Mastopexy Augmentation is the combination of Breast Augmentation and Breast Lift. When is Breast Augmentation alone enough? When is a Breast Lift the best choice? When should a combination of Breast Augmentation Lift be performed? It’s a big subject, and requires an in-person consultation for your specific needs, but some general rules for the procedures are explained below. There are many options, so be certain to consult with a Board Certified Plastic Surgeon before making the decision.
Breast Augmentation Lifts Come in May Sizes
Breast Augmentation lifts, like the breasts themselves, come in many shapes and sizes. When the shape of the breast is good, but a larger version is desired, Breast Augmentation with a Breast Implant is often enough. When the size of the breast is good, but the breast tissue sags, a Breast Lift alone may be enough. The exception in this case is when there is no upper pole fullness, often seen as gapping of the upper bra. A small implant may be beneficial to add a bit of volume to the upper breast in these cases. When the breasts are small and saggy, the Breast Augmentation Lift is the procedure of choice.
The case above is an unusual lift in that a periareolar (defined below) and an inframammary incision (hidden in the crease beneath the breasts) were used, but there is no vertical scar. The “Horizontal Breast Lift” is great for breasts that have bottomed out or for breasts with more extreme sagging.
Breast Augmentation Lift for Tubular Breast
Smaller Breast Lifts require smaller scars. In the case above, a periareolar scar was used to reposition the nipple and reshape the breasts. Periareolar literally means “around the areola”. The areola is the pigmented skin that surrounds the nipple. While this does provide the smallest scar, it does the least. It tends to flatten the end of the breast and it is not great for reducing the size of the areolae.
For cases of Tuberous Breasts, flattening of the shape of the breast is a plus. It can be used to prevent the puffy nipple from sticking out like a cherry on top of a sundae. This patient’s breasts are narrow at the base, and the constriction gives a narrow, elongated, tubular breast. The Breast Implant helps to round the breast out, but it may not correct the areola when it is puffy.
Bigger Sagging, Bigger Problems, Bigger Breast Aug Lifts
For patients with severe postpartum breast involution (shrinkage), and for patients after massive weight loss, the breast volume has left the building, leaving only a loose, empty flap of skin. Breast Augmentation Lifts are the only solution to this problem. Breast Implants are used to restore the breasts’ volume, and it is combined with a Breast Lift to restore the breasts’ shape.
Often, I will see on the Internet the misconception that if a big enough implant is placed, you will not need a lift. This is not true. Imagine an implant, the size of the one used above, placed under the skin of the pre-op picture. The breast would be the same size; however, the loose skin holding the nipple would hang off the end. In the above case, only a Breast Lift can correct the problems with the breasts’ shape, nipple position and excess skin at the bottom of the breast.
More Scar = Happier Patient?
The ultimate goal of Cosmetic Plastic Surgery is a happy patient. So how can more scar lead to a happier patient? It all depends on the circumstances. If a scar is not needed, then more scar is bad. I have had patients on the borderline of needing a lift elect to not have lift because of the extra scar. Some are happy with their decision of not completely correcting the sagging, and not having extra scars. Others have come back for a Breast Lift after their Breast Augmentation, and are much happier now, after the Breast Lift. Staging does make it easier to see what each procedure has to offer the final result.
Above, an inverted-T Breast Lift was performed along with placement of a Breast Implant. A periareolar lift would have left the nipples low, the areolae much larger and the end of the breasts flat. A vertical lift would not have tightened the lower pole sufficiently, or coned the shape of the breast as beautifully. In my experience, the incision underneath the breasts is well hidden. By keeping its length short, the scar will hide in the shadow under the breasts.
Breast Augmentation Lift Consultations
If you are considering a Breast Augmentation, Breast Lift or the Combination Augmentation Mastopexy, be certain to consult an experienced Board Certified Plastic Surgeon. While there are advantages to combining the procedures, it is also more complicated than both procedures done separately.
If you are in the San Francisco Bay Area, give me a call at (925) 943-6353, and schedule a private comprehensive consultation. Your options will be reviewed and the best course selected to optimize you breast aesthetics.