Breast lifts rank about 7th on the list of most frequently performed cosmetic surgery procedures in the U.S. Most women are seeking a return to their youthful, “perkier” breasts that they had before child rearing or aging when gravity took it’s toll. The procedure involves incisions above and around the nipple, reduction of areolar size,  removal of excess loose skin, and reshaping the breast tissue higher on the chest wall. It is essentially a “hemming” of the breast. Patients frequently manually pull the skin above their breasts or raise their arms to mimic the desired effect.

Mastopexy is not so simple and requires a combination of knowledge of anatomy and artistic flair to achieve a good result. One of the problems with lifting is that gravity will continue to effect the result and the full high breasts of the early postoperative period are bound to “fall” with time. Various techniques have been adopted to overcome this. One technique, the vertical Mastopexy,  uses internal sutures to shape the breast tissue which is somewhat different than the traditional method which relies on the skin to hold up the shape. This technique also results in less scar length. However, not all patients are candidates  for “reduced scar ” techniques. Those with very droopy breasts  and with lots of excess skin are better served with the traditional inverted T or “anchor scar” . These women usually have lost a lot of weight or suffered significantly from gravity and aging. In many cases, adding additional internal support with an absorbent surgical mesh such as Seri silk or Strattice is recommended to hold the re-positioned breast tissue in place while wound healing occurs and allows for a more lasting result.

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The need or desire for a breast implant in addition to the lift is a critical decision . If you cup your breast tissue together and simulate a lift and still feel you are not big enough, then you need an implant. It does not need to be too big; in fact I advise patients to avoid going too large. Augmentation Mastopexy is a tricky surgery where the surgeon is simultaneously trying to reduce the skin excess while enlarging the breast volume. Two goals that run somewhat contrary to each other. The revision rate can be pretty high, as much as 25% even in nationally renowned breast specialists. Performing augmentation separately from the lift does not necessarily eliminate the need for revisions and requires two separate operations, something few patients desire.

In general, satisfaction with Mastopexy or  an Augmentation Mastopexy is very high, but be prepared for minor adjustments to achieve the ideal outcome.



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