Lift First THEN Augment? Hard Time Choosing

Hm, interesting reasoning. Did you tell him that your mind was made up about what you wanted?

I'd probably take into account the concern that the results would be better if it's done in two surgeries. That seems like a valid point.

I had lift and augmentation done separately. Our skin and vasculature is under so much stress. You want to optimise blood flow to nipple and tissues. Having a lift then adding stress of implant is not worth the risk.

As for doing a LBL vs a TT it all depends on where your excess skin is. If you have a lot above BB a LBL may not address it. That being said I had a TT with vertical incision (fleur de lys) I then ended going back to have the completion of the posterior lift done with autologous butt implants.

How droopy are your breasts? Dr. LoMonaco (who posts here and I hope he will chime in in case I am getting his reasoning wrong) says for those of us with "long-folds" (super-droopy breasts), it is better to lift first and let the skin/incisions heal, then implants 3-6 months later so that the implants stay up in place better and do not droop back down. From his experience, the long-term results are much better doing this.

He did my lift and I was planning on the implants later, but am satisfied with just the lift. I have no upper pole fullness, but with the right bra (and bathing suit top), my boobs look pretty good.

Good to know! My boobs are not that droopy. I've never been pregnant (breast-fed, etc.), and they do point out, not down.

I was surprised because no other doctors mentioned the procedures should be split up.

In each of my plastics consults, both surgeons said they would do the lift and augmentation separately mostly because the procedures do opposite things (one reduces, one increases) which means your tissues are working against each other as they heal, increasing the chances of complications (excess scar tissue, pulled sutures, etc.).

I am replying with my personal experience both selecting a surgeon and having gone through both massive weight loss and 2 rounds of plastics now.

I lost 152lbs (literally half my size). It left me with so much loose skin in many places. Last July I had my first plastics (arm lift). Then on January 19th I had a full abdominalplasty, breast lift and augmentation all at the same time.

Again, this is my experience and I have had a lot of surgery in my life. Many spine surgeries with plates and screws so I understand recovery and pain very well.

I chose the surgeon that I went with not because of her experience with WLS patients. I chose her because she understood my goals extremely well. Unlike any other surgeon I spoke with. She is board certified and has a 5 out of 5 on her reviews on every possible site I could check her out on. She offered a free consultation and did not make me book separate appointments for separate body parts like so many other did. I knew she was going to be the surgeon for me just from speaking to her assistant and reading her reviews.

I had my brachioplasty done first and it was done as an outpatient. I ended up having an alergic reaction to the surgical glue and the pain and itching from that alone almost made me think twice about going back for seconds. I chose to have my arms done by themselves because I they were the most important and I had to save more money for the second much bigger procedure. My arms looked fantastic and this surgeon took her time to make them as perfect as possible. It was instant gratification but the pain was incredible. For 3 long weeks it felt as if I had placed both my arms on the hot stove. At week 3 we removed the glued bandages and that same day, the burning and itching stopped so we knew it was for sure a allergy. I can remember night 3 praying to god that he would just take the pain down a notch so I could better handle it. It really scared me to have more surgery but within a week or two after bandage removal, I started feeling normal and loving what I had done.

So back to the surgeon I went to decide on the next phase. I wanted my tummy and breasts done. We had already decided that a full abdominalplasty was the way to go. I did not carry a lot of loose skin on my back so we chose not to do this as a lower body lift or a 360. At the time we discussed the option of doing the lift first and then going back and doing an augmentation 12 weeks later. I did not want that for many of the same reasons you spoke about. My breasts have always been fabulous until I lost my weight and they turned into empty hanging socks (LOL). I did have some breast tissue left so we went with an average size of 350CC moderate plus silicone implants.

Knowing how rough my first surgery was I decided to pay the extra 500 per night and stayed in the hospital and I am so thankful I did. The first 2 nights were the toughest having to get up and move around was rough on the tummy. My surgeon installed a pain pump right into the muscle area and I that made my recovery so much better but if I had to do it all again, staying in the hospital where they can give you IV pain meds is the way to go for sure. By the time I went home on day 3, my abdominalplasty and breast lift/augmentation was a piece of cake compared to the pain I had in my arms. Yes, I was very sore and felt discomfort getting up and down but honestly easy peasy......The right pain meds make a big difference. I also had a revision done to my left arm by the elbow. When I woke from surgery my left hand had gone completely numb. It was damage to my medial nerve and even now, 12 weeks post op my hand is numb, weak and painful. My hand was the worst part of my whole recovery. The good news is, they tell me the nerve will repair itself and I am beginning to notice small positive changes although it is a slow process.

The other thing I would tell you is that having the lift and augmentation done at the same time puts a lot of stress on the opening under your breasts where the two incisions meet. If you go on realself you will hear about this a lot. The benefit to having them done separately is that it gives your lift incisions time to heal before you now put the weight of the implant in there. I heal extremely well, I do not smoke, I get lots of protein and I had small openings under both breasts which took 9 weeks of wound care and doctors appoints for follow up. The biggest fear is that it opens and exposes the implant. If that happens they remove the implant completely and wait for the scars to heal before installing a new implant which you get to pay for all over again. The cost of my implants alone was 2K and then the operating room.....I chose to have them both at the same time and I am glad I did but I also knew how I heal.

Sorry for the length of this post but thought maybe some of my experience might help? Best of luck to you on your journey. It is so exciting. Today.....my husband ordered a ton of lingerie. Apparently he loves my new look. I find it funny but I take pics of the new girls and text them. We have been married 30 years. LOL it so weird that I feel so confident in my body now.

I might consider doing something with my missing rear and my thighs down the road but for now, I am just loving the new me!

Thank you so much for sharing your story. I don't mind the length at all!

I will have to go on realself and research more about the lift/BA risks. So far, I have looked through a lot of the pics on there of breasts that look similar to mine after the Lift/BA and am impressed with what is possible.

I think I'm certainly leaning towards combining the two procedures. I do heal rather quickly and am in generally decent shape. I'm so looking forward to filling out a bra again...and not having my breasts completely disappear when I lay down.

Hahah! I would completely do the same and take lots of pictures for the hubby. :) I am also really excited to be able to wear sexy lingerie and actually feel confident and NOT awkward and self-conscious. :) So happy your results were worth it and thank you so much for sharing!!

This is kind of funny but recently I went to purchase new wired bras in my new size. My surgeon recommended a place and even provided me with a coupon. Off hubby and I went to this store called allure.

I saw this gorgeous bra on the wall and wondered if that would come in my new size. This is a true fit bra store where Victoria's secrets and Soma really have their own vanity sizing system.

Anyway, some lady take me in the back and measures me and low and behold I am now a 36DD where prior to bypass I was a 46C.

Hubby of course love the DD part. LOL. Anyway, I find two bras that I absolutely love and I try them on and love them. So I walk out of the dressing room toss them up on the counter and quickly though I would look for matching panties. I picked up the pair that matched my bra and looked at the price tag. I think I had a small stroke! The panties were 55.00 a pair!!! Now I have paid decent Money for bras in the past (70.00 or 75.00 for the really high end ones) I was absolutely terrified to look at the two bras I picked out. Well, one was 95.00 and the other 110.00! I again had another stroke. Hubby says, you need them and you worked hard to get to this size, just this once get them. So, I did.....

One of the two bras I have a hard time taking off. It is the most comfortable gorgeous bra I have ever put on my body. It is even comfortable enough to sleep in and I have done so many nights when my breasts feel tender. Hubby now knows this purchase was worth it because he finds me walking around my house in just my bra and a pair of yoga pants. LOL.

So this past saturday he went back to that store and ordered me that same bra in every color. He is friggin nuts!!!! Apparently he loves his new girls. I guess a bra is worth 110.00 if you want to live in it. Food for thought!

Oh man, a good bra is worth more than it's weight in gold. When I started losing weight I started going to a local lingerie store to get properly fitted, etc. The bras I found and love are in the 50-60 range and they're epic. So freaking comfortable. I normally go in March because they do a 10% discount for the month of your birth, but I skipped this year due to upcoming plastics. I'm looking forward to my March 2018 visit already. I figure that I should be all healed up and most of the swelling gone by then.

Tim Gunn is right when he says that foundational undergarments are everything!

Incidentally I ended up with a very perky 36DD and honestly they are fabulous. I am 12 weeks out and you cannot see the scars around the nipples at all. All of my scars are flat, thin and getting lighter as I use BioCorneum on them.

We were scared to do a lift because I have seen so many bad breast lifts on realself. Nipples that are not symmetrical or for some reason just dont look right. My surgeon knew this was a concern and took her time.

When I had my arms done, my surgery took 5.5 hours......she did lipo in my arms as well.

My abdominalplasty, breast lift and augmentation took 10 hours but my results are amazing and it was worth it.

Expect to be very tired and sore for quite some time.