Bay Area & Oakland California Breast Lift Surgeon

Augmentation Mastopexy, or breast lift, is designed to improve the appearance of a sagging or ptotic breast and simultaneously add breast volume.

Mastopexy Surgery | Breast Lift

In similarity with mastopexy alone, there are four main types of breast lift which may be performed at the same time as breast augmentation, and the common names for them are based on the shape of the incision and resulting scar. The more sagging a patient has, the more likely that she will need more extensive and longer incisions to achieve a desirable result. With any of these techniques, the nipple and areola complex can be shifted to either side as well as up, if necessary, for the most aesthetic appearance. A breast lift does not involve removal and replacement of the nipple. The nipple and areola remains attached to the breast, and only the surrounding skin is removed.

A summary of the 2 most common techniques I follow are as follows:

Augmentation Techniques with Mastopexy

The balance between opposing forces of removal of excess and ptotic breast skin and the addition of breast volume is a careful one. The ultimate goal is to design the breast with sufficient skin tension to fight the tendency of recurrent ptosis and laxity without jepardizing blood and nerve supply. Please refer to the augmentation section for specific questions regarding augmentation in general. The choice of type of implant is an individual one. If the patient has a significant history of breast feeding, I prefer to use a textured implant. I believe that the textured surface has a lower risk of forming a capsular contracture. Breast feeding may pose a risk of colonization with local skin flora within the breast tissue. It is for this reason that breast augmentation should not be performed within 6 months of breast feeding. If the lateral and inferior poles of the breast have thin skin and the breast tissue itself lacks density, it is probably better to use a silicone jel implant in order to avoid early or later rippling. Rippling refers to the feeling of a palpable irregular edge of the implant through the skin. It is for this reason that the textured round silicone implants have become increasingly popular over the last year in my practice.

Superior Crescent Mastopexy

For patients with mild sagging and excess breast skin in the upper half of the breast, requiring no more than 2cm of nipple/areola lift and a normal amount of skin in the lower half, a semi-circular incision is made on the upper border of the areola. A crescent shaped piece of skin is removed, and when the skin edges are sewn back together, the nipple and areola are raised slightly (1 to 2 cms). A crescent mastopexy is best for women with only mild breast ptosis (sagging). This technique is particularly useful in patients who have a pointed breast with a tight and short inframammary crease. If the nipple is not lifted at the time of surgery, then the implant will be high riding and a double bubble is likely to form at the inframammary crease.

Anchor Mastopexy

Also referred to as a Wise pattern (or sometimes Weiss pattern) mastopexy, full breast lift, or inverted-T incision. The anchor mastopexy is considered the traditional technique for breast lifting, elevation of the nipple/areola over 3cms is achievable as well as removal of excessive laxity of skin in the lateral and lower poles. The incisions are made around the areola, down the center of the lower portion of the breast and then across the breast in the inframammary fold. Like the donut and lollipop incisions, the areola can be made smaller at the same time. The resulting scar is in the shape of an anchor. Anchor Mastopexy is now usually reserved only for those with moderate to severe breast sagging. The implant is placed under the pectoralis muscle. The sub pectoral pocket provides 4 important helpful effects over the submammary (implant over the muscle) placement: 1. the implant is less likely to fall since the rectus muscle sheath is lifted at the base to support the implant at the time of surgery, 2. the superior pole is more gradual in the take off point-providing a more natural breast contour, 3. there is a lower incidence of scar tissue distortion of the breast termed ‘capsular contracture’ and 4. the blood supply to the nipple areola complex is less likely to be altered since the implant pocket is placed at the level of the ribcage as compared to over the muscle where there would be a larger number of blood vessels divided in nearly the same plane used for mastopexy.

Patient before and after photos

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The author is aware of the recent concern regarding the possible formation of a rare form of lymphoma within the capsule of breast implants. To date, there are a total of 60 reported cases of anaplastic large cell lymphoma in the 5-10 million women world wide who have breast implants. All cases were contained by the implant capsule and did not invade surrounding tissue. The median time from implantation to clinical diagnosis is 8 years. The implants involved are both silicone and saline. Four of the 34 case reports world wide, since 1997, specifically described the implant surface and all 4 implants were noted to be textured, suggesting that texturing may have a role in the causation of this rare tumor. Further studies are underway to confirm whether or not texturing has a role in causing the disease process. The current recommendation by the FDA is not to remove textured, or for that matter, smooth breast implants at this time.” For additional information click here.