The Surgeon Minute

A Breast Lift with Mesh

A Breast Lift with Mesh

A breast lift is an ideal procedure for eliminating ptosis, or drooping in the breasts. It will lift the breasts to a higher point on the chest wall, excising excess skin and tightening the breast mound. However, it can not change the actual quality of your breast tissue.

In the past, there was not a  great procedure for addressing severely drooping breasts and weak breast tissue. Now there is. Dr. Mark D. Epstein of Stony Brook, NY discusses the breast lift with mesh. Not only does it deliver all of the benefits of a traditional breast lift, it also adds a layer of internal support for potentially weak breast tissue. The results are truly spectacular.

What is a Breast Lift with a Mesh?

A breast lift with mesh is a fairly new procedure aimed at those patients who have severe ptosis or droop in their breasts as well as weak breast tissue. The mesh works as a means of extra support,; some refer to it as an “internal bra.” With a traditional breast lift, the plastic surgeon is lifting the sagging skin off the breast, and reshaping the breast tissue. This is what creates a perkier, more youthful-looking breast mound.

Breast ptosis in breast lift.

What a breast lift does not change is the quality of the breast tissue. In patients who have weak breast tissue, meaning that there is not enough firmness to hold things in place, Dr. Epstein will add a sheet of GalaFLEX mesh for additional support.

GalaFLEX Mesh = Bioengineering Your Breast Tissue

GalaFLEX mesh is a biologically-derived, lattice-like scaffold made of poly-4-hyroxybutyrate (P4HB). During a breast lift with mesh, Dr. Epstein will place a piece of this mesh all along the lower portion of the breast from one side to the other. He also puts a little piece of the mesh in the upper breast in order to anchor it to the muscle, giving the breast mound more support. Over the next 18 – 24 months, the body will weave scar tissue in and out of the mesh lattice. Then, the mesh itself will dissolve and what’s left is a patient’s own, strong tissue support. Basically, “we’re bioengineering a new layer of tissue,” explains Dr. Epstein.

GalaFLEX mesh.

Breast Lift with Mesh for Breast Lift Only

Most breast lifts rely on the skin brassiere alone to provide support for the newly lifted breast. However, this doesn’t work in patients where the skin brassiere itself is weak. In the breast lift with mesh procedure, the skin brassiere is really “a passive participant in the lifting process,” says Epstein. It’s the mesh along with the suture reconfiguration inside the breast that is doing all the work here.

A breast lift with mesh is for patients who only want a lift. Due to the technical nature of this procedure, Dr. Epstein does not perform a breast augmentation at the same time. In fact, in the vast majority of these patients, they have enough native breast tissue so volume is not the problem. However, if there is a patient who does want an augmentation as well, he will perform one a few months later in a staged fashion. Separating the breast lift and the breast implant procedures is only necessary in these patients who are going to need the additional support of a mesh. For the patient with mild to moderate sagging, it is perfectly acceptable to perform a breast lift and a breast augmentation at the same time.

Breast lift with mesh results.

Breast Lift vs. Breast Lift with Mesh

In a standard breast lift, Dr. Epstein typically uses a circumareolar approach. This entails placing incisions:

  • around the nipple
  • vertically down the front of the breast

If there is any lower scar beneath the breast, it is very minimal. However, in the breast lift with mesh procedure, it is necessary to use what’s called a wise pattern incision.

Breast lift with mesh scar placement.

The wise pattern incision entails the above plus an incision all the way along the lower portion of the breast in the crease. This is really the only way to excise the extra skin in order to give the lift that patient’s need and give the surgeon the necessary access to place the mesh in the proper position. The results, however, are quite dramatic.

Recovery from Breast Lift with Mesh

Although the procedure is more time consuming than a traditional breast lift, “interestingly enough, I’ve not seen any difference in the recovery,” shares Epstein. As long as the surgeon handles the breast tissues gently and performs the surgery in as minimally-traumatic fashion, the post-op recovery and discomfort from a breast lift with mesh are really not that much different from a regular breast lift.

The results from this procedure are long lasting. “The surgical mesh here is basically mitigating the effect of gravity on the breast tissue,” explains Dr. Epstein. A huge plus is that the mesh will “give you a longer lasting result.”

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