What is a Breast Lift? Do I need one?
Breast lift is a breast surgery in which the tissue of the breast, especially the nipple, is changed to make it sit higher on the woman’s chest. It is also called mastopexy. There are many different breast surgeries that all fall under this title. A breast lift can be done as a stand-alone procedure. It can also be done at the same time as other breast surgeries. It is common to increase or decrease the size of the breasts at the same time. When breast tissue is removed in a significant degree, it is called a breast reduction. So breast reductions are a type of breast lift that also includes removing breast tissue. Breast lifts can also be done and the size of the breast increased. This is called a breast lift with augmentation.
What are the goals of a Breast Lift?
Many things can affect the look of breasts over time:
- Pregnancy and breastfeeding can affect firmness, volume, and the amount of sag (the volume changes stretch the skin and connective tissue)
- Changes in weight can leave excess tissue or stretching
- Aging causes loss of skin elasticity, stretching of the skin, and a change from firmer fibrous tissue to softer fattier tissue
- Hormonal changes of menopause affect breast tissue density
- Prior breast surgeries, such as having breast implants removed, will result in sagging breast tissue
- Genetics can affect breast size, shape, density, and skin elasticity
Breast lifts seek to combat many of these changes. The goals of breast lifts are:
- To change the alignment of the nipple and breast or raise the nipple position in relation to the rest of the breast.
- To pull up sagging breasts (correcting breast ptosis).
- To make the breasts appear fuller.
- To reshape the breasts.
- To change the size and/or shape of the areola.
All of these goals are achieved while keeping the functionality and sensitivity intact. Usually a change in size is not the main goal of a breast lift. That said, if a size change is wanted it can be done at the same time. It is important to note that even though a size change may not be the goal, it may occur naturally as a result of changing the shape. This should be taken into consideration when deciding whether to have breast implants placed during the same surgery. It may be surprising to know that sometimes the size can stay the same even when using a breast implant. This is because other tissue may be removed. It may also be a surprise to learn that an implant may be placed even after a breast reduction. This is because it will allow the new breast to sit higher and fuller on the chest with less sagging. There unique risks of the breast reduction.
How is a Breast Lift Done?
During a breast lift, the plastic surgeon can take many actions to achieve the final goal. The surgeon may:
- Change the position of the nipple and areola. However, it is a common misconception that the nipple is cut away and placed in a new spot. The nipple tissue is usually left attached at the same location. The surrounding tissue is manipulated, resulting in a new final position.
- Lift and reshape breast tissue.
- Remove excess skin.
- Remove glandular tissue. This will result in a smaller breast.
- Insert implants. This may be to achieve larger breasts. It could also be for increased fullness at the top of the breast. Sometimes implants are used solely to keep the final result the same size as before since other tissue will be removed.
When evaluating a woman’s breast shape the nipple position in relation to the breast fold will dictate if a breast lift is indicated and then what type of incisions will be required. Grade 1-3 and Parenchymal maldistribution in the above image are breast lift candidates. Pseudoptosis is typically corrected with breast implants.
The procedure can be done in several ways, depending on how much lift is needed and where the nipple is located. For example:
- With only mild sagging, a lift can be done with a small incision around a portion of the areola. This is called a crescent lift. This is the least invasive lift, but also only creates minimal changes. Some tissue can be removed and the position of the areola can be changed. This lift can also be done with an incision that goes fully around the areola. If the incision goes fully around the areola, it may be called an Areolar, or Periareolar lift or donut lift or Benelli lift. This option is most useful when the size of the areola is being changed.
- With moderate sagging, usually an incision is required both around the areola and vertically down to the breast crease. This is often called a lollipop lift or Vertical lift. With the additional access, greater lift and shaping can be achieved. This option often gives great contouring. Sometimes this incision will have a small extension resulting in a “j” or “l” -shaped scar.
- For more severe sagging, the incision will begin as the lollipop lift would. It will also include an incision along the breast crease. This is called either an anchor lift or an inverted-T or Weir incision. This option gives the most space to allow major changes to the breast. Despite the scar, the surgery achieves good results.
Any of these types of lifts can be done with an implant inserted as well. (Some lift can actually be achieved with implants alone.) Talk with your surgeon about what option might work best for you.
Regardless of the amount of lift desired, always ensure you are comfortable with your surgeon before proceeding. You want someone who:
- Is qualified. The surgeon should be certified by the American Board of Plastic Surgery.
- Has enough experience. You should ask to see before and after photos. Also ask about the number of breast lifts performed each year.
- Is someone you’re comfortable with. You should feel comfortable asking questions and getting all of the answers you need. The surgeon should explain everything about the procedure, the preparation, and the recovery.
Should I Get a Breast Lift?
Some women may wonder whether a breast lift is right for them. Good candidates for a breast lift have at least one of the following:
- Breasts that have drooped over time.
- Breasts that are no longer firm.
- A nipple that points downward and/or is located below the crease of the breast.
Good candidates also must have:
- Good health (including being a non-smoker, ideally).
- A stable weight.
- A realistic expectation of the result.
For some, a breast lift combined with an implant is the best choice. To determine the best option to reach your goals, the surgeon will ask questions like:
- How do you feel about your current breast size? Would you prefer larger, smaller, or the same?
- Are you looking for a fuller breast shape? More fullness at the top of the breast?
- How do you feel about the firmness of your breasts?
- What are your concerns about position of your breasts?
- Are you willing to have scars as a trade-off for a new breast size or shape?
In addition to these questions, a full exam will be needed. The breast tissue must be able to cope with the surgery to have a good result. The plastic surgeon will need to evaluate the breast tissue. He will also take a full medical history. He needs all of the information to make a good assessment; withholding info can affect your health during the process. You will also be made aware of the risks of breast lift surgery.
It is important to have realistic expectations. Your body and breast shape and size before the surgery will impact the results. There are health risks, as with any surgery. It is also important to know when a breast lift is not the right choice. For example, women who are planning these things may want to wait to have a breast lift:
- Pregnancy now or in the future. Pregnancy can change the look of the breasts. Having a lift done prior to pregnancy may mean that the lift benefits are reduced.
- Breastfeeding now or in the future. The milk ducts are usually left intact. So if a woman does get pregnant after having a breast lift, she will usually still be able to breastfeed. However, there can be problems. Discuss such plans with your surgeon to understand the risks.
- Planning weight loss. Weight loss can affect the breast size, shape, and the skin. This may mean that the breast lift results are reduced because more sagging may happen after weight loss.
Breast lift results are typically long-lasting. However, all of the factors that cause breast sagging can take effect again in time. Usually the sagging that occurs after a breast lift is not as extreme as prior. However, some women do seek second surgeries after time has passed.
Best Cosmetic Surgeon in Northern Virginia*
The Loudoun Center and Dr. Michael J Brown have been voted by Virginia Living Magazine as the best cosmetic surgeon in Northern Virginia for 2012 and 2013. Dr Brown has won similar awards of Top Doctor and Top Plastic Surgeon from Northern Virginia Magazine (2009-2016), Washingtonian Magazine, Best of Ashburn and the Consumer’s Research Council (1999-2016). He and The Loudoun Center have been selected as the Best of Ashburn for 9 consecutive years (2008-2016).