PSC Roundtable

Breast Rejuvenation Options

Breast Rejuvenation Options

Childbirth, age, genetics, and weight gain/loss can all take their toll, but today, women are taking control of the look and feel of their breasts like no other time in history. Breast rejuvenation – which may include a breast augmentation, breast lift or both – is one of the most popular cosmetic surgery procedures in the world. However, many patients are still confused as to the best method for restoring a more youthful look to their breasts. Three of our top experts in breast surgery, Dr. Kevin Smith of Charlotte, NC, Dr. Caroline Glicksman of Sea Girt, NJ and Dr. Richard Restifo of Orange, CT, discuss your breast rejuvenation options.

by Katherine Stuart

Breast Implants or Breast Lift?

Oftentimes when a patient comes in for a breast rejuvenation consultation, she knows that she’s not happy with the look or feel of her breasts, but she’s less certain of the best way to fix the issue. For Dr. Glicksman, the first question that she asks every breast rejuvenation patient is, “Do you want to be bigger?” If the answer is yes then the issue is a loss of volume and a breast implant will be the best course of action. However, if the patient is happy with her size, but she’s not happy with the way her breasts look when she takes off her bra, then the issue is one of breast tissue that has stretched out with time, age, and/or childbirth. For these patients, a breast lift is going to be the best way to restore a more youthful look.


Dr. Smith agrees that if a patient doesn’t want to be bigger then an implant is not the way to go. He’s found that patients aren’t just worried about the appearance of the breasts, they also care about how they feel. “After kids, sometimes the breasts are a little more jiggly or floppy [than patients would like],” he says. This is something that can be more difficult to fix than shape or getting the nipple at the top of the mound. As Dr. Restifo explains, a lift won’t increase your size and an implant won’t change your nipple position. “So if you want to be larger, you’re going to need an implant. If you want to move the nipple, you’re going to need a lift. And if you want to do both, you’re going to need both.”


Breast Implant & Breast Lift Together, or Not?

Many of the women who come in complaining about the appearance of their breasts want to specifically restore fullness to the upper pole. They want that look of cleavage with a rounded top. In the right patient, a breast lift with an implant can be an ideal way to achieve this. The lift can tighten the stretchy skin that has made the breast droop in the first place while a small implant can make the top of the breast “pop”, according to Smith. But should the procedures be done separately or together?

Glicksman likes to start with the augmentation then let her patients live with it for awhile before deciding whether or not a breast lift is needed. The reason for this more conservative approach is that the results from a breast lift aren’t going to last forever. Time will eventually take it’s toll again on the restored breast tissue and she doesn’t want to put scars on a woman that will last a lifetime until it’s really necessary. For Restifo, he can tell in the consultation whether or not a patient will benefit from a breast lift with an implant, and since he feels that the procedures can be done safely at the same time, he has no problem doing so. While Glicksman doesn’t argue that they can safely be performed together, she does question whether or not “your complication rates go up?” The latest data out there shows that the complication rates are up at the 25-30% range at three years. “I don’t think that’s acceptable.”  She feels that splitting the surgeries lowers a patient’s risk of having to have revision surgery down the road.

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