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For women who have lost breast size or with breasts that have become droopy as a result of childbearing, age, and/or weight loss, a combination breast lift and breast augmentation is usually the most effective method for breast enhancement.
Though in some cases of very minor breast ptosis, an implant can inflate and lift the breast adequately, the majority of women with significant ptosis and insufficient breast size require a combined breast lift and augmentation to achieve optimal results. An implant is used to increase the volume, proportion and upper breast fullness. The breast lift is used to reshape the breast, elevate the areolas and to remove extra skin.
The mastopexy-augmentation techniques available are similar to those used for mastopexy alone. That is, areolar, vertical and inverted-T breast lifts are all used with augmentation.
It is important to note that mastopexy and breast augmentation can be approached in a "staged" fashion. In a staged approach, one procedure is performed alone and the results are assessed. If the other procedure is then desired, it is performed 3-6 months after the first.
The staged approach is nice for women with minor breast ptosis, or mild breast asymmetry that may be happy with augmented, but slightly saggy breasts. In such cases, breast augmentation is performed first and the breast lift is performed later, only if desired by the patient.
Mastopexy alone can also be performed in patients that are not certain they need the additional volume from an implant. In these cases, the mastopexy is performed first and the breast augmentation is performed months later, only if desired.
In most cases where a breast lift and breast implants are clearly desired, we combine the procedures as a single operation. Dr. Connall will discuss these options with you in detail during your consultation.
This example of a circumareolar breast lift shows the circular pattern of skin that is removed around the areolas. The implants are placed through the lower edge of the areolas The skin is then tightened around the areolas like a "purse string" and the breasts are lifted and the areolas are repositioned in a higher location.
This drawing shows a circumareolar mastopexy and augmentation. For the first few weeks after surgery, the implant is high on the chest and the skin is very puckered around the areola. Over time, the puckered skin flattens and the implants settle at the bases of the breasts.
This figure shows the results of a vertical breast lift after several weeks of healing. The upper breast fullness and swelling have resolved, the breast tissue has "dropped", and the lower poles of the breasts have rounded out.
This is an example of a vertical breast lift. The implant is inserted through the lower part of the skin cut-out. The areola is then slid into a higher position and the skin is tightened and closed around the areola. Often, the deeper layers of tissue are also sewn together and tightened to shape the breast.
Here is the vertical breast lift and augmentation after the implants have been placed and the incisions are closed. Note the scar around the areola and down the center of the breast in the shape of a lollipop. The first few weeks after surgery implants are slightly high on the chest and the lower breast is flat and tight.
This figure shows the results of an inverted-T breast lift after several weeks of healing. The upper breast fullness and swelling have resolved, the breast tissue has "dropped", and the lower poles of the breasts have rounded out.
The inverted "T" breast lift results in removal of skin from around the areola, down the center of the breast and from the lower portion of the breast. The areola remains attached to the breast tissue, nerves, and blood vessels. This technique is used in moderate to severe cases of breast ptosis.
This figure shows the final skin closure and the breast shape after surgery. After removal of the skin, the areola is slid into a higher position and the skin is wrapped around the breast tissue and closed with dissolvable sutures. During the first few weeks after surgery, the breasts are tight, swollen and perky.