If you are contemplating a breast lift, it can be intimidating to meet with a plastic surgeon to discuss something so personal. At Alamo Plastic Surgery our mission is fully educate patients so they are empowered to make great decisions for themselves. In this blog article, we strive to walk you through the process and different options. Please contact us at firstname.lastname@example.org or 210-670-5302 if you have additional questions or comments.
First we will obtain a past medical history and surgical history. As a breast lift is a cosmetic procedure, it is important to make sure there are no medical risks associated with the surgery and we can meet your cosmetic goals. All of these things we will discuss in depth when you come for a visit. In addition, we will conduct a physical exam which will include several measurements to assess the skin quality and the breast tissue volume. These will dictate which procedures are best for you.
For a traditional breast lift, we strive to correct two issues:
1. Excess skin and potentially low nipple position
2 Breast tissue that has slid off the chest
1. Skin - To address the excess skin and low nipple, the most common skin incision pattern in the US is a Wise pattern, also called an 'inverted T' or 'Anchor scar'. During this procedure, I will also cut into the areola (pigmented skin around the nipple) to make it smaller, if it has become stretched. Immediately after surgery, the areola will appear to be a little too small but, don't worry, it will stretch out over time like it did the first time. Utilizing this pattern, the nipple is raised and inset into position at the center of the repositioned breast mound. The skin below the new nipple position is then sewn together to create a nice straight vertical line. The side to side scar at the bottom fold of the breast is variable in length depending on the magnitude of extra breast skin (a smaller lift will result in a shorter scar as less skin needs to be removed). As you can see from the diagram, the scar pattern looks like an upside down letter 'T' or anchor.
2. Breast Tissue - Now to address the sagging breast mound. This has to do with what is being changed on the inside (under the skin). I utilize a "superomedial pedicle with a caudally based 'auto augmentation' flap technique". To start, you can think of it as cleaving the breast in two. This sounds dramatic, but just below the nipple and areola there is an incision through the breast. The nipple is going to stay attached from a blood supply from upper inner part of the breast or 'superomedial' (definition is above and towards the sternum). This is going to supply blood to nipple and areola. The nipple will move upward and rotate slightly into its new position. The lower portion of the breast (not attached to the nipple) is analogous to an inferior pedicle. But, in this case, the lower part of the breast is only used to provide additional bulk and function like an implant; it will be moved up to the new mound position underneath the new nipple. Thus, "auto augmentation" flap just means using your own breast tissue like an implant. However, it is not an implant as the shape produced is a teardrop shape, not round like most breast implants. A full profile implant associated with a breast augmentation creates superior pole fullness (rounded at top of the breast). To have more superior pole fullness with a breast lift, breast fat grafting can improve the contour and volume. Many patients are happy with this approach to avoid a breast implant.
For a breast lift, I try to keep as much of your breast tissue as possible. With a breast reduction, I would remove some breast tissue to reduce the overall size and weight of the breast.
For breast lifts, the immediate result after surgery, the breast shape may look a little like a breast augmentation (round full top), but this is temporary and due to postop swelling. Also immediatly after surgery, the nipple position will look artificially low and maybe even pointing down. As the breast ultimately settles lower, the nipple will be in an ideal position.
Scars may widen and stretch over time. There is potential for hypertrophic scars (thickened, wide, often raised scar that develops where skin is injured) to develop if you are predisposed to them. These may be treated with steroid injections and they are only a cosmetic issue. If you have a family history of keloid scarring or know you develop keloid scars (enlarging raised scars). During the initial consultation, we will discuss any concerns you may have about scarring.
For some women, this is very important. About a third of my patients will have some decreased sensation in one nipple. It is very rare to have it in both nipples.
Usually women interested in breast lift have already had children so this is not a concern. There is no guarantee you will be able to breast feed, but most women who want to can.
The result that you see after surgery will not last a lifetime. I recommend bra support all the time and avoiding activities that prematurely age the skin like tanning and smoking. This will help improve the longevity of the breast lift. Still the breast will undergo the normal aging process and is subject to gravity and genetics.
For a specific event, please allow 4 - 6 months after surgery before breasts are perfect out of clothes.
Wear a bra all the time, no intense exercise, sleeping on your side, and any big travel plans.
Most of the swelling should disappear by 2 months after the surgery. At this time, you may buy new bras (even with underwire) and new clothing for your new breast shape.
Breast lift shape should be well established with potential for minor changes up to six months.
Scars should stabilize and heal by around 8 - 12 months. After this, options to tattoo or laser the scars to reduce their visibility are available.
Breast lifts cost between $4700 - $7500. The main cost variables are duration of the procedure (larger breasts may take slightly more time) and whether or not fat grafting (fat transfer) is also being performed. Alamo Plastic Surgery offers Care Credit with 6 or 12 months of interest free credit.