The changes that may occur in the breasts of both men and women after massive weight loss from weight loss surgery or dieting can be very disturbing and distressing in many of the previously obese people. The redundant skin and remaining fat that is present in the breast area is difficult to conceal in men and may be very problematic, both in and out of clothes. Previously morbid obese women also express discontent in the size, shape and position of their breast tissues. Fortunately, for these women, the bra may serve as a temporary aide in concealing this redundant skin and fat problem area.
Like other skin and body areas that have suffered through tremendous weight gain and then loss, the character of the breast skin will typically have lost its elasticity and have descended as a result of the weight loss. Carrying extra fat in the breast area will further weigh the breast area down and cause more problems for the previously overweight or obese individual. The breast changes that the women may see can parallel those changes that some women can experience with a large weight gain pregnancy and breast feeding. Ageing and gravity will further cause this problem to perpetuate. Usually by the time the massive weight loss has occurred, the proportion of true glandular firm breast tissue is limited and the breast area is almost all redundant skin and fat. Even without significant weight loss, women's breasts will eventually become less firm and consequently change shape over time. Adding weight loss to this natural process may make the resultant breast shape very disturbing.
When the breast skin descends, in both men and women, it carries the breast nipple and areolar (colored) tissue with it. When the breast nipple descent travels to below the crease of the breast, the breast nipple position is described as being ptotic or the person has breast ptosis. The degree of breast ptosis (descended nipple position) may vary in severity. Plastic surgeons have a scale that aides in determining which plastic surgery option may best be used to treat the current malpositioned nipple and breast. The aim of the plastic surgery procedures is to restore the breast and the nipple position to a more acceptable position. The scale separates the breast and nipple positions into three degrees. First degree breast ptosis usually is described for the breast when the breast nipple position is at the crease or just slightly below it. Second degree breast ptosis is usually described for the breast when the breast nipple position is clearly below the crease but the breast nipple is not pointing straight down. Third degree breast ptosis is usually described for the breast when the breast nipple position is pointing down. This breast scale is not absolute and is subject to interpretation by the plastic surgeon performing the examination. The purpose of the scale is to aide the plastic surgeon in selecting which plastic surgery breast lift (mastopexy) operations are reasonable choices. After using this scale develop a list, the choices may then be presented to the previously obese individual to assist in making a decision. Like most plastic surgery procedures, there is a spectrum of different plastic surgery options and no one way is the only way to correct the redundant breast skin problem.