A Breast Lift Technique that Restores Upper Breast Fullness without Implants
Many plastic surgeons routinely place breast implants as part of the breast lift (mastopexy) operation. They do this to provide fullness in the upper portion of the breast after surgery. Many common breast lift techniques do not provide adequate volume to the upper portion of the breasts over the long term unless implants are used.
Many methods of breast lifting rely upon a tightening of the skin as the only mechanism to lift the breast. A pinch of skin is taken from along the fold under the breast, from the midline of the breast below the nipple, or from both zones. This tightening of the skin will lift the breast, but with time the lift may be partially lost due to a stretching out of the skin. As this happens the deeper tissue of the breast tends to settle, which leaves a hollow upper portion of the breast.
If the plastic surgeon places an implant behind the breast structure or underneath the pec muscle, the implant will help to keep the upper portion of the breast full, even if the breast settles. Although this seems to be a logical solution, there are two disadvantages.
Two Possible Disadvantages to Combining Breast Implants with a Breast Lift
The first disadvantage of adding an implant to a lift is that many patients who desire a lift really don’t want larger breasts. They simply want to restore the breasts to a pleasing tone and position.
The second disadvantage is that the patient who has undergone a combined breast augmentation and lift must be willing to accept the long term disadvantages of breast implants. Although a well-performed breast augmentation carries a very high rate of long-term satisfaction, some patients will require surgery to address implant issues.
There are two main problems that can occur in some patients after breast augmentation surgery. The first problem is a loss of integrity of the implant shell. This can occur just with the wear and tear of everyday life. The second problem is capsular contracture, a tightening of scar tissue around the implant which can make the breast feel firm and affect breast shape. Both problems can be fixed, but further surgery is necessary. If a woman desires greater breast volume, she may be willing to accept these two possible disadvantages of implants. On the other hand, if an implant is used simply to round out the upper portion of the breast and actually makes the breast larger than the patient would like, it can be frustrating if the implant develops a problem.
How a Structural Breast Lift Uses Natural Breast Tissue to Restore Fullness to the Upper Part of the Breast
With a structural breast lift I release a portion of the breast tissue from the lower part of the breast and tuck it under the breast so that it is anchored beneath the upper part of the breast. This has two desirable consequences. First, the upper portion of the breast is filled out with natural breast structure rather than an implant. Some people refer to this as auto-augmentation. Second, the structure of the breast is anchored to a new position at a deep level. This means that the skin does not need to do all the work of breast lifting.
Is the Structural Breast Lift by Itself the Answer to Every Woman Who Desires a Breast Lift?
There are two key issues that I assess when I evaluate a patient for structural breast lifting. The first is how well I be able to move the nipple and areola to a higher position with a given breast structure. There are certain breast structures that impose a limit in this regard. If I don’t feel that the nipple will move well, then I will suggest that we use a classical anchor pattern for the breast lift.
A second issue is when there is severe horizontal stretching of the lower portion of the breast. If this is so I may need to use a classical pattern incision to remove all of the excess skin.
Structural Lifting Works Very Well When Combined with Breast Implants
What I have just said does not in any way imply that the structural technique of breast lifting cannot be combined with breast implants. For patients who desire a lift plus increased volume a structural mastopexy and breast implants provide an excellent combination.
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