Everything you need to know about the Breast Lift, written by Dr Nerina Wilkinson MBChB (Stell) M.MedFC PLAST (SA)
The rising trend of the breast lift
According to a new survey, requests for the breast lift surgery has sky-rocketed of late, even outpacing breast implants by two to one. Dr Nerina Wilkinson discusses this procedure and its rising trend…
It’s no secret that breast implants remain one of the most requested and popular procedures in cosmetic surgery. However, new survey results from the American Society of Plastic Surgeons (ASPS) show that since 2000, breast lifts have been outpacing breast implants by two-to-one. Although three times as many women still undergo breast augmentations as breast implants, the number of women undergoing breast lifts has increased by 70% since 2000.
So what is this from?
One of the reasons may be that while patient’s desire firm, beautifully shaped breasts – they still want them to appear natural-looking (and not like they have been operated on). In patients requiring breast augmentation surgery, the trend is to use more naturally shaped breast implants i.e. anatomically shaped implants – as these prevent the telltale round ‘stuck on’ appearance of breast augmentation surgery. That said, however, many patients are now completely happy with the size of their breasts, and are more concerned about them eventually sagging. Patients want to be able to wear revealing clothes without a bra – but don’t want to look like they’ve had ‘work done’.
Sagging breasts: How to perk things up…
Breasts generally sag due to the dreaded effects of gravity. Breastfeeding also plays a part as it stretches the breast skin. Then there is the ageing process: as we grow older, our hormones decrease – which sees the volume of the breasts diminishing as well. As the skin loses its elasticity, the breasts often lose their shape and firmness, making them sag. Breast lift (or mastopexy), is a surgical procedure to raise and reshape sagging breasts—at least, for a time. (Surgery can permanently delay the effects of gravity.) Mastopexy can also reduce the size of the areola (the darker skin surrounding the nipple). Breast lift surgery has for many years been a life-changing procedure for many patients. Recent advances in minimizing the extensive scars of the past have improved results – and have encouraged more ladies to seek breast lift surgery. I tend to use the short “lollipop” scar technique in most of my patients (unless the breasts are too large). The resultant short scar gives patients more confidence and allows them to wear more revealing clothes than they could with the longer, older inverted T scar. A short scar breast lift procedure is more than just a change in the scar. It is a change in the philosophy of how a breast lift is performed. Rather than using the skin to uphold the breast, the breast tissue is completely remodelled – creating an internal bra so that the breast sits in a higher position without the help of the skin. The breast tissue that remains is never disconnected from the nipple, which optimizes the possibility of breastfeeding in the future. Sagging breasts with enough volume and without stretch marks – as well as good elasticity – are perfect for lollipop scars. Some patients may experience sagging of their breasts and would like a slight increase in the volume of the upper pole of the breasts. In the past, plastic surgeons have tried to give the illusion that the breasts are lifted by inserting a larger implant to fill this extra skin, thus preventing the scars associated with a breast lift. I, however, find that most of these patients are disappointed a few years after the surgery, as they have traded “small hanging breasts” for “larger hanging breasts”. They are still unable to wear a shoestring top without a bra, as the nipple-areola complex is still sitting in the same place as before the surgery. In patients requiring a more natural result without a breast implant, a breast lift can be performed to improve not only the sagging but the shape and volume of the breasts as well. This can be done by injecting their own fat into the upper pole of the breast for a natural upper pole fullness. Autogenous fat grafts offer the advantages of preventing the long-term complications associated with the implantation of a breast implant.
How do fat transplants work?
Liposculpture is performed by removing fat from a part of your body that has abundant unwanted fat deposits (e.g. those stubborn love handles). This fat is then purified through a specific technique and then injected into the breasts.
Fat injections create fullness; while providing a lift to the general structure. The goal is, therefore, to give fullness to the breasts, thereby achieving a more youthful state. In addition to adding volume, fat is extremely rich in stem cells, which are reinjected with the fat. Stem cells are known as ‘the fountain of youth’, and helps to stimulate many other cells in the body to improve their functions. Women who desire large, firm or round breasts may not be an appropriate candidate for autogenous fat transplant, as fat grafts result in a more natural-looking appearance. Similarly, fat grafts to the breasts are not a viable option for women lacking significant sources of donor fat for liposuction i.e. they are very thin (as the volume required is very high). Lipofilling can realistically only achieve a natural, small 100cc volume breast augmentation.
Breast lift surgery: How does it work? (From consultation to the operation & recovery care)
Most patients will consult me two-three times before their final surgery day to discuss and plan the size/shape of their breasts, incisions/scars and the possible side effects associated with surgery. The surgery is then performed in the day clinic under conscious sedation. Most patients return home on the same day on analgesics and antibiotics. Yet I recommend that my patients spend a night under specialized nursing care in the postoperative recovery unit for comfort. Recovery is usually uneventful with follow-ups to remove drains and sutures during the 10 days post-operative. Patients can expect some pain and tenderness for a few weeks post-surgery. Special scar plasters are prescribed and should be used for six-12 weeks post-operative to achieve optimal scars.
Who is not a good candidate for a breast lift?
Patients requiring firmer breasts are a good candidate. However, if they require a full round upper pole, then only a breast augmentation would be able to achieve this result. A natural breast has a pear shape – and this is the result you will achieve with a breast lift – with or without fat injections in the upper pole. Patients who are unable to accept scarring on the breasts are also not good candidates. Even though the scars are short, and mature well over 18 months to a light white scar, some patients can heal with hypertrophic scars that will be visible forever.
Prosthetic breast implants have been the golden standard for decades.
Although, many women today are looking for options without the possible complications of an implant – and are therefore looking at some of the newer, more natural techniques to improve the shape and the size of their breasts. A mastopexy i.e. breast lift – with or without lipofilling of the upper pole – is a safe and predictable procedure, resulting in naturally perky breasts.