This 49 year old woman reached her plateau weight after losing 100 pounds following bariatric surgery.  She is an excellent example of an individual whose breast tissue had been largely replaced with fat and as such, after massive weight loss, there was not enough breast tissue remaining to rearrange into a new breast shape that appeared typical of what one might expect after a breast lift or mastopexy.

From an aesthetic standpoint, this woman informed me that she would be satisfied with any improvement in her breast shape.  Her primary goal, however, was to remove the extra skin that otherwise laid across her abdomen unless she wore an underwire bra.  Her skin had lost a great deal of its elasticity and was unlikely to tolerate insertion of an implant to replace lost volume without sagging or becoming ptotic in a relatively short period of time.  The use of commercially available skin substitutes, which would have allowed use of an implant, was not an option for her.

Her post surgical photographs show her result after I performed a breast lift or mastopexy using a short scar technique that leaves behind scars in the shape of a “lollipop.” 

This 26 year old woman reached her plateau weight after losing 74 pounds following bariatric surgery.  She had a breast lift or mastopexy using a technique which leaves behind scars in the shape of an “anchor.” 

In some patients who lose a large amount of weight, the natural end point of the breast laterally disappears and the breast appears to continue around towards the back.  This is what has happened to this woman. 

In selected individuals who have this problem, the “anchor” scar type breast lift can be amended to remove that skin excess on the side of the body beneath the arm.  This is the reason that I selected that particular breast lift technique in this woman even though the scars that it leaves behind are longer and more difficult to conceal in a swimsuit.

Looking at her photographs after surgery, it is obvious that there is no longer a "wing" of skin that continues laterally towards the back.  Instead, the breast has a round shape and ends as it typically does before the side of the body that lies beneath the arm. 

Unfortunately, there is now a visible scar there.  This is an example of what I refer to as a “trade off” in plastic surgery.  It is important to decide what is more important to each individual patient- a scar or better contour.  Sometimes, it is not possible to have both!

This 37 year old woman reached her plateau weight after losing 91 pounds following bariatric surgery.  She had a breast lift or mastopexy using a technique which leaves behind scars in the shape of an “anchor.”

A breast lift or mastopexy is an operation which rearranges breast tissue so that the new breast shape is typically shorter and rounder.  Unfortunately, patients who have lost a large amount of weight often do not have enough breast tissue remaining to rearrange into a naturally appearing breast.  This woman was fortunate to have enough breast tissue after a 90 pound weight loss to achieve the breast shape that is visible in her post surgery photographs.

While an implant can provide the volume that is lacking after massive weight loss, the weight of the implant can also be very taxing on compromised skin, such as that which is typical after massive weight loss.  Commercially available skin substitutes can provide the strength needed for successful use of implants in such cases. 

This case depicts a 41 year old woman who wished to have slightly smaller and shapelier breasts. She underwent breast reduction using an inverted T or "anchor" incision pattern.

Her post-operative photographs depict her appearance approximately two months after surgery.

With optimal design before surgery, the portion of this incision that runs along the fold of the breast is nearly completely hidden. Reduction of the areolar size for balance and proportion is an additional advantage of this procedure.

This case depicts a 29 year old woman with symptomatic breast hypertrophy who underwent a breast reduction using the inverted T or "anchor" incision pattern. Because of this individual's symptoms, medical insurance covered a portion of the costs of this procedure.

Not only did her symptoms improve following surgery, but she also gained a more aesthetically proportionate breast. Her post-operative photographs show her appearance approximately one month after surgery.

This individual suffered from gigantomastia and underwent a breast reduction in which almost three and a quarter pounds of weight was removed from the breasts.

The breast reduction was performed in a manner that so that the breasts were shortened in length and lifted. This photograph was taken at approximately four months following surgery. No liposuction was performed in this procedure.

This individual underwent a breast reduction in which almost two and a quarter pounds of weight was removed from the breasts. The breasts were shortened in length and lifted to give a rounder appearance. This photograph was taken at approximately four months following surgery.

Liposuction of the tissue that lies between the upper outer quadrant of the breast and the upper arm as well as the side of the body directly beneath the arm pit area can decrease bra band size and give the breast a narrower appearance after surgery.

This individual suffered from large breasts, breast droop and extra tissue in the breast tail and armpit area. She underwent a breast reduction in which slightly more than two and a half pounds of weight was removed from the breasts.

With integrated breast and torso contouring, the breasts are not only shortened in length but then contoured with liposuction to give a rounder appearance. These techniques allow a breast reduction to look like a breast lift. This photograph was taken at approximately five months following surgery. Scars, while still visible, are still expected to mature and fade over the next year.

This 39 year old woman underwent breast reduction in which approximately one and a half pounds of tissue was removed from each breast. 

I view breast reduction as a two part process:  first, tissue is removed to decrease the size and weight of the breasts; second, the remaining tissue is rearranged to create a new breast that has an aesthetically appropriate appearance.  This rearranging process is very similar to what is done in a breast lift. 

In this individual’s case, the incisions used to perform the breast reduction were of the “anchor” type and the incisions healed well.