Austin Texas Board Certified Plastic Surgeon

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Breast Lift

Understand, Respect, Empower, Deliver

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Introduction

Attractive and youthful appearing breasts have several hallmark features. While all breasts have a teardrop shape to some extent, youthful breasts are rounder and firmer than older breasts. Youthful breasts are positioned higher on the chest wall and with the nipple areolar complex (NAC – the nipple and the surrounding round pigmented area) located over the central portion of the breast mound. Thus the distance from the collar bone to the nipple is shorter in younger breasts and the nipples point straight ahead forwards with the bulk of the breast mass behind them instead of downward. However as a woman ages her breasts loose some if not all of these characteristics that are associated with youth and attractiveness. The procedure designed to help restore many of those youthful features, the elevated position, the increased roundness, the firmness, is called a breast lift. The formal medical term for a breast lift is a mastopexy and this is a very common procedure for women you are interested in experiencing the confidence that having more youthful and shapely breasts can bring about.

Problem

As a woman ages, her breast tissues loosens. The loosing of tissue, both the external skin and the internal parenchyma results in the descent of the breast tissue. This is experienced as and commonly referred to as sagging, although the medical term for this is ptosis. Compounding the problematic loosening is the atrophy, or loss of volume, that occurs with the progression of age. The reduction in breast volume through the process of involutional atrophy has a deflation effect on the breasts. The deflation effect contributes to the sag as well. One can understand this process but imagining an ordinary plastics bag filled with air. When the bag is completely filled the bag is taught and firm. As air is let out of the bag, as the bag is deflated, it become less taught and starts to sag.

As the breasts sag other changes are seen. For example the nipple comes to rest as lower position and may even point downward. The breasts loose some of their roundness and loose fullness in the upper half. The breasts become longer with an increased distance between the collar bone and the nipple.

Furthermore, removal of a breast implant without replacement of a new implant leaves the breast with sagging, also known as ptosis, due to the reduction in the overall volume of the breast as the skin area remains the same. This is a sense an immediate deflation affect and results in a lowering in the position of the breasts and decrease in the projection of the breast from the chest wall. For this reason, many women elect to undergo mastopexy, breast lift surgery, at the time of implant removal.

Solution

A mastopexy, a breast lift, is a surgical procedure designed to lift and reposition the breast tissue. This procedure involves the two main focuses. The first focus it to reposition and reshape the breast tissue also known as parenchyma. The second focus is to remove excess breast skin that is associated with and contributes to the sagging. These two focuses are accomplished through the same incisions. The breast tissue is gently and precisely repositioned higher up on the chest wall. It is also shaped and sculpted into a more round and firm breast mound. Excess skin removal is accomplished using well planned incisions and precise tailoring. While the majority of the excess skin is located below the nipple, some is located above the nipple as well. Thus skin is removed above and below the nipple, but with the majority excised below the nipple. Upon closing the skin the remaining skin is tighter and thus addressing the skin also contributes to creating a more firm, youthful, breast mound. The nipple and the surrounding pigmented circle, the areola, are referred to collectively as the nipple areolar complex (the NAC). Inherent in the breast lift procedure is the repositioning and elevation of the NAC. The goal is to elevate the NAC so that is located directly over the breast mound and higher up as well.

Key Points

  • Emphasis on preserving nipple sensation
  • Techniques to reduce scar burden
  • Focus on natural shape and symmetry maintenance
  • Selective use of liposuction for enhanced control of shape in improved natural results

Patient Experience

Breast lift, mastopexy, is general y preformed as an outpatient procedure. Recovery times can vary from a weekend to a week depending on the physical demands placed on the women by work or other activities. Strenuous activity should be avoided for two weeks. When strenuous activity is resumed it should be do so with a supportive shorts bra to limit the independent motion of the breasts. Swimming or submersion bathing can be done at about 10 days or when the incisions are completely healed, whichever comes first. Drains are not generally used in mastopexy surgery unless it is performed in combination with removal of a breast implant, and even then rarely.

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