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Breast Lift Candidates

Women who benefit from mastopexy, (breast lift), include those who have sagging of the breast and/or low position of the nipple on the breast mound. This can be a situation that occurs after pregnancy, weight loss or patients can have sagging breasts from puberty. In some cases, patients need both a lift and an implant. If you like your breast size in a bra, you may not need an implant. Patients who require a breast lift are often concerned about the scars. However, good surgical technique and the use of good sutures can minimize scars. If a patient has excess skin that needs to be excised, there is simply no way around this and a scar is needed. A common mistake is to use an overlylarge implant to “take up”the excess skin. This results in a patient who is unhappy with her too large breast size and it also leads to increased sagging over time. Overly large implants is not a solution.

Scar Pattern

Breast sagging,or ptosis, is commonly classified by grade. Grade I, II and III. This refers to the position of the nipple in relation to the inframammary fold. How low the nipple is and how much extra skin needs to be removed determines the scar pattern. The scar can be: peri-areolar only, lollipop (peri-areolar plus vertical), lollipop with a short horizontal scar in the fold or anchor pattern.

Ptosis grade does not tell the whole story however. The breast tissue itself, not just the nipple, can be sagging. This is very common. In many cases I see the majority of the breast tissue is located below the fold. This tissue needs to be repositioned above the fold to create a pretty breast shape. Patients with poor tissue quality and loss of elasticity, including those with stretch marks (straie) are prone to recurrent sagging of the breast tissue. In some cases, I use material such as Galaflex or Seri to provide support to the breast weight, similar to creating an internal bra. This can help increase the longevity of the result.

Recovering from a Breast Lift

The recovery process for patients following a breast lift is fairly similar for almost all people. Paper tape is used to cover the incisions and patients wear a supportive, compressive bra. Drains are sometimes used. They are typically removed 1-2 weeks after surgery. When they are removed depends on how much fluid is draining. Typically there is minimal discomfort. As with all surgeries patients are advised to avoid strenuous exercise and heavy lifting for at least 2 weeks after surgery. Over time the initially swelling subsides and the scars will fade.

Breast Lift with Augmentation

Known as an augmentation mastopexy, this approach provides patients with a single surgical procedure that addresses the breasts in multiple dimensions. The excess skin is removed, the nipple is repositioned, the breast tissue is shaped and lifted and an implant is use to restore volume. In addition to having the ability to increase the size and fullness of the breasts, an augmentation mastopexy can correct breast sagging at the same time. The key to successful mastopexy augmentation is to use the smallest size implant possible. Implants add weight to the breast and, over time, can lead to recurrent sagging. For this reason, I prefer to use textured implants when performing a breast lift with implants. The texture helps to stabilize the position of the implant.

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