In some cases, a breast lift alone may not give the desired result. The patient may want additional volume to the breast which requires the use of an implant. A breast lift with an implant is called an "Augmentation Mastopexy."

This operation is one of the most technically challenging operations in surgery because of the multiple variables that have to be controlled. Each maneuver influences and changes the shape and contour of the breast. The addition of the implant magnifies this dynamic. Success requires careful planning and superb execution of skills.

Technique

A breast lift with an implant ("Augmentation Mastopexy") is performed similarly to a breast lift. In most cases, the implant is inserted first. The implant is usually placed under the muscle. Once the augmentation is completed, the breast shape and its contours are carefully analyzed. The amount of breast tissue shaping and skin removal can then be determined. The goal is to create an augmented breast that has a natural, round, lifted and aesthetically pleasing appearance.

Recovery

The recovery is similar to a breast lift. Most patients return to light activites after 5-7 days. Most bruising resolves after about 2 weeks. Swelling improves after approximately 3-4 weeks. Most patients return to their full level of activity after about 4 weeks.

A support bra must be worn for the first 3 weeks. This helps support the breasts while they are healing into their new shape.

Results

This is a patient who complained about the apperance of her breasts. She felt that her breasts were too low. She requested a breast lift (mastopexy). She also desired to retain the fullness of her breasts. Sometimes, when a mastopexy is performed, the breasts may appear smaller after surgery. In these situations, a breast implant is needed. In addition, her breasts were asymmetrical. The right breast was larger and lower than the left breast. Our surgical plan was to perform a breast lift with an augmentation and to improve the symmetry of the breasts.

In order to create the lift, we used what is called a vertical type of skin excision pattern. This creates a scar around the nipple and vertically down the breast. It allowed me to remove the extra saggy skin and to improve the shape of the breast. We inserted an implant and placed it underneath the muscle. We inflated the implant on the right side less than the implant on the left side in order to improve the symmetry of the breasts.

The "After" pictures were taken approximately two months after surgery. As you can see, the breasts appear lifted. Their position on the chest is higher. In addition, there is fullness throughout the breast. Lastly, the breasts appear more symmetrical. The scars have faded considerably. In fact, the scars continue to heal and improve in appearance and, in many cases, become inconspicuous with time.

The patient below had a previous breast lift with augmentation done by another surgeon. She came to me because she was unhappy with the appearance of her breasts. The implant had moved upward and the breast tissue was beginning to drop over the implant. There was also excessive scar formation inside the breast. Our approach was to begin by removing the old implants and excess scar. We replaced the implants with a slightly smaller size. We then carefully molded her breast tissue around the new implant in order to provide a more lifted and natural appearance to her breasts. As you can see in the "After" pictures, she has a dramatic improvement in the appearance of her breasts. The breasts have a smooth and natural looking contour. The shape is also significantly better.

The patient below had a type of breast shape described as "Tuberous." There is insufficient volume of the breast. There is also tightness of the skin in the lower half of the breast. Lastly, the breast and nipple appear too low in position. This is a very challenging case to improve. The breasts need to be augmented in volume, they need widening of the skin below the breast and they require lifting.

We decided to correct the breasts in one stage. We made an incision completely around the areola in order to try to reduce its size. Once this was done, we carefully manipulated the breast skin and tissue in the lower half of the breast to create a more rounded shape. Once these maneuvers were carefully completed, we then inserted a saline implant under the muscle. We meticulously positioned the implant to create the best shape and contour possible.

The "After" pictures were taken approximately one month after surgery. Notice the dramatic improvement in the appearance. Note also the smooth and round shape to the breasts.