Breast Augmentation & Mastopexy (Lift)
Breast Augmentation & Mastopexy Overview
When the breasts are small or deflated and also show a significant amount of drooping, a procedure combining both the placement of implants and repositioning the breast tissue may be required. This combined procedure is technically more demanding than either procedure performed alone but can give a great result in a single operation.
Best Candidates
When the breasts are small or deflated and also show a significant amount of drooping, a procedure combining both the placement of implants and repositioning the breast tissue may be required. This combined procedure is technically more demanding than either procedure performed alone but can give a great result in a single operation.
Patients who have this procedure performed most often are those that have had deflation of their breasts due to pregnancy or the aging process. When possible, we try to correct borderline patients with placement of a breast implant alone, as this is a more straightforward procedure.
However, for some patients implant placement alone is not adequate. Try this test: if your nipple hangs lower than the fold where the lower part of your breast meets the chest, you will probably require a lift as well as an implant to correct your appearance.
Patients who we see in consultation regarding a breast lift alone are often good candidates for this if they have adequate breast tissue available. However, the addition of a small to moderate size implant to a lift can help maintain the long term result of the lift, particularly in keeping fullness in the upper pole.
Types of Implants
- Silicone – For the majority of our patients, we utilize round, smooth walled silicone gel implants. For most patients we find that the silicone implants have a softer, more natural feel than the saline implants. The silicone implants now available are superior to those used many years ago that were prone to leakage and rupture, as the gel that fills the implant is thicker and the outer shell is more durable than the early styles.
- Saline– In the early years of our practice, before silicone implants were available for routine use in cosmetic patients, we had many patients with great results using saline implants. In terms of appearance, the difference between a saline and silicone implant is seldom visible. Although they don’t feel quite as soft as a silicone implant, there are some advantages. In addition to being a less expensive implant, they can generally be placed through a smaller incision as they are filled to their final volume once they are inside the breast. Minor size adjustments can be made on the operating table to correct asymmetry by putting different amounts of saline (salt water) in each implant. Although long-term studies have shown they are more prone to leak after many years than a silicone implant, they are easier to replace should a leak occur.
- Round versus teardrop shaped– We typically use round implants for cosmetic augmentation/mastopexy although we have placed the anatomic (teardrop) shaped implants in the past. We stopped using them around 20 years ago. While we had no real problems with the anatomic implants, they were more expensive, somewhat more difficult to place, and we really couldn’t see much difference in the final appearance compared to a round implant. These implants are not currently available in the U.S. as they had a textured surface to prevent rotation of the implants.
- Smooth Versus Textured– We place smooth walled implants, as textured implants are not currently on the market due to FDA concerns regarding their long term safety.
- Low, Medium, or High Profile– The “profile” of an implant essentially refers to how tall it is relative to the size of the base. A low profile implant has a broad base but is relatively flat compared to a high profile implant. For most patients, we use a moderate pr
Choosing an Implant Type
The implant size we use during the surgery depends on many factors. We feel there is no magic formula or computer imaging system that can pick your implant for you. Choosing the right-sized implants requires time. We begin by measuring your breasts and chest wall and assessing the amount of tissue already present. We’ll talk to you about your desired appearance, your level of physical activity, and other factors.
We then have you try different sizes of implants placed within your bra to see what you think looks full and natural for you. Based on our measurements and your input, we’ll work with you to choose the right implant that fits you and your lifestyle.