Sagging breasts due to past pregnancies, weight changes, genetics, or aging. Enlarged nipple-areola complexes (pigmented areas around nipples). Asymmetry of the level of the nipples in the standing position.
An elevated, more youthful breast contour.
The consultation for breast lift first begins with a question. Are you happy with the size of the breast? From this point, we can then decide if we will be augmenting, reducing or keeping the size the same as we lift the breast. We stress to our patients that gravity is unyielding. Adding weight to an already sagging breast and then trying to lift it and keep it there is often times hard to accomplish. Therefore, adding large implants and doing a lift at the same time may be counterproductive. It is always better to add a smaller implant to just fill the upper portion of the breast and do a lift that removes as much of the stretched skin as possible. There are many different types of lifts, ranging from small crescents of skin removal above the areola, to lifts that produce scars extending around the areola and vertically downward to the crease (lollypop shape). The options of each type of lift and whether an implant will also be used will be discussed at consultation.
Mastopexy (Breast Lift) either with an implant or small reduction is done under a laryngeal mask anesthetic with added local anesthesia as an outpatient. The design of the incisions can be a crescent; lollypop or “T” shaped depending on the amount of the skin that needs to be removed to correctly position the breast on the chest wall.
A small crescent of skin is removed from above the areola leaving a scar at the top of the areola only. This procedure is reserved for very small amounts of lifting and sometimes to correct asymmetry.
PURSE STRING (PERIAREOLA) MASTOPEXY
In small to moderate breast skin removals, we can sometimes do the lift using only a scar that surrounds the areola in a circle. We will also utilize this technique for misshapen breasts that have a pointy appearance (tubular breasts) in order to flatten the contour of the breast.
When more skin removal is necessary to lift the breast, the extra is removed from the bottom in a vertical direction in addition to around the areola. The resulting scar takes on the shape of a lollypop but can also have a small horizontal portion, extending out to the side of the breast.
This type of lift is reserved for situations in which a fair amount of skin needs to be removed. We see this commonly after severe weight loss or when a significant breast volume reduction is also desired. The resultant scar appears as a T shape connected to the circle scar around the areola.
Recuperation and Healing
The patient goes home with only a light dressing over the incision lines. Sutures dissolve on their own. Initial discomfort is easily controlled with oral pain relievers. Light activities can be started in 7-10 days. Contact sports should be avoided for 6 weeks.
Additional procedures that may enhance the result are a small breast reduction or breast enlargement with an implant placement.
The specific risks and the suitability of this procedure for a given individual can be determined at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.