lost a lot of weight. This is a tedious and very artistic procedure of which good symmetry between the two breasts is difficult to consistently achieve. For this reason, anyone considering this combination breast procedure must accept the risks of the potential need for revisional surgery.
Dr Barry Eppley is a board-certified plastic surgeon in private practice in Indianapolis, Indiana at Clarian Health Systems. (http://www.eppleyplasticsurgery.com ) He writes a daily blog on plastic surgery, spa therapies, and medical skin care at http://www.exploreplasticsurgery.com