The Surgeon Minute

Lift and Volumize with Mastopexy Augmentation

Lift and Volumize with Mastopexy Augmentation

Perky breasts are youthful looking breasts. They sit high on the chest with a full, plump appearance without any droop or sag. Unfortunately, childbirth, weight gain/loss and age can all adversely affect the look of your breasts. If yours more closely resemble two deflated balloons than ripe fruit, you may be an ideal candidate for a mastopexy augmentation. This procedure combines two common breast surgeries: a breast lift (mastopexy) and breast augmentation.

Dr. Charles Messa of Weston, FL discusses the breast lift with an implant, who is the ideal candidate for a maxtopexy augmentation as well as why he prefers to perform these two procedures in one single operation.

Ideal Candidate for Mastopexy Augmentation

When a patient comes in for a breast surgery consultation, Dr. Messa begins with a dimensional analysis of the breast tissue. He will analyze:

  • Where the nipple and areola are in relation the inframammary fold or crease beneath the breast.
  • The amount of vertical skin excess between where the nipple should be and where it is currently positioned.
  • How much breast tissue does the patient have?
  • Is the skin stretched?
  • Once the patient has a lift, is there still going to be a lack of fullness in the upper pole or cleavage area of the breast?

The patient with loose breast skin who is missing the upper pole fullness or cleavage that she would like is the ideal candidate for a breast lift with an implant. This is the patient who will achieve the best overall aesthetic result.

Breast Lift with Implant in One Single Operation 

With the majority of his patients, Dr. Messa’s approach to the mastopexy augmentation is to perform the procedures in one stage, or as a single operation. “One stage augmentation mastopexy can be performed very safely with complication and reapportion rates that are much lower than if the procedure was staged,” explains Dr. Messa.

The potential problem with a breast lift with an implant is that the surgeon is trying to do two opposing things: add volume to a breast that is deflated, and reduce the size of a breast envelope that has stretched or sags. “So, those oppositional forces can complicate the overall operative predictability of the surgery,” explains Dr. Messa.

Nipple position in a mastopexy augmentation.

Success is really going to depend on the goals of the individual patient as well as her medical history or health. For example, if the patient is a smoker, this will make the procedure more difficult and therefore risky. The objective for a plastic surgeon with any procedure is to:

  • identify what bothers the patient about her appearance
  • clarify what, exactly, the patient expects to achieve in terms of outcome
  • devise a treatment plant to safely deliver her desired result

Reducing Breast Lift Scars

A road block for many patients when it comes to considering a breast lift is the scars. Any time that a plastic surgeon lifts and removes excess skin, there are scars from the incisions. On the breast, in 99% of patients, those scars will fade over time. This is especially true if the skin is treated properly with scar creams as well as the avoidance of sun and smoking. Dr. Messa tells his breast lift patients: “I will do whatever I can to minimize the scarring by meticulous layer closing of the skin.”

Augmentation mastopexy before and after - Dr. Messa.

Furthermore, not every patient needs an anchor or inverted T scar. Surgeons will typically attempt to choose the least-invasive incision that will work for a patient’s anatomy and desired outcome. Some patients do very well with a cirumareolar incision, one that simply goes around the areola. Others will need a lollipop incision which adds a vertical component to the one around the nipple. It is important to individualize the procedure to the patient’s needs keeping in mind that every patient wants minimal scarring.

To Breast Lift or Not Depends on Nipple Position

During the breast surgery consultation, surgeons can immediately tell whether or not a patient needs a breast lift based on her nipple position in relation to the inframammary fold, or crease below the breast. If the nipple rests at the crease or above, then the patient can probably get away with an implant alone in order to increase the volume and rejuvenate the breast.

If the nipple rests below that crease or is pointing downward, “those cases are more severe in terms of the amount of sagging so you are not going to get the optimal result by just putting an implant in,” explains Dr. Messa. “It will give you a look called “waterfall deformity” where it looks like your breast is falling off the implant.” These patients will need a breast lift with an implant.

Augmentation mastopexy before and after - Dr. Messa.


Patient Satisfaction High with Mastopexy Augmentation

The patient satisfaction rate for a breast lift with an implant is typically very high because the surgeon is addressing two distinct problems: a lack of fullness and loose, sagging skin. “By combining the two procedures in a single operation, it reduces cost and recovery period while giving them a rejuvenated breast,” shares Dr. Messa.

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