- 1 Description
- 2 Options
- 3 What is a Normal Breast Position?
- 4 Anatomy Of The Breast Tissue
- 5 Indications
- 6 Evaluation
- 7 Option Details
- 8 Procedure Description
- 9 Recovey
- 10 Frequently Asked Questions (FAQs)
- 10.1 What is a breast lift procedure?
- 10.2 What are the incisions like in a breast lift?
- 10.3 What is breast ptosis?
- 10.4 What causes breast ptosis?
- 10.5 A woman’s breasts often change throughout their lifetime, and these changes and loss of skin elasticity can result from:
- 10.6 What will a breast lift do?
- 10.7 A breast lift procedure can accomplish any or all of the following by:
- 10.8 What can’t a breast lift do?
- 10.9 Why should I consider a breast augmentation with lift?
- 10.10 How long does a breast lift surgery procedure take to perform?
- 10.11 What are the possible side effects from breast lift surgery?
- 10.12 Will I lose nipple sensation from my breast lift?
- 10.13 How do I know if a breast lift is right for me?
- 10.14 How long will the results from my breast lift surgery last?
- 10.15 What is the recovery like after breast lift surgery?
- 10.16 When will I be able to return to work?
- 10.17 Will I have to spend the night in a hospital?
- 10.18 The breast consists of:
- 10.19 What will my consultation at Gabbay Plastic Surgery be like?
- 10.20 What will determine if I am a good candidate for breast lift surgery?
- 10.21 Can I have a breast lift if I plan to get pregnant in the future?
- 10.22 How long will my scars be obvious?
With age, our tissues loses collagen and elasticity, and can contribute to a condition known as breast ptosis (sagging of the breasts). Fortunately, a breast lift (mastopexy) can restore the pert, youthful appearance to your breasts by raising and reshaping your breast contour. When necessary, a breast lift can also be utilized to reduce or reshape the size and appearance of the areola (the dark skin surrounding the nipple). Unlike a breast augmentation, which increases the size and volume of the breasts, or a breast reduction, which reduces the size of the breasts, a breast lift is performed to raise and re-shape sagging breasts, without impacting their size. Some women elect to undergo breast lift surgery in conjunction with a breast augmentation, in order to simultaneously lift and increase the size of their breasts within the context of one procedure. At Gabbay Plastic Surgery, Dr. Joubin Gabbay M.D. is highly experienced performing breast lift surgery for women who want to rejuvenate the appearance of their breasts, and will work closely with you to develop a treatment plan to bring your breast surgery goals to fruition.
There are several variations of breast lift surgeries, which differ primarily in terms of the incision pattern used during the surgery.
- The Anchor or Standard Lift
- The Lollipop or Vertical Lift
- The Donut or Concentric Lift
- The Crescent Lift
After conducting a thorough initial evaluation of your breasts, and discussing your surgical objectives and goals, Dr. Gabbay will select the appropriate procedure to ensure optimal results from your breast lift.
Age, childbirth, breastfeeding, genetics, and sun damage can all contribute to the loss of elasticity in breast tissue over time. At Gabbay Plastic Surgery, Dr. Gabbay has helped thousands of women rejuvenate their figure by lifting and restoring the youthful shape and contour of their breasts with mastopexy surgery. Following your breast lift surgery, your breasts will look and feel firm and lifted, and the position of your areolas and nipples will be more proportionate and balanced. If you have additional questions about breast lift surgery, please contact Gabbay Plastic Surgery today. We look forward to speaking with you and scheduling your initial complimentary consultation with Dr. Gabbay.
What is a Normal Breast Position?
Every woman’s breasts are unique in terms of their shape, pigmentation, volume, texture, and size; however, all female breasts do share the same internal structure, and undergo similar changes during the aging process.
Because the human breast does not contain muscle, suspensory tissue and ligaments (Cooper’s ligaments) are responsible for supporting it and keeping it in a lifted position. When the ligaments stretch out over time, the supportive tissue and internal structures weaken. The aged dermis is also unable to contract back to its original shape, causing the breast to change shape and begin to sag.
In medical terms, the condition for sagging breasts is called ptosis. Although ptosis can be exacerbated by fluctuations in weight, breastfeeding, genetics, and childbirth, the primary cause is the skin changes that occur along with breast involution. Breast involution takes place when milk-producing glands shrink and shut-down as a woman’s milk-producing system is no longer needed. As the tissues inside the breast shrink, and the skin surrounding the breast stays the same, the breast appears to be empty and drooping. Breast involution can occur after pregnancy (if a woman does not breastfeed), or as a woman ages and experiences menopause.
If you are interested in a cosmetic procedure to correct your sagging breasts, the first step is to determine your level of ptosis. Plastic surgeons frequently utilize the classification below when measuring the degree of ptosis:
- Normal Breast—no symptoms of ptosis; the nipple of the breast sits firmly above the lower (inframammary) fold of the breast.
- Grade 1: mild ptosis; the nipple lies slightly above or directly in front of the breast fold.
- Grade 2: moderate ptosis; occurs when the central point of the nipple sits 1-3 centimeters (cm) below the top of the breast crease (inframammary fold).
- Grade 3: severe ptosis; occurs when the central point of the nipple and the areola falls more than 3 cm below the breast crease, pointing downward, at the lowest point of the breast.
- Pseudo-Ptosis: the nipple rests above the inframammary crease; however, the breast still appears to droop because of a the breast tissue and skin droop substantially below the lower breast (inframammary) fold.
- Low Breast: the breast rests naturally low on the chest with no sagging.
Anatomy Of The Breast Tissue
Human breasts are specialized organs located on the anterior chest wall. The breasts make milk for breastfeeding and are comprised of glandular tissues and supporting (stromal) tissues. The glandular part of the breast includes the lobules and ducts (tiny tubes that carry milk to the nipple). For women who are breastfeeding, the cells of the lobules make milk; the milk then moves through the ducts, and the ducts lead to the nipple.
The amount of adipose tissue (fat) a breast contains varies among females (a mature female breast can fluctuate between 50-500 grams), and it is this fatty tissue and fibrous connective tissue that helps give the breast its size and shape. The nipple is composed of dense connective tissue, and is the end point for the milk ducts. Both the nipple and the areola (the pigmented area around the nipple) contain pigmented skin and numerous sebaceous (oil) glands.
Blood vessels (arteries and veins) carry plasma, white blood cells, red blood cells, and platelets to and from the breasts, while lymphatic vessels carry lymph away from the breast. Lymph is a clear fluid containing tissue, fluid and immune system cells and plays a crucial role in fighting infection. The breast also contains lymph nodes (bean-shaped cells found along lymphatic vessels), with most lymphatic vessels in the breast connect to lymph nodes under the arm.
In summary, the breasts are composed of:
- Fibrous Tissue: provides support for the breasts and separates the breast into segments that extend from under the skin’s surface to the chest wall.
- Mammary Glands: the part of the breasts that produce milk
- Fat Tissue: forms a protective covering for the breasts–after menopause, fatty tissue replaces the mammary glands, causing the breasts to lose their firmness.
Breast sagging begins when the connective tissues of the breasts stretch out and become weak and when the breast looses its volume.
You may be a good candidate for breast lift surgery (mastopexy) if you have one or more of the following conditions:
- Breasts that lack firmness
- Breasts that are small and drooping
- Breasts that are flatter after weight loss
- Breasts that are deflated from pregnancy and breastfeeding
- Breasts that are elongated in shape
- Breasts that lack fullness
- Breasts that are pendulous (hanging)
- Nipples that point downward
- Unsupported nipples that fall below the breast crease
- Enlarged areolas
- Areolas that point downward
- Breasts that have stretched skin
- Breasts that are asymmetrical including different shape, size, or one that is lower than the other
- Breasts that are heavy
The best candidates for mastopexy are healthy women who are satisfied with the size of their breasts, but not with their shape or firmness. Good breast lift candidates are physically healthy, psychologically stable, and have realistic expectations for surgery. Breasts that are large and heavy can be lifted; however, the results may not be as long-lasting as when the procedure is performed on smaller breasts.
Many women choose to undergo breast lift surgery before having children, and go on to successfully breastfeed in the future. It is important to note that having a breast lift will not prevent the breasts from drooping again if presented with similar conditions responsible for the initial sagging (such as pregnancy, breastfeeding, and/or drastic weight loss). Dr. Gabbay will discuss your options in detail during your consultation to determine when and if a breast lift is right for you. Dr. Gabbay will place incisions in inconspicuous locations so that they can be covered with a bra or bathing suit.
During your initial breast lift consultation, Dr. Gabbay will conduct a thorough medical assessment, and will discuss your medical history in detail, including information about: medical conditions, allergies, treatments you have received, previous surgeries, and medications that you currently taking. It is crucial that you are completely open and honest with Dr. Gabbay during your consultation, in order to avoid unnecessary complications and to ensure a successful and rewarding outcome.
In order to determine if a breast lift procedure is appropriate for you, Dr. Gabbay will:
- Examine your breasts to determine the degree of ptosis
- Evaluate where your nipple is in relation to your inframammary fold
- Assess the looseness of your skin
- Establish how much excess skin you have
- Verify the size and position of your areola
If it is determined that you are a good candidate for breast lift surgery, Dr. Gabbay will explain the surgical options, including the type of anesthesia that will be used, where the incisions will be placed, and any possible risks. He will show you before and after photographs of some of his many satisfied patients, and if you decide to proceed with a breast lift, your pre-operation consultation and actual surgery date will be scheduled.
There are several types of breast lift surgeries, which differ primarily in terms of their incision pattern.
The surgical options of breast lift surgery include:
- The Anchor Lift: The anchor lift is the traditional technique used in a breast lift procedure, and it receives its name because the scar from this breast lift looks like an anchor. The anchor lift is mainly used for breasts with severe sagging, and it involves three incisions: one around the areola, another running vertically from the bottom of the areola to the crease under the breast, and a third placed horizontally beneath the breast.
- The Lollipop Lift: The lollipop lift involves two incisions–one around the perimeter of the areola, and one that runs vertically down from the areola to the breast crease. The lollipop lift is used for women who have a moderate degree of breast ptosis.
- The Donut Lift: The donut lift, also known as the periareolar lift or the “Benelli” lift (named after the surgeon who invented it), involves an incision around the perimeter of the areola–this type of breast lift is suitable for mild-to-moderate sagging.
- The Crescent Lift: The crescent lift involves an incision just along the upper half of the areola. The crescent lift is typically performed in conjunction with breast augmentation, and is appropriate for women with mild cases of ptosis.
Dr. Gabbay and the professional staff at Gabbay Plastic Surgery are committed to making your breast surgery as safe and comfortable as possible. A breast lift is an outpatient procedure, meaning you will go home the same day, and generally takes 1-4 hours to complete, depending upon how complex your surgery is, and whether you are having other procedures performed at the same time. Dr. Gabbay will determine whether to perform your breast lift using general or local anesthesia (with or without intravenous (IV) sedation) based on the extent of your surgery and personal preferences.
Once you are anesthetized, Dr. Gabbay will make the necessary incision(s) utilizing the incision pattern chosen beforehand.
During surgery, any stretched and loose skin will be removed, while the nipple and remaining underlying tissues are relocated to a higher position. If the areola of a sagging breast has been stretched out as well, it can be reduced in size during the breast lift procedure. The nipples and areola will remain attached to underlying mounds of tissue (to allow the preservation of sensation) and the skin formerly located above the areola will be brought down as the breast is reshaped. For women who desire larger breasts, implants can be inserted during the breast lift surgery (this is referred to as a ‘breast augmentation with a lift’). Dr. Gabbay will complete your surgery by closing your breast incisions with sutures.
Your breast lift recovery time will depend on the specifics of your surgery and your individual healing capacity. Following your breast lift procedure, your breasts will be swollen and bruised and you will wear a compression garment (surgical bra) over the gauze dressings to minimize swelling. You may be uncomfortable for a couple of days, but the pain should not be severe and can be easily controlled with pain medications if necessary. Walking and getting out of bed for brief periods is advisable; however, you should avoid straining, bending, or lifting, as these activities will increase your risk of developing complications. Bruising is generally mild, and typically disappears after 2-3 weeks, while any swelling should subside over a period 4-6 weeks.
Within the first few days after your breast lift surgery, you will return to Gabbay Plastic Surgery for your first postoperative visit, at which time you will be examined to ensure that everything is healing properly. Your surgical dressings will be changed and you will be allowed to start wearing a soft support bra, which must be worn 24 hours a day for at least one month. If necessary, sutures will be removed after one week, and you may notice that your breasts feel unusually firm (particularly along the edges of the incisions). These symptoms will typically subside over the next few weeks; although, in rare cases, it may take longer or may even be permanent.
You will be instructed on how to massage your breasts in order to expedite your recovery, and most patients find that they are able to return to work after one week. If your job involves excessive stretching and lifting, it is advised that you refrain from that type of activity while your breasts heal. Although you will notice immediate improvement in the appearance of your breasts following surgery, it may take up to six months for your scars to fade and the complete results of your breast lift to become evident.
As with any surgery, breast lift complications are possible, and may include:
- Anesthesia complications
- Wound separation
- Loss of sensation
- Hematoma (break in a blood vessel)
- Seroma (collection of fluid under the skin)
Frequently Asked Questions (FAQs)
What is a breast lift procedure?
A breast lift procedure, also known as mastopexy, involves repositioning the nipple-areolar complex and removing excess skin, before reshaping the breast in a more aesthetically pleasing and higher position.
What are the incisions like in a breast lift?
Individual factors and personal preferences will determine the specific incision pattern selected for your breast lift, however, for any technique used, Dr. Gabbay will place the incisions following your breast’s natural contour(s) to minimize scarring.
What is breast ptosis?
Breast sagging, medically known as breast ptosis, is identified in different degrees that include:
- Grade 1—Mild ptosis that occurs if your nipple lies slightly above or directly in front of the breast fold
- Grade 2—Moderate ptosis that occurs if the central point of your nipple is 1-3 cm below the top of your breast crease
- Grade 3—Severe ptosis that occurs if the central point of your nipple and your areola is more than 3 cm below your breast crease
- Pseudo–Ptosis—This type of ptosis occurs when the nipple is still above the inframammary crease, but the breast appears to droop because of a large, flattened breast lobe
What causes breast ptosis?
A woman’s breasts often change throughout their lifetime, and these changes and loss of skin elasticity can result from:
- Significant fluctuations in weight
What will a breast lift do?
A breast lift procedure can accomplish any or all of the following by:
- Lifting your sagging or drooping breasts
- Reducing the size of your areola
- Repositioning your nipples
- Reshaping your breasts
- Restoring the contour of your breasts
- Lifting your breasts after the loss of breast volume
- Correcting asymmetries in your breast
What can’t a breast lift do?
Breast lift surgery cannot significantly change the size, or round out the upper portion of your breasts. If you want your breasts to look fuller, many women consider a breast augmentation with lift; and if your breasts are too large and you want smaller breasts, a breast lift combined with a breast reduction may be right for you.
Why should I consider a breast augmentation with lift?
Breast enlargement will not correct sagging breasts, and a breast lift alone will not increase the size of the breast. A breast lift combined with breast augmentation is called an augmentopexy, and together, the procedure will sculpt your breasts into the size that you want, create firmness, correct the position and shape, and add volume, without the need for multiple procedures. A breast augmentation with lift is a good choice for women who have breasts that have deflated after pregnancy or massive weight loss.During your consultation, Dr. Gabbay can help you decide which breast procedure will help you achieve the look you desire.
How long does a breast lift surgery procedure take to perform?
Depending on the extent of the procedure(s) you are having, time requirements vary from patient-to-patient, but in general the surgery can take from 1-4 hours.
What are the possible side effects from breast lift surgery?
Breast lift surgery side effects can include temporary discomfort, bruising, and swelling. Your breasts may also be temporarily numb, and you will be required to wear a surgical bra home from surgery to minimize swelling and speed up the healing process.
Will I lose nipple sensation from my breast lift?
Most patients do not experience nipple sensation loss, however, in a small percentage of cases, patients do experience some or complete loss of nipple sensation.
How do I know if a breast lift is right for me?
Breast lift surgery is a highly individualized procedure that you should choose for you: not to fulfill someone else’s desires or to try to fit into what others consider an ideal image. After a thorough consultation with Dr. Gabbay, you will be able to make an informed decision if a breast lift is right for you.
How long will the results from my breast lift surgery last?
Breast lift plastic surgery results can last permanently, although the procedure does not stop aging, gravity, and weight changes, which can alter the results, and eventually create the need for breast lift revision surgery.
What is the recovery like after breast lift surgery?
Because a breast lift can be more complex than other breast surgery procedures, it may require additional recovery time. To heal properly, you will be instructed to refrain from professional, or physical activity for at least one week and any pain should resolve in 2-3 days, which is controlled with pain medication if necessary. Regular exercise must be avoided for at least one month (or until Dr. Gabbay approves), and most women are able to resume their normal routine 4-6 weeks after their breast lift surgery, although this depends on the results of your healing.
When will I be able to return to work?
Most women take at least one week off from work for their breast lift, and when you return to work, Dr. Gabbay will restrict you from lifting more than 10 pounds the first week, and no more than 25 after that until your incisions have completely healed.
Will I have to spend the night in a hospital?
In most cases, a breast lift is performed as an outpatient procedure, which means that you will be released to a family member or friend to drive you home the same day.
I hear that knowing breast anatomy is important when considering any cosmetic breast procedure. What are the main components of the breast?
The breast consists of:
- Milk glands (lobules) that produce and supply milk
- Special ducts that transfer milk from the lobules to the nipple
- The nipple
- The areola (the pigmented region surrounding the nipple)
- Connective (fibrous) tissue
What will my consultation at Gabbay Plastic Surgery be like?
During your consultation at Gabbay Plastic Surgery, Dr. Gabbay will ask you about your desired breast shape and size, and you should be prepared to discuss anything about your breasts that you would like to see improved, as this will help him understand your expectations and determine whether they can be realistically achieved. If Dr. Gabbay feels a breast lift would benefit you, he will explain the procedure and discuss how your breasts, nipples, and areolas will be repositioned. Your medical history will be evaluated, the surgical options will be decided upon, and after your thorough consultation, your breast lift surgery will be scheduled.
What will determine if I am a good candidate for breast lift surgery?
You may be a good candidate for breast lift surgery if:
- You have breasts that are satisfactory in size but they droop or sag
- You have breasts that lack substance or firmness
- You have breasts that have lost shape and volume
- You have nipples and areolas that point downward
- You have nipples that fall below your breast crease
- You have breasts that have become flatter, elongated, or pendulous
- Your breast skin is stretched
- You have enlarged areolas
- You have one breast that is lower than the other
- You are physically healthy
- You maintain a stable weight
- You do not smoke
- You have realistic expectations
- You have breasts that have become flatter, elongated, or pendulous over time
Can I have a breast lift if I plan to get pregnant in the future?
It is generally recommended that you wait until you are finished having children to have a breast lift, as pregnancy and breast-feeding may have significant and unpredictable effects on the size and shape of your breasts resulting in changes your breast lift results. Nevertheless, many women decide to undergo breast lift surgery before having children, and since the milk ducts and nipples are left intact, breast lift surgery usually will not affect your ability to breastfeed.
How long will my scars be obvious?
Although every surgery involves some degree of scarring, as a distinguished plastic surgeon, Dr. Gabbay is committed to taking every necessary precaution and aggressive measure possible to minimize scar visibility. A special tape will be placed on the incisions to promote a thinner, less defined scar, and he will apply a solution to treat the skin and aid in healing. Other options may include IPL (Intense Pulsed Light) laser treatments, to improve any marks on the breast.