Breast Lifts/ Breast Lifts with Breast Augmentation Undoing the Effects of Pregnancy
Breast lift involves lifting and reshaping the breast and lifting the nipple/areola up to the ideal position. In plastic surgery the term for this surgery is Mastoplexy.
Patients may require breast lifts due to a number of factors. These may include being born with breasts that are droopy, breasts that fall after significant weight loss, and probably most commonly breasts that droop and decrease in size after one or more children. As a general rule the breasts become more droopy and smaller with each pregnancy that the mother has. The medical term for drooping is ptosis.
The good news is that there are some excellent procedures that can reverse this damage and create lovely breasts. This correction may involve just a breast lift alone or a breast lift with augmentation with a breast implant.
Who are candidates? The patient alone can determine if this is something that they are unhappy about and would to improve or change. The degree of breast lifting can be fairly minor or major recontouring with breasts that have little or no support and are significantly drooping. The breast augmentation is usually done to make up the lost volume. In fact most women who have lost volume choose to have their breasts augmented to a size that may be larger than the size they initially were before they were pregnant.
Depending on the degree of breast drooping there are a number of different breast lifting techniques that can be tailored to what it is the patient’s looking to achieve and what their present breast shape requires. The lift may involve only incisions around the areola (this is called a circum-areola Mastoplexy). This works well for breasts that require minimal lifting. The most common procedure that I perform involves an incision that goes around the areola and then straight down to the inframamory fold. Some call this a lollypop Mastoplexy as the incisions and scars resemble that of a lollypop (the actual name is a circum-vertical Mastoplexy). The Mastoplexy that is necessary to correct the greatest degree of drooping is called a full Mastoplexy, which involves incisions around the areola, down to the inframamory fold, and then along the inframamory crease.
Obviously any experienced Plastic Surgeon should use the simplest technique that will allow the necessary improvements. In my practice I have done over fourteen-hundred breast lifts and I always am looking for the surgery that will cause the best result with the least scarring.
If breast augmentation is done at the same time, it is crucial that the breast augmentation be done first. This is because the degree of breast lifting and skin resection will be modified by the breasts being made bigger. In addition it’s almost impossible in most patients to determine the right size of the implant for the breast augmentation due to the fact that the breasts are drooping and don’t accurately show the size of the breast with the breast tissue being in the right place.
Not all San Diego Plastic Surgeons perform the surgery in the manner I do. I am confident however that in my hands this gives the absolute best result. The surgery is done with a pocket for the breast augmentation created and a sizer placed in the pocket. At that point the skin is stapled together in a way that approximates the degree and type of breast lift that will be done. Then the back of the operating room table is raised and my nurses and I examine the patient in regards to breast size, the degree of lift, and the anticipated position of the nipple. In this way not only can the correct size of the implant be determined but the breast lift and the degree of skin resection be correctly evaluated without burning and bridges. Once the correct size and the correct degree of breast lift with optimal nipple positioning determined, the tacking staples are removed after being carefully marked out and the breast augmentation is then completed with the correct size implant. Then following the marks of the tacking staples, the breast lift is then performed.
What is the key to a great breast lift? Simply put, the breast should be lifted to an ideal and correct position and the incisions closed in a precise manner that will give the beast scars possible for that particular patient. Therefore in closing the breast lift incisions, the tissues must be brought together with a precise multi-layered closure, so that there is minimal tension on the actual top layer of the skin closure. Then in addition, I like to keep the incisions taped with a special flexible tape for six weeks. The tape itself is changed on a weekly basis. While this type of closure requires more time, there is no question in my mind that this gives the very best scars possible.
In my La Jolla Plastic Surgery practice, my patients frequently ask me if this operation will need to be repeated in the future. In my twenty-five year experience, unless the patient gains and loses a great deal of weight or becomes pregnant, it is unlikely that they will require another breast lift.
The procedure itself has very little post operative pain, this is primarily due to numbing medication being placed in the breast augmentation pocket and the fact that once the skin is closed in a precise and general manner, there is minimal pain associated with the lift itself.
When a patient is having a consultation with a Plastic Surgeon in regards to a breast lift it is important to ask a number of questions. Is the implant being placed on top or underneath the muscle? How is the breast size chosen and exactly how is the size and degree of breast lift determined? Is the breast augmentation done prior to the lift? Exactly what type of lift will be necessary and what are the scars associated with it? What is done to minimize the scarring and can you see photographs of the surgeons work? All these questions and more should be involved in the consultation so that the patient has a clear idea of what is to be done and how exactly how it will be done. In my practice, these consultations frequently take forty-five minutes and involve a great deal of explanation and photographs of prior patients so that the patient fully understands what I believe would be the right procedure and why.
In summary, this is an excellent surgery which can make a tremendous difference in the way a woman looks and feels in regards to her breasts and her overall appearance. Properly done, the satisfaction with this surgery is extremely high.
David L. Wolf, M.D., F.A.C.S. offers breast augmentation surgery in:
