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Over time, the effects of gravity, along with the loss of the skin’s natural elasticity begins to have an effect on the appearance of a woman’s breasts. These factors, combined with pregnancies and nursing will often cause the breasts to lose their youthful shape and firmness. Breast droop can occur from many causes: pregnancy, breast feeding, weight gain and loss, and development can cause breast droop.
If you are happy with the size of your breasts, but not the appearance, a mastopexy or breast lift is the surgical solution. If you wish a larger size and have droop, it could be implants alone, or an implant plus a breast lift. An implant is needed for a lot of superior fullness.
Correction for breast ptosis depends on the degree of droop. For mild degrees of droop, simple enlargement of the breasts with an implant may be all that is needed. For moderate degrees of droop, a shaped implant that is anatomically shaped like a teardrop may partially or totally correct the droop. The implant may be placed in the bi-planar position, partly covered by muscle, which helps correct droop.
If you have a small amount of droop or loss of fullness and do not wish an implant, breast fat grafting can be done. Fat grafting usually increases the breast by one half cup size and can add superior fullness.
The greatest degree of droop is not correctable by either of these methods, and would require a breast lift to correct the droop. If you are happy with your breast size, the lift alone may be all that is needed. However, if you wished to enlarge the breasts significantly, an implant may be done at the same time as the lift. It might be better to do the lift and the implants as two separate operations for several reasons. The lift is trying to tighten the breast and the implants are expanding the breast. The increased complications of the two procedures together must be balanced against the increased cost of two separate procedures. A larger implant usually is best done as a separate operation after the breast lift. A small implant may not give fullness. An expandable saline implant can be placed with the breast lift, and expanded after the breast has healed.
The breast lift also can reduce the size of the areola (the darker skin surrounding the nipple).
A mature looking breast can be achieved with a mini¬lift that uses a shaped implant and the scar is limited to just around the nipple. The incision around the nipple alone draws up the skin in a draw string purse fashion and will take time to flatten and improve, and sometimes needs revision.
This version of the full lift has an “L” shaped scar. It avoids the medial scar or scar closest to the cleavage. It is best for smaller breasts or thinner women. It has more superior fullness, and less “bottoming out” over time, but does have a higher touch up rate. It also does not look as good at first, since less skin is removed and you need time for it to resume the better shape.
This is a full lift that requires an incision around the nipple and an inverted “T”¬shaped incision. It has the best initial appearance and is better when tissue is needed to be removed or more lateral shaping is needed.
Complications include permanent numbness, excessive scarring, revisions of the scars, changes in nipple sensation, and healing problems. You must quit smoking to have a breast lift due to the significantly higher risk of complications.
Other complications include bleeding (hematoma) or infections. Many women react to the dissolvable sutures. Touch ups of the nipple/areola size or shape may be done.
Other breast shape problems include the tubular breast deformity (the breast is more tube¬shaped and based on a very narrow base), or an underformed breast where the inferior portion of the breast is very tiny compared to the superior part of the breast. These shapes often require a mastopexy or use of an expandable breast implant.
Breast implants inserted in conjunction with a mastopexy procedure can increase both firmness superior fullness, and size.
Dr. Van Raalte and Iowa Plastic Surgery has the experience to help you choose your best option!