Q: Dr. Eppley, I have severe breast sagging/ptosis I believe. I would like a breast reduction or lift without implants if possible. I have udnergone a 150lb weight loss which has ruined my breasts! I’m 33 years old with 90 year old bags for breasts. They are heavy,ugly sagging breasts. I currently weigh 220lbs with a weight goal of 180lbs. I have read that some surgeons will not preform the surgery on someone with a certain weight or BMI, so I’m working on dropping further weight. I obviously need other areas worked on but right now my breasts bother me the most. Do I qualify for the Lollipop procedure or the one that follows after that? Have you worked on breast this large or severe? Can you help me?
A: There is no question that you have extreme breast sagging and near total breast involution. (loss of breast tissue) Breast sagging or ptosis is classified by where the nipple sits relative to the lower breast fold. When the nipple and the breast mound hangs way below the lower breast fold that is known as a Type 4 breast sagging. (on a scale of 1 to 4) Given how your breast sags I would have to classify yours as a Type 5 sagging which is off the scale!
I have seen breasts just like yours and successfully operated on them. The question that relates to your breast surgery is what type of reduction/lift is needed and the timing of the surgery as it relates to your weight. Understand that every breast reduction incorporates a breast lift. (although not every breast lift is a breast reduction) Your breast lift is way beyond that of the lollipop lift, rather you will end up with a anchor scar pattern due to extreme amount of lifting needed and the amount of breast skin removal. Another consideration would be a partial breast amputation and free nipple grafting technique. This will get you the greatest amount of lift and reduction although your young age and the desire to maintain some volume probably precludes against this more simplest approach. If you were a smoker thisn would have to be the technique of choice. As it relates to your weight, you should be within 25 lbs or less of your weight loss goal to have the procedure.
Dr. Barry Eppley