The breast lift, or mastopexy, describes several types of procedures that lift sagging or misshapen breasts. Breast Ptosis, or sagging breasts, may occur for several reasons, including the inability of the skin and breast tissues to hold up a normally developing but full breast; the changes during pregnancy and breastfeeding resulting from initial breast engorgement causing stretching of the internal breast ligaments and skin after which the breast deflates and sags following breastfeeding; significant deflation due to weight loss; or developmental changes that result in misshapen breasts. Regardless, the higher breast typically found in youth falls with gravity and the loss of thicker collagen in the breast tissue matrix and thinning skin. The tissues just can’t hold up the weight of the breast, leaving it and the nipple too low, resulting in discomfort and the appearance of it being too low on the chest and even over the upper abdomen. There is an absence of the breast on the upper chest and the loss of cleavage and the youthful female silhouette.
I Want Implants! Why Do I Need a Breast Lift?
One of the most common questions that Dr. Stephens sees on patient portals, such as RealSelf or when women come for a consultation, is if they can get away without a lift. There is a common and unfortunate misconception that using a larger implant will lift the breast and nipple position. Also, that placing the breast implant above the muscle will lift the breast and nipple better than with the implant below the muscle. Simply put, the nipple is low because there is too much loose skin. It is the skin and breast tissue that are supporting the implant, so when they are too loose they are going to fail to support the implant and everything is going to fall. If the nipple is below the center of the implant, which is placed on the breast with the bottom of the implant at the inframammary fold, it will look even lower and more distorted. The larger the diameter of the implant, the lower the nipple will look on the new breast mound. Sometimes rearrangement of the internal breast tissue without using external scars, or in combination with lesser scars, is an option.
Dr. Stephens will place as little of a scar on the breast as possible to provide the proper shape to the breast and to correctly position the nipple/areola complex in order to provide a beautiful shape. During your consultation, Dr. Stephens will examine your breasts with you and review whether you need a breast lift as well as the type of lift he recommends for you. He is experienced and an expert in all types of breast lifts and the correction of poorly shaped breasts.
Is it Necessary to Have Implants to Give the Breasts a Good Shape With a Lift?
It is not necessary to use an implant to give the breast a nice shape with a lift. Dr. Stephens utilizes the upper (or superior) part of the breast to improve the shape of the upper breast and reduce the risk of the lifted breast relapsing and falling down again. Where there is enough breast tissue in the lower part of the breast, he will use that tissue to “auto augment” the breast to provide volume where possible. A well-executed breast lift provides an improved breast shape as well as lift it. In larger breasts, Dr. Stephens may recommend an internal bra made of a biologic resorbable mesh to support the breast tissue. This mesh dissolves, leaving a natural collagen tissue to support the breast.
However, where there is an inadequate amount of breast tissue, or the breast tissue has poor structural integrity, a breast implant will be necessary to provide a good shape. The type, shape, and size of the implant will be reviewed with you at the time of your consultation. VECTRA® 3D imaging can provide a simulation of the results from a breast lift alone or with implants for you to review. Implant sizers may be also tried out if this is practical.
Breast Scars – Breast Lifts
Dr. Stephens is very sensitive to the idea that no one wants scars on their breasts and will endeavor to provide the smallest and most hidden scars with the most meticulous surgical repair of the incisions. When doing a circumareolar or “donut” procedure, leaving the scar only around the areola, he will use a suture to “anchor” the scar that may otherwise widen, thicken, and spread out. The circumareolar approach is used to correct minor lowering of the nipple position but may result in a flattening of the breast shape. For this reason, there are tradeoffs, and in cases where there is more nipple lift or better breast shape is desired, the circumvertical breast lift is performed. Where even more lift and shaping of excessive breast skin is necessary, then the “anchor” breast lift is recommended. The anchor, or inverted “T”, breast lift scar can be hidden within the fold of the breast.
While Dr. Stephens is meticulous about breast lift scars, we recommend scar treatment products to optimize incision healing and scar thickness. We recommend Biocorneum®, an FDA-approved, silicone-based scar treatment to reduce the size and thickness of your scars. In darker skin types, we recommend a scar lightening medication as well. These products have been clinically proven to improve the quality of scars when used correctly. In some cases, scars may widen and thicken due to the patient’s genetic or ethnic factors despite meticulous surgery. There are advanced modalities, such as laser treatments and microneedling, that can improve the quality of the scars in such cases.
Each of the breast lift procedures can be performed with simultaneous breast augmentation in most cases, with some exceptions. Some surgeons recommend doing a breast lift procedure prior to placing implants because it is a technically difficult procedure and because they say that there are more complications with the combined procedure and less risk of revision procedures. However, like many good surgeons around the country, throughout the years, Dr. Stephens has combined the simultaneous breast lift and placement of breast implants where it is indicated with no increased risk of complications. All plastic surgery procedures have a risk of revision, including staged breast lift procedures.
Dr. Stephens can help you sort out your options to provide you with optimal results, the best breast shape, and optimal size based on your individual desires, leaving a beautiful and youthful profile.
The Minimally Invasive Breast Lift: The ‘Scarless’ “BodyTite® Breast Lift”
The “BodyTite®” procedure can lift a younger and smaller breast with mild ptosis. Utilizing minimal scars in the upper chest, the device can be placed in the superficial subcutaneous breast tissue to tighten and lift it. Together with Fractora™, that tightens the skin, it provides a moderate amount breast lift.
Our Ambulatory Surgical Suite (ASC)
All procedures are performed by Dr. Stephens and are conducted in our beautiful, state-licensed, AAAASF-certified ambulatory surgical site (ASC). Conveniently located within our office, our ambulatory surgical suite ensures your privacy, comfort, and safety.
Our ACGME board-certified anesthesiologist is uniquely experienced and is an expert in outpatient cosmetic surgical procedures. Our anesthesiologist utilizes a gentle, fast-acting, light general anesthetic, allowing for a fast recovery after the procedure. You do not feel anything during your procedure, and your recovery should be quick, comfortable, and uneventful.
During your procedure, our anesthesiologist administers specific medications designed to reduce pain after your surgery. Dr. Stephens uses local anesthetic and nerve blocks to reduce post-operative pain. You will be cared for by one of our skilled and attentive recovery nurses after the procedure in our private, confidential facility.
Your Recovery After Your Breast Lift
Following your procedure, you will wake up with a special breast bra garment to provide comfort and ease of your recovery. There will be some swelling, bruising, and discomfort initially, so you will need to take TYLENOL® as well as a prescription muscle relaxant. You may need prescription pain medication for several days to a week. Swelling and bruising may persist for two or three weeks, and some patients also experience temporary breast numbness.
If your job requires low activity and is not demanding, you should be able to return in about one week. Exercise is discouraged for at least three weeks after your procedure.
Everyone heals at their own pace, and Dr. Stephens will discuss your recovery progress and provide post-operative care instructions so you can rest easy while you recuperate.
Minimizing Pain and Ensuring a Quick Recovery
Our office has developed a detailed, comprehensive recovery program for our patients to help you get back on your feet and resume your usual activities as soon as possible.
This recovery program is designed for quick healing, allowing you to resume gentle, quiet activities as soon as possible, return to work within one week, and begin non-impact exercises that do not affect the chest in two to four weeks.
Mild stretching and early range-of-motion exercises can be therapeutic and help promote your recovery. Our goal is to reduce your dependency on powerful pain medications with therapy, muscle relaxant medications, anti-inflammatory medications, and customized prescriptions.
Your comfortable and fast recovery begins with Dr. Stephens’ meticulous surgical methods, employing as little force as possible to minimize tissue trauma.
Can I become pregnant or breastfeed after a breast lift?
This procedure does not hinder your ability to become pregnant, but we highly recommend finishing childbearing before having a breast lift. Pregnancy significantly changes the breasts and can undo your results, requiring another surgery to reverse the effects of childbearing.
Breastfeeding is typically possible after a breast lift, as the nerves and glandular tissue are left intact.
Can I smoke cigarettes prior to or following a breast lift?
We do not recommend smoking cigarettes for two months prior to and for six weeks to two months following a breast lift procedure. This is because there are multiple substances in smoke that can rob the skin and breast tissues of oxygen and cause catastrophic loss of tissue, including nipple loss, opened incisions, and infections.
Can I go without a bra following a breast lift?
It is a good idea to wear a bra, even to bed, following a breast lift to prevent gravity from pulling down the breast. Realize that it is the skin and the breast tissue that hold the breast up in its perky position, especially in a larger, fuller, and looser breast. In smaller breasts there isn’t as much weight, so the breast may stay nice and perky without a bra, but consider that it can only help.
What sort of care will I need after my breast lift procedure?
You will have dressings on with a bra when you wake up following your surgery. We will want to see you the following day to check on everything. There will be temporary tapes on your incisions called Steri-Strips that will stay on for several weeks following your procedure. It is okay to get these wet when you shower, which is typically two days following your procedure. We don’t typically use drains with breast lift surgery. It is important to get up and move around following your surgery and in the subsequent days in your recovery to speed up your recovery and to reduce the risk of deep vein thrombosis (DVT), which is a rare but life-threatening complication. There are a small number of sutures we will remove between a week to two weeks after your procedure. The incisions will usually take a month to heal completely.
Take the guesswork out of Plastic Surgery
We are extremely pleased to feature the Vectra XT 3D system in our patient consultations. The results are spectacular and our patients are consistently amazed by the realism of the image!Schedule a Consultation