Breast Lift (Mastopexy) with or without Augmentation
Breast lift is typically performed to lift the lower level of nipples, and also, elevate the saggy breast tissue. Often, patients refer themselves to request a “breast lift”, but often, these patients do not require “lifting” but are well served with breast augmentation.
The patients who truly need a breast lift are those with a significantly lower level of nipples – lower than the bottom of the breast on a profile view. Those whose nipples are at the level of the bottom of the breast may be treated with breast augmentation, depending upon the length between the nipple and the collar bone. In general, the patients with saggy breast with a low level of nipples, have a large amount of excess skin – typically seen after pregnancy, or after the large volume weight loss. Those patients usually need to have anchor shaped breast lift – scar around the nipple, then down to the bottom of breast, and along the base of the breast. This is also called “inverted T” shape incision or a “Wise” pattern scar. Alternatively, depending upon the shape and volume of the breast, a short scar lifting may be possible. This procedure is usually for those with lower level of nipple but not too much sagging of the breast tissue, and it leaves a circumferential scar around the nipple and short vertical scar – avoiding the long scar at the bottom of the breast.
Often, those patients with flatness over the upper half of the breast tend to have over all small breast volume (although there is an excess of the SKIN of the breast), a breast lift alone may not be enough to achieve fuller shape of the breast particularly to provide a fullness over the upper portion of the breast. In these patients, it would be reasonable to place an implant to give more volume to the breast.
Performing a breast augmentation at the time of the breast lift is one of most challenging procedures in breast cosmetic procedures. There are risks of scarring, delayed healing, unevenness (particularly the bottom of the breast), and asymmetry. Generally, Dr Kim places moderate sized implants to avoid excess tension to the breast incision.
If the patient wishes to have a large breast after lifting and augmentation, Dr Kim usually recommends to have a breast lift first, and then, 6 months or more later, she can have an augmentation with the saline or silicon gel implants with her desired size.
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