A breast lift is one of the most difficult procedures to execute in plastic surgery. This procedure can restore your breasts to their previous form, but there are many things that make this procedure a surgical challenge. A breast that is saggy occurs for various reasons. One of the most common one is pregnancy. During pregnancy, the slow enlargement of the breasts and the weight stretch the internal structures including the skin and the coppers’ ligaments. These ligaments are the ones that provide support, thus helping firm and shape the breasts. After pregnancy, although there is typically a decrease in the size of the breasts, there is a recruitment of excessive skin that, unfortunately, does not return to its previous form. In addition, the skin itself loses significant elasticity, and this can be perceived as stretch marks of various forms. In other words, there is a loss of support in every single aspect of the anatomical components that compose the breasts as a unit. All of these factors will make the breasts sag in various forms.
As mentioned before, a breast lift is a challenge. Breasts are very different; there are always asymmetries in each breast. Even a breast that does not require a lift will be slightly asymmetric to the other one. Some of the asymmetries include the following:
- breast shape
- breast volume
- breast base
- areola dimension
- mammary fold location.
Now, just imagine having certain asymmetries and, on top of that, your breasts are saggy and the volume has decreased significantly. For example, we need to match the breast volume and many times this will require different implant sizes in each breast. The amount of skin to be removed differs in each breast among other things.
If you are thinking about having a breast lift, there are certain things that you need to consider before the procedure. In the first place, decide the size of the breasts that you want to be after surgery. A breast lift by itself will tend to decrease the size of your breast for the simple reason that, whichever technique is used to lift the breasts, the main maneuver to do so is by removing the excessive skin to make the new breast “fit” the existent breast tissue. If you want to have the breasts smaller and / or of the same size, then, a typical breast lift without implants will be the choice. On the other hand, if you want a bigger breast, then, you need to consider augmenting the breasts with breast implants.
Secondly, depending on how much sagginess you have, you will need to accept some scars. These scars can be located just around the areola if the sagginess is minor; a more extensive scar can be vertical in nature and horizontal in more severe cases.All of this will be determined during your consultation. For example, if your breast sags approximately less than 3 cm, then, a breast lift around the areola will be sufficient to lift the breast to its previous form. If your breast sags more than 3 cm, then, you will need a vertical breast lift. If your breast sags even more, you will need, not only a vertical scar, but a horizontal scar. I do not use a complete horizontal scars for a breast lift because this scar can go all the way to the midline and can show if you wear sexy clothes or want to show some cleavage.
In addition, any current technique to lift the breasts will tend not to provide long-term results because of the evolution and natural course of the breasts after the procedure. What this means is that avoiding the breasts from sagging early after surgery and even a few years after surgery is not a very easy task to accomplish. Any surgeon will be able to lift your breasts to the proper position, but keeping your breasts lifted requires a level of technique that relies more than the skin envelope to preserve your results.
Experience has taught me to make adjustments by being very critical about my work when using both techniques: the breast lift with implants and the breast lift without implants. What I have called the wonder breast lift is the closest ideal procedure that can provide very long-term results. Believe me. That really requires a combination of expertise and creativity that nor all plastic surgeons possess.