Many women are frustrated by undesirable changes in the shape of their breasts over time. Pregnancy, breastfeeding, weight loss and heredity are all potential causes of breast droop or sagging. It is a common misconception that breast augmentation makes breasts perkier, but an augmentation will only make you bigger. A breast lift (mastoplexy) procedures are designed to improve shape and perkiness. Dr. Vennemeyer uses multiple breast lift techniques and can recommend a specific technique based on your goals and current breast shape.
Breast lift, fullness and size
If you are happy with your current size and simply want to be perkier, a breast lift may be the right procedure for you. If you want perkier breasts with enhanced fullness or a bigger cup size, then you may need a breast augmentation-lift to fulfill your goals.
Breast lifts work by removing extra skin and elevating your nipples to create more youthful shaped breasts. Your breasts would be essentially the same size after the procedure—the removed skin is very thin and minimally affects size. The shape improvement can be significant, but many women want more improvement in upper breast fullness than a lift can reliably create.
Breast augmentation combined with breast lifting is commonly performed to correct deflation and sagging. The implant volume helps improve fullness in the upper breasts, which is often a major goal for women requesting a breast lift. The lift component of the procedure tailors the skin to your new breast volume to maximize shape. Dramatic improvements are possible for many women.
Getting the right amount of lift
Determining your level of perkiness is the first step in deciding if you need a lift and/ or what kind of lift is needed to reach your goals. Important factors in determining the degree of breast sag are the nipple position relative to the breast crease and the amount of breast tissue sagging below the crease. The diagram below categorizes degrees of breast sag. The horizontal line represents your breast crease.
- Breast A is very perky and does not need a lift.
- Breast B is less perky, but the nipple and most of the breast are above the fold.
- The nipple of breast C is at the level of the breast crease.
- In breast D the nipple and most of the breast tissue are below the fold.
- The nipple is above the breast crease in breast E, but much of the breast tissue sags below the fold.
If you want to be perkier, but stay the same size…
Shape and perkiness can be improved with a breast lift, known as mastoplexy, if your breasts are shaped like breasts B through E. Notice how breasts C, D and E have less fullness in the upper breast. Often, only mild improvement in fullness results from a breast lift, even though shape and perkiness improve significantly.
If you want to be bigger and perkier…
If your goal is to have larger breasts, a breast augmentation will likely provide a good result if your nipples are above your breast crease (breasts A and B). A small lift may be required in type B breasts if you select a smaller implant size or want the maximum amount of perkiness possible.
If your nipples are at the level of your breast crease, like breast C, you may get a good result with a breast augmentation alone, but for the perkiest result possible you would need an augmentation plus a lift. Often a donut-type lift (peri-areolar) or lollipop-type lift (vertical) work well if your breasts are shaped similar to this example. Women with breasts shaped like example D require a full lift with an "inverted T" type scar, in addition to the augmentation.
In breast E, the nipple is in a perky position, but some of the breast tissue is sagging below the fold. If only a small portion of the breast tissue is sagging below the breast crease, a good result is possible with an augmentation alone. A breast augmentation plus a lift would be necessary if a significant portion of your breast tissue sags below the fold.
Breast Lift Techniques
Breast sagginess results from excess skin and stretching of the tissues that attach your breasts to your chest. Dr. Vennemeyer uses a variety of techniques to address these causes. First, excess skin is removed to tailor your skin to fit your breast tissue better. Second, rearrangement or redistribution of your breast tissue may be necessary to maximally improve your shape and improve the longevity of your result.
The amount of skin removed is determined by the amount of lift needed. Any time skin is removed, scars result, just like a tailor leaves seams when altering a garment. Fortunately, the scars usually fade significantly over time. Breast lifts are usually categorized by the scar location.
Donut Lift (Peri-areolar)
Women with a mild degree of sagginess, like breasts B or C, may benefit from this type of lift. A ring of skin is removed around the areola, earning the name nickname "donut" lift. Plastic surgeons call this a Peri-areolar mastopexy. The resulting scar is usually well camouflaged around the edge of your areola. This operation only works for small amounts of lift.
Lollipop Lift (Vertical)
This operation works well for women with moderate degrees of sagginess similar to breast C. It is sometimes called a "lolliopop" lift because the scar includes a ring around the areola, plus a vertical scar underneath. The addition of the vertical scar increases the lift and shaping potential of the procedure. Plastic surgeons call this a Vertical mastopexy.
Inverted T Lift
This type of operation works best for women with moderate to severe sagginess, like breasts C and D. The addition of a side to side scar in the breast fold, creates an upside down "T" or anchor shaped scar. This technique provides maximum lifting and shaping potential. Women with significant sagging usually view the more extensive scars are a fair tradeoff for the significant improvement possible with this procedure.
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