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Are you happy with your breasts?
After pregnancy, childbirth or breast feeding, breasts may lost volume (atrophy) and droop but there is much that can be done.
If the breasts droop and the woman is happy with the size, then only a lift procedure is required. If the breasts droop and the woman feels she is too large, then a reduction and lift is required. Breasts that are perceived as small and drooping, require a lift with volume replacement of augmentation.
Procedures
Breasts lift plus augmentation is often considered one of the more technically difficult procedures to perform. The lift part of the procedure tends to compress and realign breast tissue to make the breast cone tighter and more projected within a tighter skin envelope. The augmentation part tends to expand and push the breast tissue and skin envelope in an outward direction. These two effects work against each other.
Due to this difficulty, some surgeons elect to perform the surgery in two stages performing the left and augmentation separately. Other surgeons will perform surgery as a single stage but accept there may be a need for some revision.
Breast droop or ptosis is measured in relation to a number of points. The nipple should be at the level of the infra-mammary fold (fold where the undersurface of the breast meets the chest wall), or the midpoint of the arm bone (humerus) or a known distance from the jugular notch (the base of the neck). This is dependent on the woman’s height and general body habitus. The breasts need to be assessed from the basis on which they sit.
Other factors
Careful examination of the back for scoliosis, chest wall for deformities or irregularities and rib characteristics is performed as this may influence the final breast position and shape. Armpits of axillae are also examined as part of a comprehensive breast examination. Lumps, thickenings, cysts or other breast abnormalities need to be excluded.
Many techniques are available to lift the breasts. This usually reflects the amount of lift required and influences the resultant scar pattern. A lift procedure may be based around the areaola with a resulting circular scar. A bigger lift may require a vertical component to the scar, often described as a ‘lollipop’ shaped scar. Further lifts may leave an anchor shaped scar with the lower curved scar in the infra-mammary fold.
Implants
As the lift is being performed, the implants are inserted. All the usually variables that apply to implants are considered. These include size, silicone/saline, round-shaped, smooth-textured and also the position of the pocket into which they are placed – in front or behind the muscle. These are individualized depending on the relative amount of lift or augmentation required.
The procedure is usually performed in hospital with a combination of local and general anaesthetic. An overnight stay is usually required. Plastic or silicone drainage tubes are not always used. Dressings are bulky and tight to give firm support and pressure. A supportive sports-type bra is worn to hold and support the healing breasts. Scars require active management after surgery tyo optimize the outcome. Surgery is usually well tolerated with very favourable results.
More information
A good idea would be to refer to my previous articles written specifically about breast augmentation as all the choices, outcomes and complications are fully explained. Articles covering breast lift or reduction surgery should also be read as a lift plus augmentation is an overlap procedure that has aspects of the individual procedures.