Many women find that getting a breast lift is like hitting the refresh button. However, for those who undergo the surgery and then experience significant weight loss, whether through lifestyle changes or medications like GLP-1, the results may not always last. According to New York plastic surgeon B. Aviva Preminger, MD, even a perfectly performed breast lift reshapes and repositions the existing tissue and skin, but it doesn’t alter the fundamental makeup of that tissue. If a patient loses fat volume in the breasts, the skin may loosen again, causing the breasts to sag or deflate.
So, why does post-lift sagging occur, and what can be done if you want to avoid another trip to the operating room? Four plastic surgeons share their insights on the reasons behind the issue, how to minimize it, and which non-surgical or in-office options may provide a second chance at lift.
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Why a Breast Lift Sometimes Doesn’t Last
According to Nashville, TN, plastic surgeon Daniel Hatef, MD, significant weight loss can impact breast appearance, especially in patients where fat makes up a large portion of the volume of the breast. “Losing weight results in a loss of breast volume, and this effect is even more pronounced in patients on GLP-1 medications,” he explains.
Alan Durkin, MD, a plastic surgeon from Vero Beach, FL, adds that breast fat is more sensitive to calorie restriction, which can lead to preferential fat loss in the breasts compared to other areas like the abdomen and hips. While plastic surgeons aim to maintain natural volume, some degree of reduction in breast size is inevitable.
Can You Prevent It?
Experts suggest that the key to preventing post-surgery sagging is timing. “I advise patients to achieve a stable weight before undergoing cosmetic surgery,” says Chet Mays, MD, a plastic surgeon from Louisville, KY. “If weight loss is planned, it should be done before the surgery to ensure that the results remain consistent.”
Dr. Preminger emphasizes the importance of stable weight before surgery to ensure that the results align with the patient’s long-term body shape. If weight loss occurs after surgery, maintaining skin health through hydration, sun protection, and gradual weight loss is recommended.
No Surgery, No Problem?
While a second surgery may provide the most significant change, it’s not always necessary. Dr. Mays mentions a new product called Alloclae, a lipid-derived filler that can be injected into the breast to restore volume without the need for another operation.
Biostimulatory fillers like Sculptra or Renuva can also be used to add volume to the upper pole area of the breasts. Dr. Hatef notes that Renuva has been effective for small defects but may be costly for larger areas. Alloclae is expected to be more cost-effective in the future.
In terms of improving skin quality, treatments like radiofrequency and microneedling can help tighten the area, particularly for patients with good skin tone and minor sagging, according to Dr. Preminger.
Navigating Revision Hesitation
For patients hesitant about undergoing another surgery, it’s essential to understand that revision is not a failure. Dr. Durkin emphasizes that proceeding with revisional surgery should be viewed positively by both the patient and the surgeon.
When it comes to restoring volume, Dr. Hatef recommends considering breast implants as the gold standard. “Implant surgery is quick with minimal downtime, and patients should strongly consider this option,” he suggests.
For those who prefer non-surgical methods, Dr. Preminger recommends exploring options that can be done under local anesthesia, such as RF or a skin-only lift performed in-office.
The Emotional Side
It’s normal to feel disappointed when the results of a breast lift fade, but patience, perspective, and long-term care are crucial. “Surgery is an event, but aging is a process,” says Dr. Durkin. “Supporting skin health is essential to maintaining results after aesthetic surgery.”
Dr. Mays emphasizes celebrating weight loss and working on plans to rejuvenate the breasts. He reassures patients that their journeys are inspiring, and his commitment to their well-being is lifelong.
Dr. Preminger reminds patients that their bodies are dynamic, and even if the results aren’t as dramatic as before, the lift provided a period of rejuvenation and improved confidence. She encourages exploring options to help patients feel aligned with their inner selves.
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