Medical Term: Augmentation Mastopexy
Breast implants alone do not treat sagging breasts. The majority of women who are a natural B cup or larger will expectedly experience sagging of their breasts as a result of gravity, childbearing, age, and weight fluctuation. Sagging or low-lying breasts can also be genetic, and begin as early as puberty. It is also normal to experience breast size changes throughout one’s life, based on weight, hormones, activity level, age, pregnancy and breast-feeding. It is common and normal to experience a condition called "post-partum subinvolution of breast tissue" after childbearing. Basically, this means that the breast tissue shrinks at some point after childbirth, as the need for the function of the gland diminishes.
For all of the aforementioned reasons, breast lift with augmentation (augmentation mastopexy) is one of the most common procedures requested by women, and Dr. Brown is an expert in this type of surgery. To learn more about this combination breast surgery procedure, please call Desert Hills Plastic Surgery Center at (702) 260-7707 today. We are proud to serve patients throughout the Las Vegas area.
What Type of Implant Is Used in Breast Augmentation With Lift?
Dr. Brown uses both saline and silicone implants for this procedure. Silicone tends to feel more natural which may be especially relevant in thinner, smaller breasted women who perceive the implant more. Dr. Brown will honor your personal preference and assist you with your decision based on your tissue characteristics.
Visually, the results will be excellent with either device. Dr. Brown utilizes the submuscular pocket for the majority of patients who undergo augmentation mastopexy. Every surgical plan is tailored for the individual, to keep the intervention simple, straightforward, and predictable while minimizing scarring where possible. Breast tissue tightening in all dimensions is accomplished with breast lift surgery, and a certain scar pattern on the breast results from this maneuver.
There is no way to perform satisfactory skin and tissue tightening without external scars. Most women are perfectly comfortable with the trade-off of scarring in exchange for perkier breasts. These scars fade and lie in natural curves and anatomic folds so the appearance blends well with surrounding skin. They hide well in bras and the majority of bikini styles. Residual sagging is undesirable after undergoing augmentation mastopexy, and maximal tissue tightening in all dimensions is recommended, while maintaining a natural look.
Who Is a Candidate?
- Women with sagging (ptotic) breasts of low volume, a common scenario in women after childbearing and weight fluctuation, or as a result of the normal aging process
- 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, who have experienced sagging or recurrent sagging, desiring elevation of their breast mound and nipple, or reduction in areola size
- Patients with a history of previous breast augmentation, desiring a smaller implant size, and who have potential skin excess and sagging
- Patients with a history of breast augmentation, desiring a pocket site change, for example from subglandular (over the muscle) to submuscular, where the overlying breast tissue may need to be tightened and elevated
- Women with tubular breast deformity or pointy-shaped breasts
- Healthy, non-smokers
- Women who present with a significant amount of natural breast tissue may be better candidates for a breast lift alone without implants. These patients can achieve a well-contoured and full natural breast, avoiding maintenance surgery and increased risks of recurrent sagging that go along with the addition of an implant.
Goal of Surgery:
- Lifting of the breast tissue and nipple, skin envelope tightening in all dimensions
- Natural looking contours, while satisfying those patients who desire more than average superior pole fullness
- Improvement in superior and medial cleavage and fullness
- To close a wide cleavage space
- To decrease lateral displacement of the breasts (the look when breasts tend to fall out toward the sides), and increase central fullness
- Improvement in shape and contour
- Nipple and areola size reduction when desired
- Improvement in preexisting asymmetry. It is not realistic to expect perfect breast symmetry, as all breast are naturally asymmetric to various degrees
- 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. Patients who have tone and tight tissues support increased breast weight and larger breast sizes better than those who have looser, lax tissues and skin.
- Do not expect an implant to give a permanent superior pole fullness
- 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. The nipple IS NOT cut off. It remains attached to underlying blood vessels, nerves, and ducts.
- Breast tissue tightening is performed at the inferior aspect of the breast both vertically and horizontally for maximal lift, to account for implant and tissue "settling" after surgery from gravity. A small amount of skin and underlying tissue can also be resected if desired from the most dependent portion of the breast if it is redundant.
- 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 along the inframammary crease (natural breast fold)
- 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.
- Patients with tubular breast deformity are the best candidates for periareolar augmentation mastopexy (scar around nipple only)
- The surgery is done under general anesthesia, as an outpatient, and takes 2-3 hours
- The patient goes home dressed in a sports bra lined with gauze
- Drains are used in 50% of cases, depending on the nature and extent of your surgical intervention. If a drain is present, it is typically removed within 3-7 days in the office
- Muscle relaxers and pain medication help with discomfort
- Expect an initial unusual appearance of the breasts and nipples. The implants may look high, firm, and unnatural at first. This is purposeful, as it takes a few months for the implants to drop, settle, and soften with gravity, 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. Individuals with tighter tissues take longer to drop and settle versus patients with looser tissues
- All sutures are absorbable, yet Dr Brown leaves some external suture knots that are clipped off in the office in 1-2 weeks
- Incisions are usually healed by 2-4 weeks
- It takes at least one year for the scars to fade. No tanning of the scars during this time. Everyone heals at different rates and everyone forms different quality scars, depending on your inherent healing ability
- Most patients do not require topical scar treatments. Dr. Brown follows the scars and recommends certain scar therapies only if indicated
- 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 2 months, then daily use is recommended to minimize risks of recurrent sagging. Larger breasts (implants) are heavier and do respond to gravity over time. Patients with looser, lax tissue characteristics may be more at risk for this, irrespective of the implant being “under the muscle”. Dr. Brown recommends underwire bra support to stabilize the lower and outer aspect of the breast pocket, as the implants are dropping and settling with gravity. Wearing this type of bra style may lead to more predictability with respect to final implant position. This bra will maintain implant position and decrease risks for the downward and lateral effects of gravity to affect implant position over time.
- Liposuction and other body contouring procedures such as abdominoplasty may be done at the same time in certain candidates
- "Mommy Makeover" is a term coined to describe the scenario of cosmetic surgery to treat a woman’s typical appearance after pregnancies and childbearing. Surgical intervention typically happens in one stage, where breasts are contoured with implants and/or breast lift, and the waistline is contoured with abdominoplasty and/or liposuction. Dr. Brown specializes in this type of intervention.
Dr. Brown can relate to women who desire breast contouring. She understands the desired shape and cleavage that women want, as well as how the fit of various clothing styles enhance your appearance. She identifies with women who desire a very natural look, yet also understands and satisfies the goals of those individuals with a desire for a very full, curvy, and voluptuous figure.
Sagging affects the majority of women, and most women at some point in their lives may need or desire a breast lift surgery. The individual personal benefits of breast contouring surgery in women are always remarkable. Augmentation mastopexy surgery is effective in restoring a woman’s perception of herself as attractive, sexy, healthy, confident, fit, and youthful. This improved confidence and self-esteem carries over into daily life and interactions with others so that quality of life is improved.
To find out more about breast augmentation with lift, please contact Desert Hills Plastic Surgery Center online or call our Las Vegas office at (702) 260-7707 to schedule a free consultation.