What Is a Plus Size Breast Lift?
A plus size breast lift removes pie-shaped wedges of skin and breast tissue (usually from the lower, inner, and outer portions) to tighten and lift the breast. The nipple-areola complex is also raised to a more youthful, natural height.
The goal of the surgery is to restore the youthful relationship between the nipple areolar complex and the breast as a whole for a balanced, lifted appearance.
Dr. Nick Masri specializes in high BMI surgeries, especially breast lifts for plus size individuals. If you’re interested, schedule a consultation today to see how we can help.
Key Takeaways
- The “anchor” incision pattern is most common, involving an incision around the areola, straight down, and horizontally along the breast fold. Over time, the vertical scar from the areola to the crease is typically the most visible.
- Plus size patients often don’t need implants because fuller breasts naturally contain more fatty tissue, which can create cleavage and fullness on its own. However, patients who’ve lost significant weight or have minimal tissue may opt for implants to increase projection.
- A breast lift and breast reduction share many of the same surgical steps and goals. Whether a reduction is needed depends on the patient’s desired breast size and the amount of tissue removed.
- Skin quality, genetics, and lifestyle all impact long-term results. Maintaining stable weight, wearing supportive bras, and not smoking help preserve the lifted shape.
- Weight loss after surgery can cause a return of sagging because breasts with more fatty tissue lose volume and projection when fat decreases.
- The surgery is usually outpatient. Hospitalization is not required, and the average cost ranges from $10,000–$15,000, depending on anatomy, surgical time, and facility or anesthesia fees.
Main Differences from Standard Breast Lift
Plus size breast lifts involve removing significantly more skin and breast tissue compared to regular mastopexy procedures.
Key differences include:
- More extensive tissue removal
- Longer surgical time
- Greater skin excision requirements
- Enhanced cleavage potential due to existing breast volume
Unique Considerations for Larger Body Frames
Your higher BMI doesn’t automatically require a breast reduction alongside your lift. The decision depends on your specific goals and the relationship between your breast size and desired outcome.
Special considerations for plus size patients include:
- Weight stability: Future weight loss may affect your results by reducing breast projection
- Recovery factors: Your age, weight, medical history, and medications influence healing time
- Support requirements: You’ll need proper supportive bras during activities to maintain results
Your recovery typically involves 1-2 weeks before returning to normal activities. Many patients experience immediate improvements in posture and relief from neck, back, and shoulder pain.
Candidacy and Preoperative Evaluation
Dr. Nick Masri specializes in high bmi patients and can offer detailed insights into your candidacy where other surgeons cannot.
Here are some items surgeons often consider when it comes to candidacy.
Assessing Body Mass Index (BMI)
Your BMI plays a crucial role in determining candidacy for plus size breast lift surgery. As mentioned, Dr. Nick Masri is at the forefront of surgeons that work with patients with higher bmi’s so it’s always best to meet with him first to understand your possibilities.
Ideal Candidates for Plus Size Mastopexy
You may be an ideal candidate if you have sagging breasts that sit lower on your chest or point downward. Plus size patients often benefit greatly from mastopexy due to the natural weight of larger breasts causing more pronounced sagging.
Key Candidacy Factors:
- Stable weight for at least 6-12 months
- Good overall health without uncontrolled medical conditions
- Realistic expectations about breast shape and scarring
- Non-smoker or willing to quit before surgery
- No family history of breast cancer (this requires proper screening and preop evaluation for risk factors)
Preoperative Consultation Process
Physical Examination Components:
- Measurement of nipple-to-sternal notch distance (ideal: 20 centimeters)
- Assessment of breast tissue density and skin elasticity
- Evaluation of asymmetry and areola size
- Documentation of any previous breast surgeries
As mentioned, a youthful breast typically positions the nipple about 20 cm from the suprasternal notch, aligning with established aesthetic proportions (Sandberg, Wang, & Liu, 2021).
Preoperative health screenings may include blood work, mammograms, and cardiac clearance depending on your age and medical history. These tests ensure you can safely undergo anesthesia and surgery.
Your surgeon will discuss realistic outcomes, including the fact that lifted breasts may experience some future sagging due to aging, weight changes, and gravity. Understanding these factors helps set appropriate expectations for your long-term results.
Choosing a Qualified Plastic Surgeon
Dr. Nick Masri is not only a double board-certified plastic surgeon but also an expert in body contouring and breast surgery for plus sized patients.
Board certification from the American Board of Plastic Surgery represents the gold standard in this field. This is due to a surgeon’s adherence to an extremely high standard of education and competence.
The board certified requirements are so demanding that to achieve the certification surgeons must complete at least six years of post-medical school surgical training, spend a minimum of three years in a plastic surgery residency and clear the written and oral examinations, all on top of a medical degree from an accredited school, yearly continuous education, and his long-term results and commitment.
What sets Dr. Masri apart is the consistent nature of his work and his understanding of how to safely operate on plus sized patients. During his thousands of surgeries, he has a vast amount of experience and fully understands the importance of a proportionate and lasting procedure. Patients select him for his accuracy, frankness and clear-cut success in helping people to achieve their target, and get their self-confidence back.
Reviewing Surgeon Experience and Portfolios
It’s important to review before and after pictures to get a better understanding and expectation of results.
Schedule a consultation to discuss your aesthetic goals and Dr. Masri’s detailed plus size breast lift procedure to learn more about the actual procedure as well as recovery involved.
Recovery and Postoperative Care
Plus size breast lift recovery requires careful attention to specialized protocols and extended healing timelines. Your larger breast size means you’ll need stronger support systems and may experience greater initial discomfort that typically resolves within one to two weeks.
Immediate Aftercare Protocols
Your surgical team will apply specialized dressings to protect the incisions around your nipple. These bandages stay in place for the first few days while your initial healing occurs within the first few weeks.
Pain Management:
- Take prescribed medications exactly as directed
- Keep your upper body elevated at 30-45 degrees while resting
- No stomach sleeping or side sleeping for at least six weeks
The extensive tissue removal means you’ll experience more initial swelling than smaller procedures.
First Week Care:
- Keep incisions dry for first 1-2 days as directed
- Change dressings according to your surgeon’s instructions
- Avoid lifting arms overhead or carrying items over 5 pounds
The vertical scar component from your areola down to the breast fold will be the most visible initially. However, it’s good to keep in mind that scar quality along with breast shape, size, and project takes 3-6 months to accurately evaluate.
Support Garments and Activity Restrictions
You’ll need to wear a specialized compression garment or surgical bra continuously for six weeks after your procedure. Plus size patients require stronger support due to the weight and volume of remaining breast tissue after surgery.
Compression Requirements:
- Week 1-2: Medical-grade surgical bra worn 24/7
- Week 3-6: Supportive sports bra during day, surgical bra at night
- Week 6+: Well-fitted supportive bras for all activities
Your compression garment helps maintain the new position of your nipple-areolar complex while supporting healing tissue. Compression garments should be worn full-time, even when sleeping, for six weeks.
Activity Timeline:
- Days 1-7: Light walking only, no lifting over 5 pounds
- Week 2-3: Return to desk work, light household tasks
- Week 4-6: Gradual increase in daily activities
- Week 8+: Most exercises resumed with surgeon approval
Sleep on your back with your upper body elevated for the first 2-3 weeks. This position prevents pressure on your healing breast tissue and reduces swelling that could affect your final breast shape.
Avoid rigorous activities that could stress your incisions. Your anchor incision pattern requires extra healing time compared to smaller breast lift techniques.
Expected Results and Long-Term Maintenance
Plus size breast lift results can last 10-15 years on average, with proper weight management and supportive bras playing crucial roles in maintaining your new breast shape. Your specific outcomes depend on factors like age, genetics, and lifestyle choices after surgery.
Longevity of Plus Size Breast Lift Results
Your breast lift results can be long-lasting, often spanning years, but they are not permanent. The procedure repositions your nipple-areolar complex to a more youthful position approximately 20 centimeters from your suprasternal notch.
Factors affecting longevity include:
- Your age at the time of surgery
- Skin elasticity and quality
- Genetics and natural aging process
- Overall health status
Plus size patients often have an advantage because you typically have ample breast tissue. This existing volume helps maintain projection and cleavage without implants.
Your results may gradually change due to natural aging and gravity. However, the significant improvement in breast shape achieved through removing excess skin and repositioning breast tissue provides a strong foundation that ages more gracefully than untreated breasts.
Managing Weight Fluctuations After Surgery
Weight stability is critical for maintaining your breast lift results. Since plus size patients often have breasts composed largely of fat tissue, weight changes directly impact your breast size and shape.
Weight loss after your procedure can cause several issues:
- Decreased breast projection
- Return of sagging (breast ptosis)
- Loss of the youthful nipple-to-breast relationship
- Reduced fullness and volume
Weight gain presents different challenges. It can stretch your newly tightened skin and potentially compromise the lifted position of your breast and in some cases, may require an additional procedure sooner than expected.
Best practices for weight management:
- Maintain stable weight within 10-15 pounds of your surgery weight
- Follow a balanced, nutritious diet
- Engage in regular, moderate exercise
- Work with healthcare providers if significant weight changes are medically necessary
If you plan major weight loss, discuss timing with your surgeon. It may be beneficial to reach your goal weight before surgery.
Maintaining Breast Shape Over Time
Your breast shape maintenance requires consistent effort and proper support. The anchor-shaped incision used in plus size breast lifts heals well, but the underlying tissues need ongoing care. It should be noted that the anchor-type (Wise pattern) incision remains one of the most effective techniques for reshaping and lifting the breast in patients with moderate to severe ptosis (Qureshi et al., 2018).
Essential maintenance strategies:
Supportive bras are your most important tool. Wear well-fitted, supportive bras during all activities, especially exercise. The additional weight of plus size breasts requires extra support to prevent stretching.
Lifestyle factors significantly impact longevity:
- Avoid smoking, which impairs healing and skin quality
- Limit alcohol consumption
- Maintain good nutrition for skin health
- Protect breast skin from sun damage
Regular follow-up care helps monitor your results. Your surgeon can identify early changes and recommend interventions if needed.
Age-related changes will continue affecting your breast tissue. The fat and breast tissue naturally decrease over time, and skin becomes thinner. However, your lifted position provides a better starting point for these natural changes.
Signs you may need revision surgery:
- Significant return of sagging
- Loss of nipple position
- Asymmetry development
- Major life changes like pregnancy
Potential Risks and Complications
Plus size breast lift surgery carries specific risks related to the larger amounts of skin and tissue removal required. Studies have shown that BMI plays a significant role in recovery and complication risk during benign breast surgeries, emphasizing pre-operative weight management and counseling (Rezaei et al., 2023).
Common Surgical Risks for Plus Size Patients
Plus size patients face unique surgical risks during breast lift procedures due to the more extensive tissue removal required. Your surgeon must remove larger pie-shaped wedges of skin and breast tissue from multiple areas of your breast.
Infection and Healing Complications
- Higher risk of wound healing problems at incision sites
- Increased chance of tissue breakdown where incisions meet
- Potential for bleeding and hematoma formation due to larger surgical areas
Anesthesia-Related Risks: Operative times greater than 6 hours increase overall risks. However, surgery even with higher bmi patients rarely takes that long.
Tissue Loss and Asymmetry: The extensive skin removal can occasionally result in tissue death or uneven healing. Your surgeon works to reposition your nipple-areolar complex about 20 centimeters from your suprasternal notch, but asymmetry may occur during healing.
Managing Scarring and Sensation Changes
The anchor-type incision pattern used in plus size breast lifts creates more extensive scarring than smaller procedures. Your incisions extend around your nipple, vertically down, and horizontally along your breast fold.
Scarring Expectations Most patients find the vertical scar from nipple to breast fold remains most visible long-term. Abnormal scarring including hypertrophic or keloid formation occurs more frequently in plus size patients due to increased skin tension.
Sensation Changes Changes in nipple and breast sensation are common after your surgery. The extensive tissue manipulation required for plus size lifts increases this risk.
- Temporary numbness lasting several months
- Tingling sensations during nerve healing
- Potential permanent loss of sensation in some areas
Breastfeeding Concerns Your ability to breastfeed may be affected, especially when significant breast tissue removal is necessary. The repositioning of your nipple-areolar complex can disrupt milk ducts and nerve pathways essential for nursing.
Alternative and Complementary Procedures
Combining Procedures for Optimal Results
Plus size patients often benefit from combining breast lift with other procedures to achieve comprehensive results. Your surgeon may recommend breast reduction alongside your lift if you have excessive breast tissue that contributes to sagging.
Breast augmentation with implants can be combined with lifting when you have minimal breast tissue after weight loss. This combination helps restore volume while repositioning your nipple-areolar complex to create better projection and cleavage.
Fat transfer procedures offer a natural alternative to implants. Your surgeon removes fat from other body areas and transfers it to your breasts during the lift procedure. This approach provides modest volume increase while using your own tissue.
The timing of combined procedures depends on your specific needs. Some patients require staged surgeries, while others can have multiple procedures performed simultaneously. Your surgeon will evaluate factors like your BMI, skin quality, and desired outcomes to determine the best approach.
Recovery time may be extended when combining procedures, typically requiring 2-4 weeks before returning to normal activities versus 1-2 weeks for lift alone.
FAQ: Plus Size Breast Lift with Dr. Nick Masri
- What happens during a plus size breast lift?
The procedure usually involves removing skin and a small amount of breast tissue, depending on each patient’s needs. We remove pie-shaped wedges of skin and tissue from the lower, inner, and outer areas of the breast. The nipple-areola complex is elevated to a more youthful position, and the tissues are closed from the medial, lateral, and central aspects.
Most lifts use an anchor-type incision—around the areola, vertically down, and horizontally along the breast fold. Typically, the most visible scar is the vertical one from the areola down to the inframammary fold. - What does a breast lift do specifically?
A lift improves the relationship of the nipple-areola complex to the rest of the breast, restoring a youthful shape. The youthful breast typically has a nipple position about 20 cm from the suprasternal notch (the base of the neck). We try to reestablish that distance.
If a patient wants more cleavage but has minimal breast tissue—often seen after weight loss surgery—an implant may be recommended to improve projection and fullness. - Are there special techniques for plus size breast lifts?
Yes. The main difference between a plus size and standard breast lift is how much skin and tissue must be removed. Plus size patients usually have more breast tissue, much of which is fatty after a certain age. This fullness often provides enough volume to create cleavage without implants.
In comparison, smaller-framed patients usually have less tissue and therefore need less skin excision and repositioning. - Do high BMI patients always need a reduction when getting a lift?
Not always. It depends on individual goals and anatomy. Sometimes sagging breasts simply need repositioning to restore projection and cleavage. A lift and reduction share similar goals—they both aim to raise the breast and restore symmetry. Plus size patients may just need more skin and tissue removal than smaller individuals. - Will I need another lift in the future after getting implants?
Not necessarily. It depends on your skin quality, implant size, and how you age. Larger implants and time can stretch skin, but everyone’s skin behaves differently. Factors like aging, pregnancy, weight changes, and genetics all play a role in whether a future lift might be needed. - Will lifted breasts sag again over time?
Yes, it’s possible. Over time, skin naturally loses elasticity, and some sagging can return. The degree of sagging depends on individual factors such as genetics, age, and weight changes. - What happens if I lose weight after a lift?
If a high BMI patient loses significant weight, the breasts can lose projection and appear less full. That’s because the breast contains both fat and tissue, and losing fat can cause renewed sagging (ptosis) and a less youthful breast shape. - How can I maintain my results long term?
Maintaining stable weight is key. Wearing supportive bras—especially during physical activity—is also important. Over time, the skin naturally thins and breast tissue decreases, so results depend on age, overall health, nutrition, smoking habits, and genetics. - What is recovery like?
Recovery from a breast lift is usually not painful or uncomfortable. Most patients feel immediate improvement in posture, neck, back, and shoulder pain. Healing varies based on health, age, and how much tissue was removed, but most return to normal activities within one to two weeks. - How much does a plus size breast lift cost?
The average cost ranges between $10,000 and $15,000, depending on each patient’s specific needs. Hospitalization is usually not necessary. Fees include anesthesia, operating room, and professional costs, which vary based on how much time is needed to perform the procedure safely and effectively.
References
- Sandberg LJ, Wang C, Liu X. Beyond the 21-cm Notch-to-Nipple Myth: Golden Proportions in Breast Aesthetics. Plast Reconstr Surg Glob Open. 2021;9(10):e3871. Available at:https://pmc.ncbi.nlm.nih.gov/articles/PMC8547918/PMC
- Rezaei SJ, et al. Body mass index and benign breast surgeries. Ann Med Surg (Lond). 2023;85:XXXX. Available at:https://pmc.ncbi.nlm.nih.gov/articles/PMC10123250/PMC
- Qureshi AA, et al. Mastopexy and Mastopexy-Augmentation. Aesthet Surg J. 2018;38(4):374–384. Available at:https://academic.oup.com/asj/article/38/4/374/4818256OUP Academic