Six months after surgery, Dr. Bruce Van Natta of Indianapolis hears an identical chorus from almost every breast lift patient. “I really like my result, it’s SO much better than before. But I loved it in the first month or two when it had such fullness. Then it settled a little bit.”
A common occurrence in a standard mastopexy (breast lift) is that it initially pushes up the breast tissue, creating upper-pole or top-of-the-breast fullness while elevating the lower pole or bottom of the breast. Eventually gravity takes over and the first place the volume leaves is the top of the breast, followed by a bit of a drop on the bottom. “The challenge,” says Dr. Van Natta, “is rejuvenating a breast and keeping it there.” Two new devices he is using on his breast lift patients are showing incredible results. In fact, you could say gravity’s force is no longer a foregone conclusion. And neither is wearing a bra.
by Isabel Bolt
and Bruce Van Natta, MD
The 411 on Standard Breast Lifts
Age, hormones, significant weight loss and multiple pregnancies can all contribute to sagging breasts. Though your breasts may be of good size, they may droop (ptosis) and lack firmness or substance. Breasts may appear pendulous and nipples may point downward below the breast crease. To determine whether you need a breast lift, the location of the nipple relative to the inframammary fold (IMF) is the most important factor. When you have gland and/or the nipple below the IMF, then you may need a breast lift. A breast lift will reshape sagging breasts to a more naturally rounded shape and reposition the breast tissue and nipple to a more youthful height and projection. According to Dr. Van Natta, a breast lift literally lifts sagging breasts without major removal of tissues. Until now, patients had to accept that the initial result and final result would be influenced by gravity. “We always “over lift” the breasts a bit, but gravity always wins. Skin elasticity and the amount of weight will determine how much (the breasts) settle. But they settle in everybody. There is however, good news. Today, I am using two new devices that are giving us a means of trumping gravity.”
Refine® for the Upper Pole
Dr. Van Natta is the medical advisor for a company called Refine Medical that has a device made of a permanent suture. It is placed to provide added support and lift to the upper breast tissue. “I now have over 2 years of follow up and over 100 patients using this device and am really impressed with the results.” In essence, the device is placed in the breast, the tissue is lifted to the degree necessary for optimal positioning and then secured. Think “internal suspenders.” The result is permanent upper pole fullness. In fact, small implants are often recommended in a lift to round out the upper pole, but Refine® gives the breast real, natural, lasting fullness many patients desire without an implant. An added bonus is there are no telltale signs that the “suspenders” exist. Although the suture will not dissolve, it cannot be felt or seen in/on the breast, nor does it show up in a mammogram. Even women who are considered quite active are not restricted in any way.
GalaFLEX® for the Lower Pole
Dr. Van Natta describes GalaFLEX® as a “game changer.” GalaFLEX is a mesh support material made from naturally derived material which acts as a scaffold, encouraging patient’s own tissue to grow because it provides a platform for new collagen and elastin. Simply put, it creates a “sling” to help keep breast tissue “up.” According to Dr. Van Natta, while lift or reduction procedures go south after a little while, GalaFLEX is keeping women perky, longer. “It gives a boost to breast tissues to the point that it allows women to ditch their bra, if they like.” The mesh dissolves in 12-18 months and is replaced by scar tissue. “We put in the mesh material at the time we’re doing the breast lift…tightening that skin brassiere. It tricks the body into making the collagen and then after the mesh disappears you’ve got this little internal sling almost like an internal bra,” say Dr. Van Natta who has been performing this procedure for over 2 years on 90 women with great success.
The Physician as a Magician
Initially Dr. Van Natta would use one or the other device during lifts, but as the results continued to improve he had an epiphany. “They each do different things, but they both work and keep things where we put them, so why not use both?” The improvements speak for themselves in the before and after gallery. One of the most memorable patients is shown here–a 65 year old lady whose main objective was to never wear a bra again. “A couple years ago, says Dr. Van Natta, “I would have said, “Ma’am I’m a physician, not a magician.” But I looked at her and said, let me use all my tools and you won’t have to wear a bra again.” A combination procedure using GalaFLEX® and Refine® yielded a 6 month result demonstrating roundness at the top of the breast and support underneath with no recurrent drooping–astonishing for the stretchy skin that is classic at her age. The Refine® actually mimics the appearance of a small implant.
Not “Settling” for Less
In his practice going forward Dr. Van Natta is using both devices as standard in his breast lift patients. Compared with results 5 years ago, he describes this option as “very liberating and exciting.” “We are maintaining much more upper pole fullness than with the standard mastopexy, and in most cases won’t require an implant to achieve that result. No more disappointment with breasts settling and dropping. The patients love the fact that they can enjoy a more youthful appearance, and results are long lasting–bras optional.”
Dr. Van Natta is in the process of publishing some papers on the devices and procedure for peer review and speaks at society meetings making colleagues aware of these new devices. “This is going to be a big deal.”