Breast Reshaping After Massive Weight Loss
Typically with significant weight loss, the breasts undergo mild, moderate, or severe loss of fatty tissue and deflation. The dermal stretch gives a damaged quality to the breast skin. The nipple areola complex (pink part of breast) often becomes distorted and sags. The inframammary fold under the breast loses its semi-circular form and becomes semi-linear over the outer aspect of the chest due to the weight of the excess abdominal tissue and back rolls. The breasts are displaced downward and outward on the chest. They also appear broadened by the loss of outer breast tail/chest demarcation. This results in flattening and loss of breast projection with mild, moderate, or severe degrees of sagging.
Many of the aforementioned changes occur independently on each side of the body, and the degree of change is often asymmetrical. It is not surprising to find that the breasts are also asymmetrical in many aspects, most noticeably shape and size. For some, the breasts will be completely deflated and empty, whereas others will still have very large breasts (macromastia). In between these extremes, there are variable breast shapes and sizes. However, virtually all weight loss patients will require some form of a breast lift procedure. This is often combined with either a breast reduction or a breast augmentation.
For those with existing macromastia and sagging, Dr. Agha commonly performs a Wise-pattern breast reduction with internal breast lift by employing the dermal bra suspension technique. This procedure was developed, described, and published by Drs. Rubin and Agha in Plastic Surgery Book: Aesthetic Surgery after Massive Weight Loss in 2007.
For others who require breast volume, Dr. Agha offers either the use of breast implants or your own excess upper body tissue for breast augmentation. This latter technique has been pioneered and developed by Drs. Agha and Hurwitz and was published in Annals of Plastic Surgery in 2006. For certain patients, Dr. Agha has found this approach an effective and safe strategy to aesthetically contour the breast, upper chest, and back. It treats the breasts and the upper body laxity in unison, using the excess upper abdominal, chest, or upper back tissue to supplement the lost breast volume. Both the upper body lift and breast reshaping are performed simultaneously.
31 year old female who lost 110 lbs. of weight through gastric bypass surgery. She weighed 150 lbs. before her body contouring surgery. Patient had a single-stage total body lift with Fleur-de-lis circumferential abdominoplasty.