St Marks Hospitals

Breast Lift Plastic Surgery with Augmentation

Can a breast implant lift the breast? Yes but you may need a breast lift as well or you can have a breast lift without breast augmentation. However, the breast implants will give you a fuller, rounder, younger appearance. If you have a lot of natural breast tissue you may opt for just a breast lift without breast augmentation surgery.

What about breast lift scars?
There are several kinds of breast lifts available today and all will have different kind of scarring on the breast. Take a look at the breast lift before and after photos below to view the different types of breast lifts & their scars.

Can breasts sag after a breast lift surgery?
Sagging of the breast depends on the size of the breasts, pregnancy, gravity, and time. This applies to breasts even after breast lift surgery. However, breast lift surgery does seem to lessen the rate of breast sag after surgery. Discuss this with your breast surgeon.
Do doctors need a mammogram before breast lift surgery?
Your breast surgeon may require a mammogram before your surgery. Doctors have had two mammograms and with the right technician it does not hurt.

What are risks of breast lift surgery?
Potential surgical risks and complications of breast lift surgery (a.k.a. mastopexy surgery) are similar to that of breast augmentation surgery which you can read here. Be aware it can take several months before your breasts take their final shape and form. To avoid bad plastic surgery, be sure to research your breast surgeon.

Breast Lift surgery - To lift or not to lift?
There are many reasons women’s breasts are different shapes including, weight gain or weight loss, aging, pregnancy, hormonal changes, breast deformity as well as genetics. In evaluating a patient’s need for a breast lift doctors addresses several issues: overall breast shape, nipple location, amount of excess skin, amount of sag, elasticity ofthe breast skin and the best location on the breasts for the least amount of scarring.

If a woman’s breasts are sagging no amount of exercise, laser treatments, breast firming gels or creams or push up bras are proven to permanently lift the breasts. The only permanent way to lift breasts is with breast lift surgery. The goal of Breast surgery is to give each patient the best result possible. If a patient would benefit from a breast lift with their augmentation and doesn’t have one they will only have a larger version of the breasts they started off with. A breast augmentation alone only makes the breasts larger it does not lift the breasts.

Breast Augmentation without a lift performed by another surgeon. doctors corrected the appearance of the patients breasts by replacing the breast implants and lifting the breasts with a Binell mastopexy. Many patients over the years have thought or were told by surgeons that breast implants would make droopy breasts perkier and more youthful appearing. This is simply not true. The weight of breast implants will only make droopy breasts droopier and not lift anything.

Patient who wanted Perkier breasts only.
Some patients’ first surgeons tell them that breast implants give them perkier breasts. All they ended up with were larger droopier breasts. Doctors improved the appearance of these patients’ breasts by removing the breast implants and performing a breast lift. Also, a breast lift alone will not change the amount of breast tissue a patient has naturally, it will only reshape the breast and or reposition the nipples.

Breast lift without implants
If a patient wishes to have larger perkier breasts they may want to include an augmentation with their breast lift surgery.

Detailed mastopexy with breast implants
Many patients ask the breast expert, doctors, how they can evaluate their breasts before their consultation to determine if they need a breast lift. Below is a basic check list for patients which may help to determine whether a breast lift is right for them.

Breast Lift Checklist

1. One or both of your nipples point downward.
2. One or both of your nipples are at or below your breast crease.
3. Your breasts lack a pleasant shape and firmness.
4. Your breast skin is loose and sags and the nipples are at an undesirable location on the breasts.
5. Your breasts size is good, but they are pendulous and their shape and nipple location could be improved.
6. You have a breast deformity.
7. You have had children and or breast fed and noticed changes in breast shape, skin tone, firmness and the nipple location.
8. You have had weight loss and have skin laxity and nipples at or below the inframammary crease.
9. If you want your nipples higher on the breasts.
10. You want your breasts to be “Perkier”.
11. If one of your nipples is at a different height than the other and a lift is need to correct the difference.

You may be a candidate for a breast lift if you meet any of the criteria if you checked off one or more of the 11 points from the checklist and you would also like to increase your breast size you may be a candidate for a breast lift with augmentation.

If you have not checked off any of these 11 points and you just want to increase your breast size, you may be a good candidate for an augmentation mammoplasty. There are many breast surgery options to give you the prettiest breasts. Doctors can perform any type of breast lift. The doctor generally evaluates each patient’s anatomy and surgery goals to determine which breast lift will give the patient the best results. doctors performs crescent lifts, Binelldoctors breast lifts, circum areolar breast lifts, Lajour breast lifts, Spair breast lifts or inverted T breast lifts. In evaluating each patients need the doctor tries to suggest a plastic surgery procedure that will give each patient maximum lift with minimal scarring.

If a woman’s breasts are very droopy and the nipples are at or below the breast crease it is very likely that they would benefit from a circum vertical breast lift. The saggier the breasts and the lower the location of the nipple or nipples the more detailed the breast lift should be.

Not all Plastic Surgeons are created Equal (Circum vertical mastopexy)
Not all Surgeons perform the many different breast lift techniques. Beware of “the too good to be true” surgery options. The majority of the breast lift revisions corrected from other surgeons work are usually due to the patient needing a major breast lift and the surgeon only performed a minor breast lift procedure to try and correct the breast ptosis.

Breast Lift Augmentation Patient Evaluation
One of the most important aspects of a patient’s consultation is the surgeon’s physical examination and evaluation of the patients surgical needs. For example, a patient who has droopy breasts with nipples at or below the breast crease would not benefit from a crescent lift only. If a crescent breast lift is performed on this type of patient, minimal to no breast lift can be expected and because the incision is at the top of the nipple areolar only, generally the nipple will be pulled up slightly and the weight of the breasts can cause the nipples to be misshapen and or to become enlarged and stretched out.

Constricted Breast Deformity
Also for patients with various natural breast deformities like constricted breasts the diagnosis must be recognized by the plastic surgeon prior to surgery. Initial diagnosis is important for a number of reasons. First so the patient can be informed of the deformity. Second, so the surgeon can educated the patient on the corrective surgery procedure. And third, if the constricted breast diagnosis is not made before surgery, and the proper reconstructive surgery is not done, the shape and unattractive appearance of the breast deformity may look worse after surgery. Patients with constricted breasts are not candidates for breast augmentation alone. If a plastic surgeon inexperienced in this diagnosis fails to recognize the appearance of one or both constricted breasts and fails todo a liftthe patient will not have an attractive surgical outcome.

Constricted Breasts
An Accurate Evaluation + An Experienced Plastic Surgeon = Beautiful Breasts
A better candidate for the crescent lift is a patient who has nipples at different heights and needs a slight lift on one nipple to match the other nipple height or a patient who would benefit from a slight nipple lift on both sides.

Crescent Lift On One Nipple
Sometimes women who have had pregnancies and or breast fed have pseudo ptosis where there is a lot of extra skin, less breast tissue and nipples that sit above the breast crease. These women may also be good candidates for crescent breast lifts with breast augmentations to restore fullness to the breast and give them a more youthful appearance.

Pseudo Ptosis Crescent Lift Personal Consultation
The best way to determine which breast enhancement surgery will create the most beautiful breasts for you is to be evaluated by a board certified plastic surgeon who is experienced in all the different types of breast lift techniques. When booking your personal consultation with doctors’ offices please let the staff know if you think you are a candidate for a breast lift. This may add a little extra time to your consultation. The goal is to give you the most accurate, and informative information on the latest surgery techniques. Doctors should take great pride in educating you about the breast procedure that will give you the beautiful breasts you desire.

SPAIR Lift - Breast Lift Augmentation
Over the years, factors such as pregnancy, nursing, weight loss and the force of gravity take their toll on a woman’s breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. The Breast Lift or Mastopexy is a procedure to reshape the breast and create or restore a more youthful “perkier” appearance. Most women are happier with the more youthful appearance of their breasts after a breast lift and feel more attractive. Many women, especially those with very drooping breasts, say that they are more comfortable after the breast lift and are better able to participate in physical activity.

Many women seek a mastopexy because pregnancy and nursing have left them with stretched skin and less volume in their breasts. However, if you’re planning to have more children shortly after surgery, it may be a good idea to postpone your breast lift. While there are no special risks that affect future pregnancies, pregnancy is likely to stretch your breasts again and offset the results of the procedure.

Breast Lift Augmentation Procedure
Formally breast reductions and most breast lifts were done with what has been called an inverted-T or anchor scar. The inverted-T surgery, which is still performed by the vast majority of cosmetic surgeons in the world, leaves patients with a long scar along the lower contour of the breast as well as up the breast that often shows when wearing a bathing suit, lingerie, and low cut tops. In an effort to offer his patients the state-of-the-art in cosmetic surgery, doctors uses what is known as the SPAIR technique, a new procedure that very few surgeons in the United States have adopted or are even aware of. With the new surgery technique, the incision under the breast has now been done away with and the anchor scar is a thing of the past. The patient ends up with a better-shaped breast and with a limited amount of scarring. In most cases the scar can be either limited to around the nipple-areola complex, or for larger breasts, a short vertical scar going down from the areola. The results are patients with less scarring, quicker recovery and patients who are happier with the new size and shape of their breasts.

Breast  Enlargement  with Breast Lift or Augmentation Mastopexy:
Breast Augmentation in the presence of breast ptosis or skin droop requires correction of the excess of skin and the breast disproportion, in addition to enlargement of the breast volume. True ptosis of the breast is seen when the level of the nipple falls to a point at, or below, the level of the fold beneath the breast. There is usually too much breast skin and too little breast tissue volume in this situation, leading to the appearance of elongated and flattened breasts. A variant is seen where there is adequate breast volume, but a high positioning of the lower breast folds, and the resultant appearance of low - positioned nipple areolae. In either instance, upward relocation of the nipples, and tightening of the skin is needed, along with adjustment of the position of the lower and lateral breast folds. doctors always prefer placement of implants beneath the pectoral chest muscles, to prevent mammogram interference, and to prevent surface wrinkling of the breasts that is often seen with implants above the muscle (directly behind the breast gland tissues).

By approaching breast implant placement via the Trans-Axillary technique (via the armpit), doctors are also able to prevent potential contamination of the breast implants with germs that are known to reside in the breast tissue ducts, and are probably responsible for the frequent finding of firm scar formation around implants that are placed above the muscle. Also, the axillary route to the submuscular plane will preserve the intact muscular fascial envelope from the chest muscles to the abdominal muscles, maintaining “internal bra - like” support.  Breast Lift in concert with Breast Augmentation Mammaplasty is a more complex procedure than breast enlargement alone, and thus will require a longer period of skin adjustment until the absolute final result is apparent.

Mastopexy or Breast Lift at the time of Breast Augmentation always requires some type of incision, or incisions, in the breast skin, and thus there is a trade-off in achieving improved breast shape and breast size, in exchange for some scars. Depending upon the degree of sag present, several different mastopexy approaches may be used to tailor the skin, while placing the least number of scars on the surface of the breast. Mastopexy seldom leads to loss of nipple sensation by the techniques that doctors favor. Fortunately, breast scars, if necessary, will fade and flatten out with the passage of time. Examples of several techniques are shown below and on the linked pages.

Breast Lift Augmentation Choices
Women choose to have breast augmentation for different reasons. Some desire larger breasts. Others want to replace breast contour that is often lost during pregnancy. In the procedure, an implant is placed underneath the breast tissue. Sometimes it is placed under the chest muscles. The choice of implant position is based on the shape of your current breast, the amount of breast tissue and overall body size. Incisions are made in one of three locations: Under the nipple, under the breast or in the underarm. Again, the choice of incision position is based on current body and breast shape. Most of our breast augmentations use our “Silent Scar” technique to help hide the scar. You can read comprehensive information about breast enhancement at our Breast Augmentation Information Center including the latest information on silicone breast implants which were recently approved by the FDA.

During your consultation for Breast Lift Augmentation, your plastic surgeon will examine you and discuss recommendations for implant and incision placement to yield the best results. Doctors perform breast augmentation using both saline and silicone implants. The procedure is usually done as an outpatient, under general anesthesia administered by a physician anesthesiologist to minimize discomfort during the procedure. Most patients have very little pain following the surgery as well because long-acting local anesthetic is administered as part of the procedure. Most patients return to work about a week after surgery. There may be some bruising for a week or so and some swelling for a few weeks following surgery.

Breast Lift Augmentation Consultation
As women age, their breasts may sag somewhat. This can be exacerbated by pregnancy or nursing. In these situations, many women enjoy beneficial results from a breast lift or “mastopexy.” In this procedure, the skin of the breast is tightened to return the breast to a more youthful shape, firmness, and position. Sometimes an implant is placed as part of the procedure to increase breast volume. Incisions are usually around the nipple and sometimes extend down to the underside of the breast. There are a lot of options in breast lift surgery, and plastic surgeons should work with you to choose the approach that will create the best results. Some women may be candidates for a breast reduction procedure rather than a lift.

During your Breast Lift Augmentation consultation, your plastic surgeon will discuss recommendations for the type of incision to use and the possible benefits of including an implant as part of the procedure. The procedure is usually done as an outpatient, under general anesthesia administered by a physician anesthesiologist to minimize discomfort during the procedure. Most patients have very little pain following the surgery as well because long-acting local anesthetic is administered as part of the procedure. Most patients return to work about a week after surgery. There may be some bruising for a week or so and some swelling for a few weeks following surgery.

Male Chest Surgery (Gynecomastia)
Many men develop excess skin or breast tissue on their chests. This is a syndrome called gynecomastia and can lead to discomfort and embarrassment. The problem can be treated with direct excisional surgery, liposuction, or a combination of the two. Your anatomy will determine the best approach, and your plastic surgeon will explain how best to proceed. Learn more about plastic surgery for men.