Dr. Brooke R. Seckel
Following pregnancy and weight loss many women notice that their breasts have not only decreased in size but also have sagged, a condition called Mammary Ptosis. Breast augmentation with implants alone is often not enough to restore the breast to a pre pregnancy appearance. Often breast augmentation with a breast lift is required for the best possible result.
Women who have sagging breasts, technically called mammary ptosis or breast ptosis, often need a breast lift with implants rather than breast implants alone. The most common cause of breast ptosis or sagging is pregnancy and or weight loss. The breast consists of breast gland, normal fat and skin supporting the gland. During pregnancy the breast gland, fat, and the breast skin enlarge significantly to prepare the breast to produce milk. After breast-feeding is stopped the breast gland shrinks, the extra fat dissolves but the stretched breast skin does not shrink as much. The result is that the smaller breast gland is now held in a larger envelope of skin which causes the breast to sag or hang down on the chest.
Before and after photo breast augmentation with breast lift
Of course an in person consultation with a board certified plastic surgeon will be needed for you to know whether or not you need breast augmentation with breast lift.
The most important factor in determining whether or not you will need a breast lift with implants is the position of your nipple and areola in relation to your inframammary crease, the fold beneath your breast. Generally speaking if your nipple is below the inframammary crease when you look into a mirror with your arms at your side, then you may need a breast lift.
One simple test that you can do at home is called the Pencil test. Simply place a pencil into the fold beneath your breast and drop the breast over the pencil. If the pencil stays in the fold held by the overlying breast then you may need a breast lift.
Before and after photo of breast augmentation with breast lift side view
However there are many degrees of severity of mammary ptosis and simply failing the Pencil test may not indicate that you need a combination breast augmentation with breast lift. In many cases the pencil test is failed simply because the breast gland holds the pencil in place but the nipple and areola are still well above the inframammary fold. In this case a breast augmentation alone may be all that you need.
There are several different types of breast lift procedures that are available. They are commonly classified according to the type of scar that will show on your breast after the breast lift. A Periareolar breast lift produces only a scar around the areola and can be used when there is only a small amount of breast ptosis or sagging and the nipple areola is not significantly below the inframammary crease or the fold beneath your breast.
Photo of breast augmentation with periareolar breast lift
Vertical breast lifts involve a scar around the areola but also have a straight up-and-down scar running from the areola down the lower part of the breast into the fold beneath your breast. A Lollipop breast lift includes a scar around the areola down the breast to the fold and when viewed from the front the circle around the areola and the vertical line running down looks like a lollipop. This lift can be used on mild-to-moderate forms of breast ptosis. The Anchor lift involves not only a scar around the areola and a vertical scar running down the bottom of the breast but also a horizontal scar within the inframammary fold. The anchor breast lift scar is often referred to as an inverted or upside down T but when viewed from the front the scar can look like an anchor.
Photo of breast augmentation with Lollipop breast lift scar
The most important thing during a breast lift is that the blood supply to the nipple areola be preserved so that injury or damage does not occur. Plastic surgeons take great care to preserve blood supply to the nipple areola during a breast lift.
Traditionally when a breast augmentation with lift was required plastic surgeons performed the two operations as separate procedures separated by three to six months. This custom was guided by the fact that better final positioning of the breast implant could be achieved by allowing the breast first to adjust to the breast lift. In addition any necessary modifications of the lift could be done at the second procedure.
Today plastic surgery techniques and experience have advanced to improve the results when combining breast augmentation and lift in one procedure. However the main concern when breast augmentation is combined with a breast lift is that the implant should not compromise blood flow to the nipple areola by causing pressure on the blood vessels supplying the nipple areola.
Today most plastic surgeons if combining breast augmentation with breast lift insist on placing the breast implant beneath the chest muscle to support the implant and prevent pressure on the nipple areola. Very experienced plastic surgeons are able to achieve excellent results doing breast augmentation with breast lift combined in one procedure
Patients with larger breasts can accommodate larger breast implants beneath the chest muscle than can smaller breasted patients. In my practice generally speaking when combining breast augmentation with a lift, I most often use naturally sized breast implants large enough to create a full breast but not overly large.
Consult a plastic surgeon who is certified by the American Board of Plastic Surgery. Members of the American Society of Aesthetic Plastic Surgeons are board certified and experienced in Aesthetic Plastic Surgery. The Smart Beauty Guide is another good reference to check.