Breast Lift, or Breast Augmentation Which Will Work Best For You?

There are many women who come to the office requesting breast enlargement who may not be candidates because their breasts are drooping. Drooping or ptosis of breast tissue actually can occur early in some women at puberty or late teens, as well as after pregnancy, or later in life with menopause. Breasts lose their upper pole fullness as breast tissue drops, the nipple areola complex descends, and there may be a change in breast shape. In some instances a breast implant may be all that is necessary to improve the appearance of a drooping or ptotic breast. It can fill lax skin, give better contour to the breast and keep scars to a minimum. However, in other instances a breast lift or mastopexy with or without an implant may be necessary to improve the shape and position of the breast tissue and nipple areola complex.

For some women whose breasts may be small due to changes following pregnancy, weight loss or due to lack of development but are not ptotic or for women with moderate size breasts who desire cosmetic enhancement, an implant is usually the ideal solution.

Breast augmentation is one of the most immediately gratifying procedures for both patient and surgeon. Ideally the enlarged breasts will not only look good, appearing natural, and symmetric with soft curves and flowing lines but they will also feel good, feeling soft, warm and sensitive to touch.

In deciding whether a breast augmentation, breast lift, or a combination of both procedures will give the best outcome, the surgeon considers breast volume and shape, skin elasticity, and nipple position. Patients often say that they want a youthful “perky” uplifted breast without visible scars. A mastopexy is designed to return breast shape to a more youthful appearance by moving the position of the nipple-areola complex, removing excess breast skin, and reshaping the breast tissue. In some instances a breast lift is not sufficient to restore a youthful appearing breast as there has been loss of breast volume as with postpartum breast involution (shrinking of the breast after pregnancy) Combining breast lift with a breast augmentation improves breast shape, enhances breast volume and may reduce scarring. Depending on the degree of lifting necessary, one of three types of breast lifts can be performed each resulting in different degrees of scarring. When the nipple-areola is low and needs a small degree of elevation, a crescent-shaped ellipse of skin can be removed to elevated it “hiding” the scar at the border of the areola. When breast skin is loose and the nipple-areola complex also needs to be elevated a ring of skin is removed around the nipple-areola complex. This technique works best when used in combination with a breast augmentation. For moderate to large degree of ptosis, the circumareolar skin excision with a vertical elipse of skin removed below the areola the so-called “lollipop” lift can be used. When larger amounts of skin need to be removed a horizontal ellipse of skin is removed producing an anchor-type scar. The combined procedures of breast lift and breast augmentation are a surgically challenging operation and many surgeons prefer to stage the procedure first performing the lift followed several months later with insertion of an implant.

Dr. Bruck performs breast augmentation, breast lift, or the combination of lift and augmentation at Juva, a certified outpatient facility, as well as in the hospital outpatient surgical suite. Patients usually return to work within a week after surgery.