Breast Lift Procedures
Breast Lift Procedures
Breast lift procedures are another significant aspect of my practice. A breast lift or mastopexy is designed to lift one or both breasts in order to correct unwanted droopiness (breast ptosis) and improve the fullness, firmness and symmetry of the breasts. Lifting and tightening are accomplished by removing excess skin from around the nipple and/or the lower aspect of the breast. Consequently the nipple is elevated to a more youthful position and the areola is typically reduced in size. The amount of skin that needs to be removed depends on the degree of droopiness. This in turn determines the location and extent of the incisions required to achieve proper correction. Sometimes this can be accomplished with only an incision around the areola (periareolar or doughnut mastopexy) but often additional incisions are needed. These can include incisions going down from the areola to the breast fold (vertical lift) and along the breast fold (anchor, inverted T or wise pattern lift). Ideally it would be nice to limit the extent of the incisions but sometimes in doing so the overall effectiveness of the lift and therefore the result is compromised. These are things that should be discussed prior to surgery.
Breast augmentation is frequently done in combination with a breast lift. The addition of an implant serves to improve the fullness and firmness of the breasts as well as increase their size. There is a common misconception that breast implants alone will lift the breasts and that the bigger the implant the more significant the lift. The assumption is that putting an implant in a droopy breast is like blowing up a deflated ballon.The more air (bigger implant) that you put in the firmer and more upright the ballon becomes. While this may true for balloons it is not true for breasts. Be careful!!!! Implants can help some women who are borderline candidates for a lift procedure avoid one, they are not an alternative in those patients who truly need a lift. In fact, implants can actually worsen the problem in some cases. If your nipple is below your breast fold or you have a significant amount of skin hanging down below your breast fold, you probably need a lift.
One area where implants serve as a nice compliment to a breast lift alone is in improving the fullness of the upper aspect of the breasts. This is an area that many women would like to see more fullness after a lift alone. Initially, because of the tightening of the skin, there is nice fullness in the upper breast. This is similar to being in a push up bra except now unfortunately your skin is doing all the pushing. However, skin is not strong enough to maintain this fullness. It will stretch out to some degree and consequently some of this initial fullness will be lost. This you can count on. The additional volume of an implant can help mitigate this loss of fullness; however, if you are expecting your breasts to look as full and youthful as they did when your were in your late teens or early twenties or before babies, you are probably going to be disappointed. Much better yes, miraculous no.
You should also be aware that augmentation and mastopexy performed at the the same time is considered a much more difficult procedure then when either procedure is performed by its self. Understand that these procedures essentially change the breast in ways that are in opposition to each other. A breast lift is a type of breast reduction (all be it mainly skin) while a breast augmentation is breast enlargement. These donʼt always work perfectly together and knowing for certain how one will affect the other is difficult to predict with 100% accuracy. Changes, like skin stretching, will occur after surgery. These changes may leave you wishing you looked better soon after surgery. Consequently, it is not uncommon to have to revise an augmentation mastopexy 6-9 months later. Although the changes may be noticeable soon after surgery it is still best to wait this period of time in order to insure that the changes have stabilized. For this reason and for safety reasons many Plastic Surgeons will not perform an augmentation at the same time as a mastopexy. Instead the two are performed as separate procedures 6-9 months apart. The timing of the procedures depends on the individual needs and circumstances of the patient.
Each patient has unique issues with their breasts that will influence which procedure or procedures will best accomplish their goals. If you are considering cosmetic surgery to improve the appearance of your breasts please give me an opportunity to sit down with you and discuss your options.