The Surgeon Minute

Tailoring Breast Rejuvenation with Implants, a Lift, or Both

Tailoring Breast Rejuvenation with Implants, a Lift, or Both

Patients who want a fuller, firmer breast are often confused about the best procedure for achieving their goal. Should they pursue a breast augmentation, a breast lift, or both?

In general, a breast implant is going to give you more volume, but it cannot significantly lift a nipple that is heading for the floor. Sagging in the breast is a common occurrence with age, hormone shifts and pregnancy. The skin and tissues weaken and stretch past your body’s ability to “bounce back.” A breast lift can restore your nipple to its former, higher position on the chest wall, but it does leave a scar. This can be alienating for many patients. However, if patients don’t pick the right procedure for their individual needs, they will most likely be disappointment with the results. 

Dr. Craig Colville of Toledo, OH discusses the various factors to consider when it comes to improving the look of the breasts, as well as an easy at home trick to determine if you need a breast lift or not. 

Breast Augmentation & Breast Lift Address Different Concerns

When a woman comes in for a breast surgery consultation, she will typically say that she wants her breasts “like they used to be,” explains Dr. Colville. This almost always translates to her wanting an augmentation, but this does not necessarily mean that a breast implant will give her the result that she desires. An implant will increase the volume of the breasts, but it can not lift a breast that has begun to droop.

If you have just a little bit of sag at the bottom of your breast, a breast implant alone can improve or correct this issue. The following concerns will almost definitely demand a breast lift procedure:

  • the nipple faces downward
  • the distance from nipple to crease is long, about 4-5”
  • the nipple rests at or below the fold beneath your breast

Breast Lift, Scar & Incision Options

The issue with the breast lift for most patients is that it does involve a visible incision. Most women are wary of a scar on their breast, even if it will be hidden the vast majority of the time. Depending on the amount of lift you may require, there are a few differing incisions you may incur – some larger and some smaller. These include:

  • around the areolar
  • a vertical incision down the center of the breast
  • underneath the breast in the crease

With the areolar incision, the scar blends nicely into the transition between the darker skin of the nipple and your lighter breast skin. The other advantage of this incision is that it allows the surgeon to reduce size of your areolar if needed. The incision beneath the breast is hidden within the crease. The only truly visible scar is the vertical component, but scars on the breast actually heal extremely well. So, don’t let the fear of a scar prevent you from getting the right procedure for your needs.

Breast lift incision options.

Breast Lift Procedure

When lifting the breast, the plastic surgeon’s goal is to return your breast to a more youthful position, higher up on your chest wall. He or she accomplishes this by removing excess, droopy skin in order to reduce or tighten the size of the breast envelope. This lifts the nipple, producing a perkier appearance. A surgeon may also suture the breast tissue to create an internal bra. This helps to deliver a much longer lasting lift.

For patients with seriously comprised via stretched skin and tissues, Dr. Colville may add an absorbable mesh, like GalaFLEX, which acts like an internal scaffold, providing even another layer of support. This mesh material stays in the body for about 12 months before collagen replaces it inside the body, leaving a scaffolding made of your own tissue and not a foreign device.

Do You Need a Breast Lift? The At-Home Test

How do you know if you need a breast lift? Ideally, you should be assessed in person by a board certified plastic surgeon. That said, a simple at home test is to stand in front of the mirror with a ruler and take some measurements. Though not exact, if your nipple has to come up 2″, or the distance from your nipple to the crease is 4-5”, you will more than likely need a lift.

Testing for breast lift.

Another benchmark is, where does your nipple rest? If it rests at or below the crease beneath your breast, you will probably need a breast lift. Then the question is will a breast lift alone do the trick or do you need a breast lift with implants?

Vectra 3D Imaging Greatly Helps Decision Making

During any patient’s breast consultation, Dr. Colville will use Vectra 3D imaging to show the patient exactly how she will look with an augmentation alone, a breast lift alone, or a breast lift with an implant. “That does help the patient [to understand the difference between the procedures],” says Dr. Colville. This is particularly true when a breast lift patient is trying to decide on whether or not she wants an implant as well.

3D imaging and implant choices.

The right choice is going to really depend on the look that you want. “If you just want to restore and get rid of the droop and the sag, [you can do that with a lift alone],” shares Colville. “But if you want a little more volume, a little more fullness, a little more fill in the upper half of the bra, you are going to end up wanting an implant.”

A breast lift and augmentation can be performed at the same time in certain patients. It’s really going to depend on your overall health, as well your anatomy. If a patient has a thicker, heavier breast, it is hard to lift and place an implant on the same day and get a great result. Bottom line, Dr. Colville will schedule the surgeries separately if he feels that this is what will deliver the safest, best looking result. 

Breast lift with Dr. Colville.

Recovery from Breast Augmentation & Breast Lift

The recovery for a breast augmentation, breast lift or combination is relatively the same, with breast lift being a little bit longer and more sensitive. Dr. Colville performs rapid recovery with his breast augmentation patients so there is no special dressing or bra. You will go home, lift your arms over your head, and take some pain medication. Typically, over the counter Motrin will do the trick. He likes his patients to go out to dinner that first night because he knows that they are moving around. Basically, you return to your daily life, although he does like his patients to stay out of the gym for 3-4 weeks. With a breast lift, the recovery is almost the same except you are not going to go home and take a shower that first day.  

Although pushing it too far too fast will probably not hurt your end results, it will slow down your recovery. “I look at this as an investment,” says Dr. Colville. If you want to take care of your investment, it’s best to take it easy for a few weeks. It’s a pretty simple trade off: the overwhelmingly majority of Colville’s patients say they would do it again for what they received.

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