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Dr. Megan Dreveskracht
Jul 1
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Breast Lift After Weight Loss
You've done the hard part. The weight is gone, but the chest often doesn't follow — losing volume and shape in ways diet and exercise can't reach. A Breast Lift restores what massive weight loss changed, offering a natural, proportional result that matches the progress already made. Dr. Megan, a female plastic surgeon and mother practicing in Seattle, understands this stage of the journey and works with each patient during consultation to determine honestly whether a lift alone is enough or whether it's paired with another procedure.
SEATTLE BREAST LIFT
WHAT IS A BREAST LIFT?
Weight changes can lead to excess skin, drooping (ptosis), and deflation of the breasts. A Mastopexy or Breast Lift is a Plastic Surgery procedure designed to reshape and lift the breasts into a more perky and youthful position and shape. Through this procedure, the excess skin of the breasts is tightened and removed, the breast tissue is rearranged, the nipple is lifted, and the areolar size is reduced. In many women it is often combined with the addition of a Breast Implant to enhance the volume of the breast. To ensure the ideal breast shape is achieved, Dr. Megan will often also utilize liposuction to help her shape the sides of the breasts and to remove the axillary (armpit) fat.
AM I A GOOD CANDIDATE?
The ideal candidate for a Breast Lift (Mastopexy) is someone in good overall health and is at a stable and healthy weight. This is especially true after massive weight loss, since weight changes after undergoing surgery can further deflate the breasts and make revisions more likely. If a patient has a strong family or personal history of Breast Cancer or is at the recommended age for cancer screening they may be required to obtain a Mammogram prior to surgery. Patients who are happy with the overall volume of their breasts but have sagging of the nipple and breast tissue are good candidates for a Breast Lift alone. When a patient also desires to restore or add volume, a Breast Augmentation or fat grafting to the breast can also be combined with a Breast Lift.
YOUR CONSULTATION
Every Breast Lift begins with an honest conversation about what changed and what's possible now. Dr. Megan takes precise measurements of the breasts and evaluates skin quality, elasticity, and the degree of ptosis — how far the nipple and breast tissue have descended from their original position. Upper pole fullness is assessed closely, since this often tells the real story after massive weight loss, when the upper breast has lost volume even if the lower breast still looks full. Time is also spent listening: understanding the patient's goals, what bothers them most about their current shape, and whether volume restoration through augmentation or fat grafting makes sense alongside the lift. Nothing is assumed going in — the plan is built around the individual anatomy and the individual goals sitting across from her.
THE PROCEDURE:
A Breast Lift can safely be done in our Ambulatory Surgery Center in approximately 2-3 hours. Patients usually undergo general anesthesia by our outstanding team of Anesthesia Providers, and can go home to recover after the procedure. Immediately before surgery, Dr. Megan will mark the patient as a “road map” for the surgery. Once the surgery has begun, she relies on a method of “tailor tacking” in which she temporarily rearranges and lifts the breasts to ensure that she has the most optimal shape, size and symmetry prior to proceeding. This method is done both with the patient on the bed and also with the patient in a sitting position to ensure that the breast shape is optimal in both positions.
Once all the extra skin has been removed, the nipple lifted and the breast tissue rearranged, two layers of sutures are placed beneath the skin to close the incisions. Final placement of the nipple and areola is done with the patient in a sitting position. Lastly, a fine liposuction cannula is used to obtain the perfect shape of the outer breasts and remove any armpit fat that, once the breasts are lifted, will become more apparent if not removed in surgery. Tape is placed over all incisions and the patient is placed in a soft, non-underwire bra.
AFTER SURGERY:
After surgery the patient will be discharged home to recover. We ask that patients wait to shower until their first visit after surgery. Ice packs on the chest and avoiding laying flat will help manage postoperative swelling. Pain medication will be prescribed so that it is available if needed. There are no stitches to be removed and the tape over the incisions at the time of surgery will be removed at 2 weeks. Most patients take one week off work to recover from a Breast Lift. Patients are restricted to lifting no greater than 10 lbs or reaching above the head for 4 weeks after surgery. The surgical incisions will flatten, soften and fade over the course of 12 months after surgery.
WHAT WILL MY INCISIONS LOOK LIKE?
In order to move the nipple and the areola, an incision must be placed at least around the areola and vertically down the breast. This is referred to as a Vertical Mastopexy or a “lollipop” incision pattern. Many patients will also require a horizontal incision in the crease of the breast as well. This pattern is called a Wise Pattern Mastopexy or an “Anchor” or “Inverted T” incision. Although we always strive for the fewest incisions possible, the incision pattern is ultimately determined by how best to achieve the ideal lift and shape of the breasts.
VERTICAL BREAST LIFT
ANCHOR BREAST LIFT
COMBINING A BREAST LIFT WITH OTHER PROCEDURES
After massive weight loss, a Breast Lift is often paired with additional procedures to address changes that a lift alone cannot fully correct. Options include a small breast implant, fat grafting to the upper pole, or surgical mesh for additional soft tissue support. Each of these can enhance the results of a lift and help reach a specific aesthetic goal. During your consultation, Dr. Megan will help determine which, if any, of these additions will help you reach your goals.
A small implant or fat grafting is often added to a lift in order to restore volume specifically to the upper pole of the breasts — the area most affected by significant weight loss. Once the excess volume is gone, the upper pole rarely fills back in on its own, and a lift alone does not generally add meaningful volume here. For patients who want a fuller, more youthful contour at the top of the breast, an implant or fat grafting addresses this directly.
Surgical mesh is a particularly important consideration after massive weight loss. Significant weight loss stretches and thins the skin, often causing a real loss of collagen and elastin — the proteins responsible for skin's strength and elasticity. This means the tissue holding a lift in place is frequently weaker than it would be in a patient who hasn't experienced major weight fluctuation, which can shorten how long the results of a lift hold up. In these cases, mesh gives the breast tissue additional internal support while the body heals, acting as scaffolding until the tissue can hold its own shape.
Two mesh products are commonly used in breast lift surgery. GalaFLEX is a knit, monofilament mesh made from poly-4-hydroxybutyrate (P4HB), a bioresorbable polymer. It retains roughly half its strength at 16 weeks after placement and is gradually absorbed by the body over approximately 12 to 18 months, being replaced by the patient's own tissue as it goes. DuraSorb is a monofilament, macroporous mesh made from polydioxanone (PDO), also fully bioresorbable, and follows a similar absorption timeline of about 12 to 18 months. Both are designed to provide structural support through the critical healing period without remaining in the body permanently.
The right choice — and whether mesh is recommended at all — depends on tissue quality, the degree of skin laxity, and the specific goals discussed during your consultation.
SEATTLE BREAST LIFT
FAQ
01
How Long Should I Wait After Weight Loss For A Breast Lift?
Most surgeons, including Dr. Megan, recommend waiting until your weight has been stable for at least 6 months to a year. Operating too soon risks further deflation of the breasts if the weight continues to shift, which can mean a second surgery down the road. During your consultation in her Seattle practice, Dr. Megan will talk through your specific timeline and whether you're ready.
03
Will insurance cover a Breast Lift after massive weight loss?
Generally, no — a Breast Lift is considered a cosmetic procedure and is not covered by insurance, even after significant weight loss. This differs from procedures like a panniculectomy, which may qualify for coverage under certain medical criteria. Dr. Megan can help clarify what may or may not be covered based on your individual situation.
02
Do I need a Breast Lift and Augmentation, or just one?
It depends on what's happened to your breasts, not just how much weight you've lost. If you're happy with your overall volume but have sagging of the nipple and breast tissue, a Breast Lift alone may be enough. If you've also lost upper pole fullness, pairing the lift with Breast Augmentation or fat grafting is common after massive weight loss — Dr. Megan will help you determine which combination fits your goals.
04
Will my results last after such significant weight loss?
Results can last many years, but tissue quality plays a bigger role after massive weight loss than in a typical Breast Lift. Loss of collagen and elastin from significant weight change can leave the skin weaker, which is why surgical mesh is often discussed as additional support for these patients. Staying at a stable weight after surgery is the biggest factor in how long your results hold up.
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