Breast Lift
With weight loss, pregnancies, and breastfeeding, or just as a natural cause of normal aging, breasts can start to sag. This causes the breasts to lose their youthful shape and contour. As a result one may lose their self-confidence and not wear what they want, or get embarrassed of their bodies, try not to get intimate with their partners or prospective partners even if they want to in reality.
Breast lift, also known as mastopexy, is a surgical procedure that restores the youthful shape and contour of the breasts. This is done by calculating the best position for the nipple, and with skin incisions, redistribution and fixation of the breast tissues, and if preferred with addition of breast implants.
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The level of sagging of the breasts is calculated according to the Regnault’s Classification of Breast Ptosis, and it is based on the position of NAC relative to IMF. Sagging is present if NAC is below the IMF. From mild where NAC is at or 1 cm (0,4 in) below the IMF, to moderate where NAC is 1-3 cm (0,4-1,2 in) below the IMF to the severe, where NAC is the lowest portion of the breasts. The appropriate technique will be selected after a physical examination with your surgeon, during which bilateral measurements; breast position, level of sagging, skin and tissue quality, areola size, and any asymmetry will be taken. And the best surgical approach will be determined.
Circumareolar technique is widely known as a donut mastopexy as the incision looks like a donut around the NAC. It is usually chosen when the NAC is not wide and the sagging is less than 2 cm (~1 in). With this technique, scar is minimized, the duration of the operation is reduced, and NAC sensation is preserved. The incision that is made in the closed approach is hidden inside the nose. Either single incision (intercartilaginous, transcartilaginous, infracartilaginous approaches) or double incision (delivery approach) can be made, depending on the anatomical features and the problems to be addressed.
This technique makes use of an eccentric circumareolar incision; an asymmetrical donut incision around the NAC. With the crescent mastopexy, minor asymmetries and small to moderate sagging can be fixed with minimizing the scars.
Vertical techniques are very powerful ones and are good for mild to severe sagging. The incision is wider than the circumareolar or crescent techniques, but it gives the technique its ability to resect the skin and raise the nipple without putting too much tension around the NAC.
This technique is very similar to vertical methods differing in its lack of incising the skin all the way around the NAC. The top part is not incised, which gives its name as the shape looks like the letter Y. It has the advantage of minimal scarring and minimal nipple adjustment as a result. With this technique, the lower part of the NAC can be tightened, and is great for patients that want to combine their breast lift with breast augmentation. However the use of this technique is limited to those who have normal NAC diameter, and ideal nipple position, with minimum to no sagging.
The inverted-T technique is ideal for severe breast sagging or poor skin quality. It can be adjusted to the patient, as it is a flexible technique. In this procedure, excess skin is removed by resection, and the nipple is elevated. This technique has the most wide incision among all the techniques. The incision types can differ according to the anatomical features of the sagging breasts, level of sagging, as well as the preference of the surgeon.
Complications and the rate they happen can vary based on the technique used. Overall complication rate in circumareolar lifts is 41,5%, in vertical lifts 9,7% and in inverted-T 14%.
A firm or palpable ring around the areola may occur due to sutures or healing. Although this can be concerning for patients, it usually resolves over time as the tissues continue to heal.
Blood leaking from veins into tissues can cause blood to collect and form a hematoma. It can be prevented by wearing compression garments, cold compresses, and following your doctor's instructions and taking the prescribed medications.
There's a risk of slight asymmetry in breast size, shape, or nipple position following the surgery. While surgeons strive for symmetry, some differences may persist, and in rare cases, a revision surgery may be needed.
Scarring is a natural part of the healing process, but the visibility of scars can vary. Surgeons use techniques to minimize scarring, and over time, most scars fade and become less noticeable.
If a purse-string suture is used in the breast lift procedure, there's a risk of suture breakage. If this occurs, a surgeon may need to perform a revision surgery to correct the issue and ensure proper healing.
Pleating or folding of the skin around the areola can occur as a temporary side effect of the breast lift surgery. It typically resolves on its own as the swelling subsides and the skin adapts to the new breast shape.
In rare cases, a portion of breast tissue may push through the areolar incision, leading to areolar herniation. If this occurs, additional surgery may be required to correct the issue and restore the desired breast contour.