Procedures

Breast Lift with Augmentation

Medical Term: Augmentation Mastopexy

Who is a Candidate?

• Women with sagging (ptotic) breasts of low volume, a common scenario in women after childbearing and weight fluctuation
• Patients after massive weight loss resulting in excess skin of the breasts, with loss of breast tissue
• Individuals with naturally sagging, low lying or asymmetric breasts, low nipple position or enlarged areola, desiring improved shape, contour, and size
• Women who become saggy as a result of aging, gravity, or poor skin tone, and desire an increase in cup size
• Patients with a history of previous breast augmentation, desiring size change and elevation of their breast mound and nipple, or reduction in areolar size
• Healthy, non-smokers
• There is a popular misconception that larger implants can lift a breast or treat sagging. Implants add weight to breasts, and potentially aggravate the sagging condition as a result of gravitational forces

Goal of Surgery:

• Lifting of the breast tissue and nipple, skin envelope tightening
• Improvement in superior and medial cleavage and fullness
• Improvement in shape and contour
• Nipple and areolar size reduction
• Improvement in preexisting asymmetry. It is not realistic to expect perfect breast symmetry, as all breast are naturally asymmetric to various degrees

Procedure Description:

• Implants of appropriate size and proportion are placed in the submuscular position (under the pectoralis major muscle)
• Skin around the nipple is removed, so that it can be elevated to a higher and more central position on the breast mound
• Breast tissue tightening is performed at the inferior aspect of the breast. A small amount of skin and underlying tissue can also be resected from the most dependent portion of the breast
• The procedure for the lift requires more scarring on the breast than an augmentation alone. Scars are placed around the nipple itself (Periareolar Mastopexy) or more commonly in the configuration of a "lollipop" including an incision down the lower half of the breast that fades well (Vertical Mastopexy). For more severe sagging, there is also going to be a scar underneath the breast
• Most patients require the vertical mastopexy scar pattern. There are generally fewer candidates for the periareolar lift (scar around nipple only) because it provides at best only one inch or so of nipple elevation, minimal underlying tissue and skin tightening, and the scar itself around the nipple tends to be more visible
• The surgery is done under general anesthesia, as an outpatient, and takes 2-3 hours

Postoperative Course:

• The patient goes home dressed in a sports bra lined with gauze
• Drains are used for about 4-7 days, and are removed in the office
• Muscle relaxers and pain medication help with discomfort
• Expect an initial unusual appearance of the breasts and nipples. It takes a few months for the implants to drop, settle and soften, and for the appearance to look natural. This time frame varies from person to person, but expect mild appearance changes for about 6 months after surgery
• All sutures are absorbable
• It takes one year for the scars to fade. No tanning of the scars during this time
• Most patients take two weeks off of work. No heavy lifting, fitness or strenuous upper body activity for at least 4 weeks.
• Underwire bra support is required day and night for at least 4 weeks, then daily use is recommended to minimize risks of recurrent sagging

Other Options:

• Liposuction and other body contouring procedures such as abdominoplasty may be done at the same time in certain candidates

For More Information