Patients who want breasts that appear more youthful can consider combining a breast lift (mastopexy) with breast augmentation. Our St. Louis surgeons often advise women who want breast enhancement to include a breast lift to re-position their nipples so they aren't pointing downward. A breast lift and augmentation are performed at the same time to bring the nipples to a more youthful position that is centralized on the breast. An implant is used to add volume to the breast, and in particular, the upper part of the breast, when a breast lift alone may not be enough to meet a woman’s aesthetic goals.
To remove excess skin, incisions include one around the areola (the pigmented circle that surrounds the nipple) and one vertical one from the low part of the areola to the base of the breast. Some people refer to this as a “lollipop” scar. Implants are placed through these same incisions and are typically positioned under the pectoral chest muscle. As in standard breast augmentation, implants may be silicone or saline.
SEMINAR 3: BREAST AUGMENTATION AND LIFT
This is a relatively complex operation as the skin envelope of the breast is being adjusted at the same time as the breast volume. This can be an extremely rewarding operation but is associated with a higher rate of corrective surgery than either breast augmentation or breast lift (mastopexy) surgery alone.
Click here to view a video on breast lift and breast augmentation surgery.
What is StratticeTM? StratticeTM is a relatively new product that belongs to a class of products known as the biologics or acellular dermal matrices. It is derived from porcine dermis (pig skin) that has been treated with a sterilizing process called e-beam radiation. It is designated as sterile by the FDA. Acellular dermal matrices have an extensive track record in breast reconstructive surgery where they have been used with great success.
The loose breast skin often noted in patients who request augmentation-mastopexy lacks the structural integrity to support a breast implant for a prolonged period. StratticeTM can be used as an internal bra or scaffold on the inside of the breast to support the weight of a breast implant. Unsupported, the breast implant can drop, leading to a condition called “bottoming out” where the lower fold of the breast drops, making the breast position look too low and the nipple position look too high. With Strattice, the implant can be positioned and more reliably maintained in the correct location because of this additional support. Strattice can also be used to assist in the correction of other cosmetic and reconstructive breast deformities.
An augmentation-mastopexy may be combined with several other procedures including:
- Abdominoplasty (tummy tuck). Frequently, patients wishing to improve the contour of their abdomen choose an abdominoplasty or tummy tuck. An abdominoplasty is best for people with loose skin and lack of abdominal muscle tone who have undergone significant weight loss or for women who are dissatisfied with their shape after having had children and are looking for a so-called “mommy makeover.”
- Liposuction. Removal of fat from the sides, thighs, back and buttocks with standard tumescent liposuction, VASER LipoSelection, or SMART laser-assisted liposuction provides a nice complement to refinement of the breasts with an augmentation mastopexy
- Lower body lift. After significant weight loss, patients interested in sculpting their breast may also wish to sculpt the abdomen, flanks, buttocks, lower back and outer thighs with a lower body lift. An incision is extended like a belt around the lower abdomen, sides and back to help address loose skin in all of these regions. This procedure can dramatically improve the contour of the waistline after massive weight loss.
Combining augmentation-mastopexy with other procedures can be performed efficiently and safely. Click here to read Dr. Tenenbaum’s article on combining breast surgery and abdominoplasty, or here to view a television clip from KMOV of an actual patient who underwent the mommy makeover procedure including augmentation-mastopexy with Dr. Myckatyn.
Anesthesia: An augmentation-mastopexy is usually performed with the patient under general anesthesia.
Length of procedure: 90 to 150 minutes.
Estimated recovery time: You can return to work after 7 to 14 days and should avoid vigorous activities for 3 weeks. Visible bruising should clear up within 2 weeks, and swelling begins to resolve within 3 weeks. To learn how to prepare for an augmentation-mastopexy and what to expect afterwards, click here to download our patient instructions for augmentation-mastopexy.
Side effects: Common side effects include bruising and swelling. The shape of the breast may change over time, and the final result may not be realized for a few months. Augmentation-mastopexy is associated with a higher rate of corrective surgery than either breast augmentation or breast lift alone. Click here to download a detailed consent form from the American Society of Plastic Surgeons that lists the risks and benefits of a breast augmentation with saline or silicone implants and mastopexy.
Before-and-after photos: Click here to view photos of breast lifts with and without implants.