Last week, I posted about the American Society for Aesthetic Plastic Surgery (ASAPS) holding its 2014 meeting in our beautiful San Francisco Bay Area. One of the innovations I mentioned was a new approach to Breast Lifts using small incisions and internal “anchors.” I received a few questions, so I will elaborate about what I know here. First, a little background on the Breast Lift.
The Breast Lift or Mastopexy
The breast lift has been around longer than Breast Augmentation and is an integral part of Breast Reduction surgery. It is no surprise that when breasts lose volume, they lose support, but sometimes breast “arrive” with less than ideal shapes. The best treatment depends on the circumstances.
If the breasts preserve a good shape, and are too small, Breast Implants can provide the missing volume and improve the shape. If the breasts are a good size, but the shape or sagging is the main problem, a Breast Lift alone can help. When the breasts are both small and saggy, the combination of a Breast Augmentation and Breast Lift can provide dramatic improvement.
Smaller Breast Lifts Mean Smaller Breast Scars … Usually
The part of the Breast Lift that causes the most anxiety is the scars. Fortunately, less lifting requires smaller scars. Small lifts can be performed with scars confined to the edge of the areola. Moderate lifts add a vertical scar to close the donor area (the place in the skin that the nipple and areola vacate) without puling the nipple down. Larger lifts also include a scar in the fold beneath the breasts. Larger lifts = larger scars with one notable exception.
The exception to the rule is when the nipples are very low. Sometimes the nipple starts so low that the donor area can be closed in the scar that runs under the breast. Eliminating the vertical scar makes my patients very happy, and whenever I can do it, it makes me happy too.
Can’t Plastic Surgeons Lift the Breast from Inside?
A frequently asked question is, “Can’t Plastic Surgeons lift the breast from inside?” It’s a great question, but lifting the breast from inside proves to be quite challenging. Breasts are meant to be soft. The main component of the breast mound is fat, and fat is both heavy and difficult to hold in place. It is important to maintain the softness of the breasts. This is why most women considering Breast Augmentation choose Silicone Breast Implants over Saline Breast Implants. Unfortunately, softness is also what promotes breast ptosis (sagging).
Many attempts have been made to internally anchor the breast tissue with varying degrees of success. Breasts naturally fall with age. It’s a combination of events. The weight of the breast tissue, the loss of skin elasticity and atrophy of the fibrous support all contribute.
The Latest Attempt at an Internal Breast Lift
This brings me to the technology revealed at the ASAPS meeting. A new company Refine Medical is marketing an internal anchoring system which is placed percutaneously. Incisions are still involved. The good news, each breast requires two 1/8th inch long incisions, so they are much shorter than a traditional Breast Lift. Also, the method may be able to improve the upper pole fullness better than a traditional lift in some cases. The bad news, the incisions are located well above the nipples, where they are more visible and prone to poorer scar quality. The lift is not as dramatic as the traditional surgical approaches and the mechanism is new, so long term follow-up is just beginning. For patients who aren’t too large, and who don’t need much lifting, it may be a good compromise. It might also be helpful for some of my Gynecomastia Reduction (male breast reduction) patients who have a bit of skin sag after weight loss or breast tissue removal.
I have not yet used the product, but I have had the opportunity to speak with those involved with the invention and early trials, and so far so good. It seems unlikely that the device in its current form it will replace Breast Lifts, but I would be happy to be wrong. The device is new, but promising, and for the well informed and carefully selected patient who is willing to take a chance on something new, it may be a good option.
Breast Lift (Mastopexy) Consultation
If you are considering a Breast Lift, Breast Augmentation or a combination of the two procedures, give me a call at (925) 943-6353 to schedule a Breast Lift Consultation. There is a lot of information available on-line on the San Francisco Plastic Surgery Blog, but nothing can substitute for an in-person consultation with an experienced and Board Certified Plastic Surgeon.