One of the many unfortunate body changes that occurs after losing a lot of weight in women is a deflation of the breast. Rarely does any woman lose significant weight and not create a much greater sag of the breast. This breast sag is known in plastic surgery terms as ptosis. Occurring in varying degrees, severe breast ptosis results in the breast hanging completely below the lower breast crease with the nipple pointing toward the floor.
As a result, almost all extreme weight loss breast patients need some form of a breast lift. While some breast lifts may be accompanied with an implant for increased volume, an implant alone will not lift the breast or nipple. This is a common misconception of what a breast implant can do. It will merely make the breast look like a low hanging ‘udder’if a lift is not performed with it.
Breast lifts common in a variety of forms based on the amount of movement that the nipple has to be raised. If the nipple needs to be raised more than an inch or two, then a full or extended breast lift is needed. This is the case in almost all extreme weight loss or bariatric surgery patients. A full breast lift, from an incision and scar standpoint, is exactly like a breast reduction….with the exception that no breast tissue is removed. Only skin is removed which reshapes the whole breast. The skin is the sac or containment bag for the breast tissue. In a breast lift, the skin is radically removed and reshaped but the breast tissue and nipple is merely ‘re-wrapped’ so to speak. Because of the large wedge of skin that is removed, this results in the classic anchor or invert T scars. A scar runs around the new position of the nipple then down vertically to the lower breast crease which connects with a long horizontal scar in the lower breast crease.
At no time is the nipple actually removed. It remains attached to the breast tissue and is moved up as the entire breast mound is lifted and reshaped from the skin portion of the operation. It is brought out through a new hole cut in the skin at a much elevated and more centrally located position on the newly shaped breast. That is why the nipple stays alive and in most patients will still have feeling after surgery. (although the risk of losing feeling is one of the surgical risks)
A full breast lift is the foundation for reshaping the female breast after extreme weight loss. Because of the breast tissue loss, many such breast lifts require an implant for more volume also.
Dr. Barry Eppley
Indianapolis, Indiana