Background: Significant weight loss, albeit through diet and exercise or bariatric surgery, will have a dramatic effect on all body areas. As the fat is burned off the support for the skin is lost. This causes an overall body sag that creates a well known collection of body changes that are most reflected centrally in the trunk.
For women one of the most affected areas is that of the breasts. The loss of breast volume allows the overlying skin to sag and the nipples to head south. What degree of breast sag that ensues depends on how large the breasts were initially and whether they had any significant sag before the weight loss. Smaller breasts develop less sag while larger breasts can have a dramatic sag with a large skin sleeve that ends up having them lay against the upper abdomen.
Breast implants are almost always needed for ‘reconstruction’ of the weight loss breast. Whether they can be effective by themselves without the need for a breast lift depends on how much skin sag exists.
Case Study: This 22 year-old female underwent a 60lb weight loss on her own without the need for bariatric surgery. The breasts must have been initially small ad the skin sag was slight and the nipples still remained fairly centralized on the reduced mound size.
Under general anesthesia, a transaxillary approach was used to place 375cc saline breast implants that were filled bilaterally to 450ccs in the partial submuscular position. This filled out her breasts fully. Like many transaxillary breat augmentation approaches, the initial result will have slightly too much upper pole fullness which will settle over time.
With the nipples above the inframammary fold, breast implants is all that is needed in the large weight loss female. Unfortunately for many weight loss women the breast condition is not so favorable that implants alone will suffice.
Highlights:
1) Significant weight loss affects the breasts through loss of breast tissue and often creating a breast mound sag.
2) Breast implants can produce a dramatic change in breast size and shape in breasts that have lost a lot of volume. (weight loss breast augmentation)
3) Breast implants alone will work in the weight loss patient IF the position of the the nipple is at or just below the inframammary crease.
Dr. Barry Eppley
Indianapolis, Indiana