The good news is you’ve lost weight. The bad news is, you lost the weight all over, including from your breasts. What were once full, rounded and perky now look saggy and droopy.

For some women, just a few pounds can make a notable difference, and formerly obese women who lose large amounts of weight are often left with excess skin and sagging breast tissue, says Dr. Judith Gurley, a plastic surgeon who practices in Chesterfield. “It’s very individual in terms of how much weight loss can affect the breasts, but the degree of change mostly depends on the size and position of the breasts prior to weight loss,” she says.

“About half of my breast surgeries are for postpartum weight loss, massive weight loss after obesity or just tissue loss due to aging, which causes loose skin and droopy breasts,” Gurley adds.

Surgical intervention can correct for weight-related breast changes. “Sometimes it’s just a matter of lifting, tightening and reshaping the breasts,” Gurley says. “Rarely is an implant needed because there is usually enough tissue to move upward to create a full, round, perky breast. But if the patient wants a larger cup size, a breast implant is needed.”

An implant also can add volume to the upper portion of the breast, enhancing the appearance of rounded fullness, says Dr. Michele Koo, a plastic surgeon with the Aesthetic Surgery Institute. “I offer the option of a lift with or without implants,” she says. “I always offer my opinion as to what will be the most ‘aesthetically’ perfect for the breasts, but my patient makes the final decision as to how full she truly wants her breasts to look.”

Koo often recommends a small breast implant to “stabilize” the position and shape of the breast over time, creating perky but not especially large breasts.

Many patients who have lost a lot of weight seek breast rejuvenation along with other procedures, such as a tummy tuck, to remove excess skin and create smoother body contours. “Reconstruction after weight loss is a multi-surgery process and may take several years and several procedures, but I start with the area of most concern for the patient,” Koo says.

“The severity of the loss of volume, the ptosis (sag) of the breasts, and the quality and elasticity of the skin will determine if minor revisions and further surgeries will be necessary,” she adds. “Further weight loss and gain will also change the shape and position of the breasts, which will then determine if further surgery is required.”

If a patient regains weight, the breasts, along with everything else, will become larger again, Koo explains. “If enough weight is gained, a lifted breast, even one with implants, will start to drop and sag from the weight. Subsequently, the breasts may have to be lifted again and the implants may need to be changed.”

As always, both Gurley and Koo recommend seeking an experienced, board-certified plastic surgeon who can share before and after photos of his or her work.