So, when was the last time you heard your friends saying “I love my natural breasts”…? Possibly never, and this is the reason for new survey results from American Society of Plastic Surgeons (ASPS) show that the number of women undergoing breast lifts has increased by 70%. So why is there a rising trend towards breast lift surgery?
Breast lifts (Mastopexy) are slowly outpacing breast implant surgery. Many women are wanting to improve the natural shape and form of their breasts. More women are empowering themselves with knowledge and realise that they are able to achieve naturally lifted breasts without implants.
My approach towards breast surgery in all patients is to create a natural result, as patients today desire beautifully shaped breasts that do not look operated. In patients requiring breast augmentation surgery the trend is to use more naturally shaped breast implants i.e., anatomically shaped implants that prevent the telltale round stuck on appearance of breast augmentation surgery. Many patients today however are completely happy with the size of their breasts and are more concerned about the sagging of the breasts. Patients want to be able to wear revealing clothes without a bra but do not want to look operated. This is one of the main reasons why I am seeing an increase in patients requesting a breast lift rather than a breast augmentation.
WHY DO MY BREASTS SAG?
Breasts sag due to “dreaded gravity”, breast-feeding can also stretch the breast skin and as we age our hormones decrease, so too does the volume of the breasts. Losing weight can also cause the breasts to shrink and droop,
As the skin loses elasticity, the breasts often lose their shape and firmness and begin to sag. A breast lift, or mastopexy, is a surgical procedure which raises and reshapes sagging breasts — at least, for a while. (No surgery can permanently delay the effects of gravity unless we choose to move to the moon in our retirement). Mastopexy (breast lift surgery) can also reduce the size of the areola, the darker skin surrounding the nipple.
WHAT SCARRING CAN I EXPECT WITH MY BREAST LIFT SURGERY?
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 scar “lollipop” 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 hold up the breast, the breast tissue is completely remodeled, 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 and with 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 and prevent 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 not able 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 the sagging and the shape and volume can be improved 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 DOES FAT TRANSPLANT 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 give some lifting to the general structure of the breast. The goal is therefore to give fullness to the breasts 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 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., if they are very skinny, as the volume required is very high.
Lipofilling can realistically only achieve a natural, small 100cc volume breast augmentation.
BREAST LIFT SUGERY; HOW DOES IT WORK?
Most patients will consult me 2 – 3 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. I however recommend (for comfort) that my patients spend a night under specialized nursing care in the postoperative recovery unit. Recovery is usually uneventful with follow-ups to remove drains and sutures during the 10 days postoperative. Patients can expect some pain and tenderness for a few weeks post-surgery. Special scar plasters are prescribed and should be used for 6 – 12 weeks postoperative to achieve optimal scars.
WHO IS NOT A GOOD CANDIDATE FOR A BREAST LIFT?
Patients requiring a firmer breast are good candidates. If, however, 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 that 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. however, many women today are looking for options without the possible complications of an implant and therefore are 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.