Breast Surgery after Massive Weight Loss: Breast Augmentation and Breast Lift

Following massive weight loss, breast augmentation or breast lift surgery can help you achieve a figure that complements your achievement. Dr. Peter Fisher is an authority in post-bariatric plastic surgery. He can perform breast surgery after massive weight loss at his San Antonio, TX, practice to help you reach your goals. Please contact us today to learn more.

Mastopexy, with or without breast augmentation, is the second most frequently sought after procedure in our practice (most sought after in the USA), after lower body lift. Multiple different techniques have been described for performing mastopexy. Most plastic surgeons use a number of different techniques for the different breast presentations that they see. I have a particular repertoire of techniques that I prefer to use, which I will describe and what I use them for.

Inverted or anchor incision.

The most commonly used technique for massive weight loss patients is the inverted or anchor incision. As its name suggests, the final scar is around the areola, one from the bottom of the areola to the breast crease and a horizontal one in the breast crease. This last incision will meet with a J shaped incision which runs from the armpit along the outer aspect of the breast to the inframammary (crease at the bottom of the breast) crease when a mastopexy is performed with an extended brachioplasty (arm lift).

L- mastopexy

Another technique that Dr. Fisher uses and calls is an L-mastopexy results in the same incisions as the anchor, but without the crease incision from the middle of the breast towards the sternum.

Lollipop incision

It is in a very rare case that a lollipop incision is able to be used as there is often too much loose skin.

If an implant is used, especially a relatively large one (larger than 400cc), then the chances of using this technique that involves with fewer incisions becomes possible.


The name for this technique means “making larger with your own tissue.” In some patients who are still full along the outside of the breast under the armpit an auto-augmentation using this tissue can be performed. An anchor or L-lift type incision needs to be made to incorporate this technique. Another technique is to use the tissue from a reverse abdominoplasty to auto-augment the breast.


When using implants an option between saline and silicone is given. The implants are placed under the muscle. Some surgeons elect to place the implants at a separate surgery. Dr. Fisher always places them at the same time as the lift.

A mastopexy (breast lift) is often done in conjunction with a brachioplasty (arm lift). In either case, both surgeries are outpatient procedures.

Pre-operative instructions.

It is essential to stop the following medications at least two weeks prior to any surgery.

  • BCP’s and any other estrogen and progesterone combination pre and post-menopausal
  • Non-steroidal anti-inflammatory meds
  • Vitamin E

Patient is seen pre-operatively in the office for photos, prescriptions, markings and to answer any final questions.


This procedure is usually done at the same time as another procedure is performed. It begins with a vertical incision when an augmentation is also being done. This is because the implant takes up a lot of skin slack, therefore requiring less skin excision. A temporary sizing implant is then placed and an appropriate permanent implant chosen. This is placed in the submuscular position and the breast lift then done with the minimal amount of incisions as possible.

All stitches are buried and of the dissolving kind. A minimal amount of dressings are used and the patients bra then placed. No drains are used.

Post-operative instructions.

If performed with a more extensive procedure then the patient is kept in the hospital. The patient may shower two days after surgery. Antibiotic ointment and non-stick gauze applied daily for about a week. A post-operative return appointment is usually made for five to seven days after your surgery.

To learn more about how you can benefit from breast surgery after significant weight loss, please contact us today.

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Dr. Fisher has been available to answer all of my questions and provide me with not only professional medical expertise, but also a much appreciated level of personal empathy. I would 100% recommend Dr. Fisher to anyone who is considering plastic surgery.



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7950 Floyd Curl Dr
Ste 1009
San Antonio, TX 78229

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