A mastopexy or breast lift operation is designed to improve the shape and position of the breast without reducing their size. It is used for breasts which sag or droop (ptosis). Sagging of the breasts may occur with normal development for some women, or as part of the aging process. Pregnancy, breast-feeding and weight loss are other conditions which increase breast ptosis. Some patients will have a better shape to their breast such as increased superior fullness if an implant is used at the time of mastopexy. This is called an Augmentation/Mastopexy. The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create a nipple and areolae of the desired size and at the correct height.
A hybrid operation may use both an implant and fat harvested from the patient to provide the best contours of the lifted breast.
Those who are candidates for an Augmentation Mastopexy are those who are candidates for a Breast Lift and also those who are candidates for Breast Augmentation:
This outpatient basis procedure is performed under general anesthesia by a board-certified anesthesiologist, at one of our preferred outpatient surgery centers located in either Newport Beach or Huntington Beach. Both facilities are accredited and meet the highest standard of patient safety and care.
There are many techniques as we discussed with Breast Lifts. However, we commonly I prefer the lollipop or donut lift due to the shape, small scars and ease of healing. Additionally, the nipple-areola complex can be repositioned higher, excess skin removed, and the breast may be reshaped to an improved contour in a traditional position.
During an Augmentation Mastopexy, a small implant is added to restore volume or contour the upper breast. The insertion of an implant can restore superior fullness, which is lost with ptosis or sagging although the breast itself is large. An alternative is the Natura BreastLift or California BreastLift which shapes the breasts by transferring fat from a donor site, to the upper breast instead of an implant.
Mesh may be used to further support the breast. There are many types of mesh made by different companies. Each have a unique property to benefit the procedures and enhance the results of the Breast Lift.
Among the many are Seri, Belladerm , Flexiderm, Galaflex, Alloderm, Tigr, TiLoop, Strattice, ADM (acellular dermal matrix).
The main implants used in an Augmentation Mastopexy are either Silicone or Saline as mentioned in our provided Breast Augmentation page.
Shaped implants are all textured and should not rotate when used properly. You will be measured to determine the best shape and size of any implants that are used. Approximately 20% of my practice’s patients benefit from shaped implants.
Textured implants are designed to decrease cc. because the texturing holds them in place. Manually moving and massaging textured implants interferes with the healing process.
Silicone implants are pre-filled prior the surgery. Therefore, they are at their full size at the time of placement within the body unable to be altered.
The Four Common Implant Incision Sites
A full circle incision is made along the borders of the Areola (peri-areolar). This is most ideal incision used for saline implants as they require a smaller incision and are not filled until they are inside the body. The incision heals well but may increase the inability to successfully breast-feed. It also has an increased risk of capsular contracture (hardening of implant).
A well-hidden horizontal incision made in inframammary crease, or Breast Fold, at the bottom of the breast. Dr. Horowitz prefers this for silicone implants with a breast that falls over the fold. A very tiny incision can be used here for saline implants as well. This is the most common and recommended site for shaped silicone implant placement due to the longer incision necessary to accommodate the implant size.
The axillary or armpit incison should only by used by a well-qualified breast augmentation surgeon such as Dr.Horowitz. The surgeon may have special training, experience, and equipment for this method.
The Belly Button or Trans Umbilical Breast Augmentation (TUBA) is a common method for saline implants. The results are excellent and only a tiny incision in the belly button is required. Only saline implants can be inserted by this method. This must be done by a breast augmentation surgeon who has special training, experience, and equipment and often performs this technique. This is Dr. Horowitz’s preferred use for saline implants
If the incision is made through the umbilicus or under the arm, the surgeon will create a soft tissue tunnel to insert the implant into its “pocket” for the breast implant (endoscopic method). Depending on the location, existing scars on the breast or abdomen can be used as an insertion site.
The surgical sites to insert implants with a Breast Lift are the same as a Breast Augmentation on its own (http://www.pacificcenterplasticsurgery.com/breast-procedures-newport-beach/breast-augmentation/).
I usually prefer to do surgery in one stage. A number of plastic surgeons perform two operations rountinely. These procedures done separately, are usually staged at 2-3 months minimum to allow for swelling and healing to be at a reasonable point.
My revision rate for one stage is less than 15%. Two stages is not necessary for at least 85% of the patients when performed by an experienced Plastic Surgeon.
If you have significant asymmetry and tuberous breast I will still perform the breastlift and breast implant in one stage. I have about a 15% need for revision or secondary surgery but that is a better option then subjecting 100% of my patients to two stages as some surgeons prefer.
The patient will go home in a bra or with only light dressings over the incision lines. Sutures are dissolvable but an ending knot, if present is removed within 1-2 weeks. Initial discomfort is easily controlled with oral medication. Light activities may be started in 7-10 days.
Specific Information as you Heal
Healing will go on for 2-3 months for the early period. There may be some swelling, bruising, malposition, color differences. Sensation will be abnormal. Scars will be changing.
If my patients have concerns that something is unusual about their healing process, it is important for them to call the office and discuss these concerns or come in to be examined.
With time, gravity will have an effect on the breast skin causing it to stretch. The loss of elasticity and increase in sagging varies between women. Women with smaller breasts experience less recurring sagging. If sagging does occur, further excision of the skin on an outpatient basis can correct the problem. Heavy and larger breasts may lead to recurrent sagging requiring for the removal of some breast tissue to achieve an optimal shape and size. One key to a satisfying result is having realistic expectations of your procedures.
All surgical procedures carry some degree of risk. Risks with Augmentation Mastopexy are parallel with those associated with Breast Lift (Mastopexy) and Breast Implants (Augmentation). Changes in sensation, both breast and nipple, can result but occur less with Breast Lifts than Breast Reductions. Minor complications do occur but may not affect the surgical outcome. Larger Implants and aggressive Breast Lift techniques may cause more complication. However, major complications associated with this procedure are rare. Your suitability and risks for this surgical procedure may be determined during your consultation.
Revision of breast implant and lift cosmetic surgery may be needed for : asymmetry, continued ptosis, implant malposition as well as all of the other reasons needed for breast implant revision surgery.
At times the mastopexy will need to be changed from a periareola to a lollipop lift to get a more powerful lift.