My approach towards breast surgery in all patients is to create a natural result, as women today desire beautifully shaped breasts that do not look as though they’ve been operated on. In patients requiring breast augmentation surgery, the trend is to use more naturally shaped breast implants that prevent the telltale round “stuck on” appearance of breast augmentation surgery. Many patients today however are completely happy with the size of their breasts and are more concerned about sagging in this area. Patients want to be able to wear revealing clothes without a bra but do not want to look as though they’ve undergone a procedure. This is one of the main reasons why I am seeing an increase in patients requesting a breast lift rather than a breast augmentation.
Breasts sag due to gravity taking it’s toll, breastfeeding can also stretch the breast skin and as we age, our hormones decrease, so too does the volume of the breasts. As the skin loses it’s elasticity, the breasts often lose their shape and firmness and begin to sag. A breast lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts—at least, for a time, as no surgery can permanently delay the effects of gravity. Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple.
Breast lift surgery has for many years been a life changing procedure for many patients. Recent advances in minimizing the extensive scars of the past have improved results and have encouraged more ladies to seek breast lift surgery. I tend to use the short scar (lollipop) technique in most of my patients, unless the breasts are too large. The resultant short scar gives patients more confidence and allows them to wear more revealing clothes than they could with the longer older inverted T scar.
A short scar breast lift procedure is more than just a change in the scar. It is a change in the philosophy of how a breast lift is performed. Rather than using the skin to hold up the breast, the breast tissue is completely remodeled, creating an internal bra so that the breast sits in a higher position without the help of the skin. The breast tissue that remains is never disconnected from the nipple, which optimizes the possibility of breastfeeding in the future. Sagging breasts with enough volume and without stretch marks and with good elasticity are perfect for lollipop scars.
Some patients may experience sagging of their breasts and would like a slight increase in the volume of the upper pole of the breasts. In the past, plastic surgeons have tried to give the illusion that the breasts are lifted by inserting a larger implant to fill this extra skin and prevent the scars associated with a breast lift. But, I find that most of these patients are disappointed a few years after the surgery as they have traded “small hanging breasts” for “larger hanging breasts”. They are still not able to wear a shoestring top without a bra as the nipple areola complex is still sitting in the same place as before the surgery.
In patients requiring a more natural result without a breast implant, a breast lift can be performed to improve the sagging and the shape and volume can be improved by injecting their own fat into the upper pole of the breast for a natural upper pole fullness. Autogenous fat grafts offer the advantages of preventing the long-term complications associated with the implantation of a breast implant.
Prosthetic breast implants have been the golden standard for decades to improve breast shape. However, many women today are looking for options without the possible complications of an implant and, therefore, are looking at some of the newer more natural techniques to improve the shape and the size of their breasts. A breast lift with or without lipofilling of the upper pole is a safe and predictable procedure resulting in naturally perky breasts.