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NewMeNow2010

Previous Corrective Breast Augmentation

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Hello Doctor!

When I was 16, I had corrective breast augmentation surgery done because I have tubular breasts. They were C size, very, very saggy, very tubular and very painful. Also, the right was bigger than the left (not drastically but noticeably). For these reasons, my plastic surgeon at the time said the only way to truly correct what I have is to put in an implant because making them fuller would actually round out the tubular condition. This ended up very true, I only went up to a full D, small DD (I told him to only go as high as needed because the size was not of importance) and they turned out perfect. I'm pain free (occasionally, I do find if I bend forward and they drop down, I get a pain..I am guessing it is from their original tubular shape but could be wrong), the shape is much better, I haven't needed a lift to fix the sag because of filling them out, etc. Since the surgery, I've gained about 140 lbs, I weigh close to 340. I'm worried that after surgery, the rapid weight loss will cause issues for my augmentation but I am not sure what to expect? I obviously won't lose a lot of mass because they are implants but will they mainly sag? Firm up as I shrink? Any input would be great!

Thank you!

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Hello Doctor!

When I was 16, I had corrective breast augmentation surgery done because I have tubular breasts. They were C size, very, very saggy, very tubular and very painful. Also, the right was bigger than the left (not drastically but noticeably). For these reasons, my plastic surgeon at the time said the only way to truly correct what I have is to put in an implant because making them fuller would actually round out the tubular condition. This ended up very true, I only went up to a full D, small DD (I told him to only go as high as needed because the size was not of importance) and they turned out perfect. I'm pain free (occasionally, I do find if I bend forward and they drop down, I get a pain..I am guessing it is from their original tubular shape but could be wrong), the shape is much better, I haven't needed a lift to fix the sag because of filling them out, etc. Since the surgery, I've gained about 140 lbs, I weigh close to 340. I'm worried that after surgery, the rapid weight loss will cause issues for my augmentation but I am not sure what to expect? I obviously won't lose a lot of mass because they are implants but will they mainly sag? Firm up as I shrink? Any input would be great!

Thank you!

Hello NewMeNow2010,

Thanks for your question.

You will definitely notice a change in your breast appearance with weight loss after your bariatric surgery.

Skin is elastic, just like a rubber band.

If you apply tension to it, it will stretch (like a pregnant woman's belly skin).

If you release the tension, the skin (and rubber band) will contract back to it's original state.

But if you stretch the skin too fast or too much, it will "break" and lose its elasticity.

When you have breast implants in place, they place constant tension on your breast tissue and will gradually thin and stretch your skin over time.

This is especially the case with large implants such as yours.

A 140-pound weight gain will only stretch the skin even more.

Therefore I suspect that your skin has been quite strecthed and thinned out over the past several years and has probably lost a significant amount of its elasticity.

If your skin still has some of its elasticity intact, then it may tone and tighten as you lose weight, but only to a certain extent.

When you lose a lot of weight after your bariatric surgery, you are right that your breast implants won't change in size, but you will lose fat from your breast tissue, leaving behind the extra skin. This extra skin will likely have poor elasticity because of all the tension over the past years, and it probably won't tighten too much as you lose weight. So you will be left with extra sagging skin of the breasts and the implants will likely sag lower on your chest.

Therefore women in your situation usually require a breast lift (mastopexy) after the weight loss, with or without an implant replacement.

I hope that helps.

Sincerely,

Abhay Gupta, MD, FACS.

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Thank you so much Dr. Gupta, your post definitely did help me! I was figuring I may need a lift but I figure I'll wait until after having kids since pregnancy would just cause the same effects on them as well and mess up the breast lift then. It is really great to have such knowledgeable doctors on this board :) I really appreciate your reply!

Take care!

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Thank you so much Dr. Gupta, your post definitely did help me! I was figuring I may need a lift but I figure I'll wait until after having kids since pregnancy would just cause the same effects on them as well and mess up the breast lift then. It is really great to have such knowledgeable doctors on this board :) I really appreciate your reply!

Take care!

You're very welcome.

You are right that pregnancy would cause similar effects to your breast tissue and would change the results of a breast lift.

I agree with your decision to delay breast surgery until after you are done having children.

Best of luck!!

Sincerely,

Abhay Gupta, MD, FACS.

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