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Fluctuations in weight can significantly affect the size and shape of the breasts and may introduce sag, medically known as ptosis. Women will lose weight in the breast area as they lose weight overall, and the body may respond to weight loss in different proportions than to previous weight gain, possibly leaving the breasts smaller than their original size. In addition, weight loss can lead to different distribution of the fat within the breast, and it is common to lose some upper pole fullness of the breast. The extent to which a woman will experience these issues depends on age, genetics, and other factors, and gravity also takes a toll! Unfortunately these breast issues must largely be addressed with surgery, and hence, Dr. Zuckerman’s cosmetic breast surgery and mommy makeover surgery procedures are among his most popular.

Breast Connective Tissue is Sensitive to Weight Gain and Loss

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Suspensary Cooper’s ligaments are responsible for breast shape and structure. Source: McMaster Pathophysiology Review – Breast Cancer

Tiny microscopic suspensary ligaments called Cooper’s ligaments maintain the shape and structure of the breasts but have a certain elasticity, a limit to their ability to stretch. In many women, weight gain, pregnancy, or repeated hypertrophy and milk duct engorgement during breastfeeding push these breast ligaments beyond the limit of their elasticity.

Consequently, when a woman loses weight, these ligaments may not return to their exact length or shape, resulting in changes to breast shape. In more dramatic cases such as massive weight loss, this can result in significant sag, excess skin, or loss of upper pole breast fullness (“pancaking”). The elasticity of suspensary breast ligaments, the tendency to redistribute weight away from the breasts, and the tendency to distribute weight in different areas of the breast distorting shape are all influenced by genetics, starting / equilibrium weight, age, gravity, and other factors. While women with larger overall breasts may be at increased risk of develop sagging of the breasts upon weight gain and subsequent loss, it is by no means a predictive relationship.

As a final note on breast anatomy, some women also develop stretch marks during puberty, weight gain, pregnancy, or breastfeeding. Similar to the argument above, the formation of these dermal scars is multifactorial and depends on skin elasticity, genetics, age, and other factors. However, stretch marks may become more noticeable as the tissue contracts upon weight loss, leading to an increased concentration in the breast area. Like breast ptosis, stretch marks can to some degree be addressed via a breast lift or mastopexy as described below.

Breast Sag is Typically Addressed with Cosmetic Surgery

Raise the Breast Mound with a Breast Lift (Mastopexy)

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Patient underwent a mommy makeover (breast lift plus tummy tuck) with Dr. Zuckerman to address severe breast sag, known medically as ptosis.

The most common way to address issues with breast shape or breast ptosis (sag) is via a breast lift by Dr. Zuckerman, medically known as a mastopexy. The degree to which women experience breast sag varies widely, and there are medical grades to quantify the amount of sag based on where the nipple-areolar complex sits in relation to the breast. In the most severe case, the nipple is at the lowest point of the breast mound. Even so,  Dr. Zuckerman can restore a raised breast mound effectively in most cases.

It requires an expert to create round, natural-looking breasts, and you should undergo any of these cosmetic breast procedures with an experience board-certified plastic surgeon such as Dr. Zuckerman.  A patient who has lost 100lbs or more may also experience excess skin or ptosis of other areas including the arms, upper abdomen, upper back, midsection, lower back, or thighs. Dr. Zuckerman offers an array of surgical body contouring procedures to address these issues in a targeted manner.

Visit the cosmetic breast surgery before and after gallery to view more surgical outcomes by Dr. Zuckerman.

 

 

 

Add Volume or Upper Pole Fullness with a Breast Augmentation

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Frontal view of vertical breast lift combined with breast augmentation by Dr. Zuckerman. Patient, female, images taken two months postop. 275cc smooth round silicone breast implants, with submuscular placement.

A breast lift will raise the breast mound, but it cannot restore lost overall volume. In addition, a mastopexy has limited ability to restore upper pole fullness to the breast, although Dr. Zuckerman is somewhat unique in his ability to partially restore this portion of the breast with a breast lift alone. However, to address significant deficits in both overall breast volume and upper pole fullness, a breast augmentation is required. Modern silicone and saline breast implants are extraordinarily safe and create a natural, beautiful result. There are several variants in augmentation surgical technique and implant selection through which Dr. Zuckerman will help guide you to customize your surgical result.

During weight loss, it may be possible to increase the strength of the chest muscles to enhance the size of the breasts modestly via exercise or weight lifting. However, though improved strength will increase muscle size to some degree, it may be accompanied by a decrease in overall body fat and possibly breast size. A very muscular, active pectoralis major muscle can also affect the breasts’ appearance and movement, which can be significant enough that Dr. Zuckerman actually recommends that very fit breast augmentation patients undergo implant placement over the pectoralis major muscle instead the more common placement under the muscle to camouflage these effects.

Combined Augmentation/Mastopexy

For some patients, breast ptosis (sag) is best addressed by combining both of the surgical procedures above into a combined augmentation mastopexy. With this slightly longer surgical procedure, Dr. Zuckerman can address significant aesthetic deficits in most areas of the breasts. The breast augmentation guide explains more about this procedure.

Overall, the breasts are quite sensitive to weight and to other bodily changes caused by pregnancy or breastfeeding. A significant percentage of the female population experiences some sagging of the breasts. Dr. Zuckerman can help you effectively address these aesthetic issues.

 

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About Us

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Zuckerman Plastic Surgery is the cosmetic surgery practice of board-certified plastic surgeon Dr. Joshua D. Zuckerman, MD, FACS located in New York City. Dr. Zuckerman specializes in tummy tuck surgery, liposuction, buttock augmentation, and cosmetic breast surgery. Zuckerman Plastic Surgery also offers an array of non-surgical treatments including musculoparalytics such as Botox, lip augmentation, tear trough rejuvenation for dark eye circles, laser resurfacing, microneedling, medical grade skincare and more. Zuckerman Plastic Surgery is a d.b.a. name for Joshua D. Zuckerman, MD, FACS, P.C., a Professional Corporation registered in the state of New York (DOS ID #: 5192265)
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Phone: 212-231-9897
Specialty: Plastic Surgery
Joshua D. Zuckerman, MD, FACS, P.C.
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