Breast sagging (ptosis) is a natural occurrence in nearly all women. This occurs as a result of age and especially as a result of breast feeding. Although most patients who have breast lift done have had children, there is a significant number of patients who have not. As we age and as a result of having children (postpartum), the breast tissue becomes less glandular and more fatty. The volume of the breast tissue typically decreases and the connective tissue ligaments that suspend the breast gland tissue to the chest wall muscle become weakened. The net result is stretching/sagging of the breast tissue and skin away from the chest wall and also a deflation of the breasts (atrophy) that results in a loss of firmness, projection (perkiness), and breast size.
The Effects of Pregnancy
Following pregnancy, the vast majority of women will experience these changes as a natural result of the changing pregnancy hormones which influence the breast tissue and the stretching during the pregnancy as a result of breast engorgement and milk production. This is followed by the reduction in size of the breast resulting from the withdrawal of the pregnancy hormonal stimulation. A very small percentage of women (some may consider them fortunate) will depart from this usual course of breast inflation/deflation changes and actually experience a permanent enlargement of their breasts. This is typically accompanied by some degree of sagging.
The “Perks” of Breast Lift Surgery
Breast lift surgery is intended to elevate the breast center of mass and return it to a higher position on the chest more like it was at a younger age or before having children. The ideal goal is to reposition the level of the breast and nipple above the lower breast fold (submammary fold), reduce the excess skin envelope surrounding the breast tissue, and reshape the breast skin to create a more rounded or cone shape. Initially after the surgery, the breast will tend to be round in appearance, but with time, the shape will gradually change to a more natural teardrop configuration. Because the skin is tightened around the breast tissue, there is usually increased firmness and varying degrees of improved projection (perkiness).
Breast Lift in Combination
Breast lift is very often combined with breast augmentation to procedure a firmer and in some cases a larger breast if desired. The implant will also produce greater breast out lift/projection. The net result of the breast lift/augmentation combined procedure is higher, better shaped, firmer breasts with greater projection and size. Higher, firmer, bigger, perkier breasts are most patients’ goals. However, if higher better shaped breasts without greater size and projection are the goals then mastopexy alone may be the appropriate procedure. Even with this group of patients, the use of a small breast implant will serve to increase the firmness of the breast without any significant increase in size.
Tailoring to Your Needs
There are various techniques of the breast lift procedure which should be selected after careful assessment of the patient’s individual needs by the surgeon. As with most all cosmetic surgery procedures, there is usually not one best procedure technique for all patients. The specific procedure used should be selected and tailored to the patient. Not the patient to this procedure. The traditional full mastopexy procedure produces a scar that encircles the areola with a vertical line extending downward to the submammary fold connected to a horizontal curved “smiley face” scar in or just above the fold. This technique is often used when maximum elevation of the breast is required to reposition a sagging breast back higher up on the chest above the fold.
Other mastopexy procedures involve “short scar” techniques such as the vertical scar mastopexy, which also has the circular scar about the areola and only a vertical scar extending to the fold. Even smaller scar lifting procedures such as the circumareolar, periareolar or Binelli technique involve only a circular scar about the areola. These techniques however have limited application to patients requiring a small amount of lift and reshaping. Variations of any of these techniques may be used to provide the best lift and reshaping of the patient’s breasts.
The Breast Lift Procedure & Recovery
The breast lift procedure is performed as an outpatient surgery under general anesthesia or IV sedation and local anesthesia. It can require one hour to two and a half hours depending upon the extensiveness of the specific technique used and whether it is combined with the placement of a breast implant. The postoperative recovery period is typically short for the breast lift procedure alone and somewhat longer if it is done in combination with breast augmentation. Return to normal activities in three days is usual and more vigorous activity in about three weeks. The discomfort of breast lift is usually low and pain medication is given and used normally for bedtime. The scars will gradually fade and produce the best appearance at about 12 months or so after surgery.