Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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The Crescent Lift is the most minimal form of mastopexy. It is indicated for women with very mild ptosis who require only a slight elevation of the nipple areola complex. It is often performed in conjunction with breast augmentation to adjust nipple position.
The technique involves removing a crescent-shaped piece of skin from just above the upper half of the areola. When the gap is closed, the nipple is pulled slightly upward. The scar is well hidden along the upper rim of the areola.
This procedure has limited lifting power. It cannot reshape the breast mound or tighten loose skin on the lower pole. It is strictly for minor nipple repositioning. If used for significant sagging, it can result in an oval or distorted areola shape.
The recovery from a crescent lift is typically rapid compared to other techniques. It is less invasive and involves less tissue disruption. However, patient selection is critical to avoid disappointment with the degree of lift achieved.
The Periareolar Lift, also known as the Benelli or Donut lift, involves a circular incision around the perimeter of the areola. A second, larger circular incision is made around the first, creating a donut-shaped ring of skin that is removed.
When the outer circle of skin is sutured to the inner circle of the areola, the skin of the breast is tightened like a purse string. This effectively lifts the nipple and, if necessary, reduces the areola’s size.
This technique is suitable for mild to moderate ptosis. It is beneficial for women who want to avoid a vertical scar on the breast mound. However, it can sometimes flatten the breast mound slightly, making it appear less projected.
A common concern with this technique is the potential for the scar to widen or the breast to pleat around the areola. Surgeons use deep, permanent sutures to secure the shape and minimize tension on the scar line, helping prevent these issues.
The Vertical Lift, or Lollipop Lift, is a modern and highly effective technique for moderate to severe ptosis. It involves an incision around the areola and a vertical incision running down from the areola to the inframammary fold. The shape resembles a lollipop.
This technique allows the surgeon to remove excess skin from the sides of the breast and tighten the breast mound horizontally. It provides significant shaping power, creating a more projected, youthful cone shape than the periareolar lift.
The vertical lift avoids a horizontal scar in the breast crease, a significant advantage for many patients. It relies on the skin’s elasticity to redrape over the new mound.
Initially, the vertical incision may appear gathered or pleated (puckered). This is intentional and allows for the skin to smooth out over time as the breast settles. It is a highly versatile technique used for a wide range of breast shapes.
The Inverted T, or Anchor Lift, is the traditional technique used for severe ptosis and extensive skin laxity. It involves three incisions: around the areola, vertically down to the crease, and horizontally along the inframammary fold. The pattern resembles an anchor.
This technique allows for the maximum amount of skin removal and reshaping. It provides the surgeon with complete control over the breast contour in both vertical and horizontal dimensions. It is the gold standard for women with significant sagging or those who have lost considerable weight.
While it leaves the most visible scarring, the trade-off is a dramatic improvement in shape that cannot be achieved with fewer incisions. The horizontal scar is hidden in the breast crease, making it less visible when standing.
This method is often used in breast reduction surgeries as well. It allows the removal of tissue from the lower pole and lifting the nipple to a significantly higher position.
Augmentation Mastopexy combines a breast lift with the insertion of a breast implant. This is indicated for patients who have both sagging and a loss of volume, often after pregnancy or breastfeeding. A lift alone tightens the skin but does not restore upper pole fullness.
The implant provides volume and projection, filling out the upper breast. The lift tightens the skin envelope around the implant and elevates the nipple. This combination offers a comprehensive rejuvenation.
This is a complex procedure that requires careful planning. The surgeon must balance the weight of the implant with the tightness of the skin closure. Placing an implant adds weight, which can work against the lift over time.
Implants can be placed under the muscle (submuscular) or over the muscle (subglandular). Submuscular placement is generally preferred to provide greater support and soft-tissue coverage for the implant.
Auto-augmentation is a technique used during a breast lift to increase projection by utilizing the patient’s own tissue. Instead of removing excess tissue from the lower breast, the surgeon preserves it, removes the skin, and tucks it under the central breast mound.
This creates a “living implant” made of the patient’s own breast tissue. It improves projection and upper pole fullness without the need for a synthetic implant. This is particularly useful for patients who have enough volume but lack shape.
This technique reduces the risks associated with implants, such as rupture or capsular contracture. It utilizes the patient’s own vascularized tissue to create a sustainable shape.
It is often used in post-bariatric patients who have deflated breasts but still have some tissue substance remaining. It maximizes the use of available tissue to create the best possible contour.
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In cases of poor skin elasticity or recurrent sagging, surgeons may use a surgical mesh (such as Galaflex) to create an “internal bra.” This bioabsorbable mesh is placed within the breast to support the glandular tissue and maintain it in a lifted position.
The mesh acts as a scaffold. Over time, the body produces collagen that integrates with the mesh. Even after the mesh dissolves, the new collagen network remains, providing long-term support.
This technique reduces the load on the skin incisions and helps maintain the lower pole’s shape. It is particularly beneficial for patients with heavy breasts or those undergoing revision surgery.
The use of mesh adds stability and can improve the longevity of the lift results. It acts as a hammock for the breast tissue, resisting the downward pull of gravity.
The repositioning of the nipple areola complex (NAC) is a critical component of all mastopexy procedures. The NAC is typically left attached to a pedicle a bridge of tissue containing blood vessels and nerves.
This pedicle can be based inferiorly (from the bottom), superiorly (from the top), or medially (from the side). The choice of pedicle depends on the degree of ptosis and the surgeon’s preference. The inferior pedicle is robust and common, while the medial pedicle allows for better rotation.
Maintaining the blood supply is paramount to preventing nipple necrosis. The surgeon carefully dissects the tissue to ensure the pedicle remains viable while moving the nipple to its new, higher location.
In rare cases of extreme gigantomastia or massive weight loss, a free nipple graft may be necessary. This involves completely removing the nipple and grafting it as skin, resulting in loss of sensation and breastfeeding ability.
Liposuction is frequently performed during a breast lift to refine the surrounding areas. The axillary region (armpit) and the lateral chest wall often have excess fat that can detract from the breast shape.
By removing this “side boob” or axillary fat, the surgeon defines the lateral border of the breast. This creates a cleaner, more athletic silhouette and improves the fit of bras and clothing.
Liposuction can also be used to blend the breast into the chest wall, creating a smooth transition. It is a sculpting tool that enhances the overall aesthetic result of the lift.
This adjunct procedure adds minimal recovery time but significantly contributes to the overall contour and satisfaction with the result.
The incision pattern is determined by the amount of excess skin and the degree of sagging. Mild sagging may only require a donut lift. Moderate sagging usually needs a vertical lift. Severe sagging requires an anchor lift. Your surgeon will recommend the best option to achieve your goals.
“Scarless” usually refers to radiofrequency skin-tightening treatments (such as BodyTite) or thread lifts. These are non-surgical and offer very mild improvement for patients with minimal sagging. They cannot replicate the results of a surgical mastopexy for moderate to severe ptosis.
Absolutely. A breast lift is often performed without an implant. This is called an auto-augmentation or simply a mastopexy. It uses your own tissue to reshape the breast. It is ideal if you are happy with your volume but unhappy with the shape.
Most meshes used in breast surgery today, like Galaflex, are bioabsorbable. They are designed to dissolve over 1 to 2 years. As they dissolve, they are replaced by your own collagen, which provides lasting support.
A surgical breast lift can move the nipple from the bottom of the breast to a central, youthful position. It can significantly lift the breast mound. However, it cannot lift the breast’s footprint on the chest wall; it lifts the tissue within that footprint.
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