Breast Size vs. Shape
Breast augmentation and breast lifts are complimentary procedures. In our San Francisco Bay Area, Walnut Creek Plastic Surgery office, the combination of breast augmentation and breast lift can enhance both the breast volume and the breast shape. While breast augmentation increases the breasts’ volume, breast lifts can address the breasts’ shape, and the position of the nipple.
Despite what you may read, breast augmentation does not lift the breast. It can provide additional volume and support for a breast with pseudoptosis. Pseudoptosis is “fake sagging” and describes a breast with the nipple located above the inframammary fold (IMF) and the majority of the breast tissue located below the IMF. Since the nipple is already in the correct position, adding volume with a breast implant supports the breast tissue and nipple upwards, and creates a youthful appearance of the breast. When breast augmentation is performed with the nipple already low in the breast, the added volume can appear to push the nipple further down on the breast, and give a matronly appearance.
Breast Lift with Breast Augmentation
Before and After Photos (Augmentation Mastopexy)
Breast Lifts And Breast Volume
Breast Lifts alone do not add volume to the breast. This is especially apparent in the upper aspects of the chest. A breast lift can move the nipple up the breast and the breast mound off the abdomen and back onto the chest, but Mastopexy alone does not fill the upper chest. Even patients with large breasts before having a breast lift, may still have relatively little or no upper pole breast tissue. This is seen even with Breast Reduction patients, who have an excess of breast tissue. A breast lift is performed as part of the breast reduction. While breast mound and nipple are lifted, in most cases the volume of the upper breasts cannot be significantly enhanced without using a breast implant.
Because the two operations, Breast Augmentation and Breast Lift, are complimentary, a beautiful synergy can be achieved with the combination procedure of Breast Augmentation Mastopexy. It is also one of the most complex cosmetic plastic surgery procedures, and it takes years of experience to develop reliable techniques that safely and reliably combine breast augmentation and breast lift. Because of the complexity, some plastic surgeons prefer to perform the procedure as two separate operations, but with careful planning, a mastopexy that includes breast implants can be performed safely and effectively as a single operation in many cases.
Breast Augmentation with Breast Lift Videos
Why Combine Breast Augmentation and Mastopexy?
The most common indications for combining breast augmentation with a beast lift are listed here:
- After pregnancy, child birth and breast feeding
- After weight loss, especially massive weight loss or after bariatric surgery
- Breast ptosis (sagging) combined with a desire to increase cup size
- Breast ptosis (sagging) combined with a desire to increase fullness in the upper breast
- Breast enlargement when the nipple is low on the breast
Types of Breast Augmentation Lifts Available
Breast augmentation can be combined with any of the common breast lifts. A short review is provided here, and more details on breast lifts can be found on the breast lift (mastopexy) page. Breast lifts are listed in ascending order from mastopexies which provide the shortest scar (and the smallest amount of lift) to the largest.
- Breast Augmentation Mastopexy Crescent Lift (Crescent Augmentation Mastopexy): Periareolar breast augmentation is normally performed via a periareolar incision placed below the nipple from about four to eight o’clock. When a small lift is needed, the incision can be moved to above the nipple (from ten to two o’clock). A small crescent of skin is removed, and the nipple and areola are lifted. Since the areola remains attached along its lower half, the amount of lift is limited, and pulling too hard will distort the shape of the areola. This lift is not effective enough to correct true ptosis.
- Breast Augmentation Mastopexy PeriAreolar Lift (PeriAreolar Augmentation Mastopexy): The periareolar breast lift is sometimes called a circumareolar lift as it utilizes an incision around the circumference of the areola. It is similar to a crescent lift with the tips of the crescent meeting at the bottom beneath the nipple. Since the lower aspect of the areola is closed horizontally, along the edge of the areola, it does limit the amount of vertical lift. Normally one or two centimeters of upward movement is obtained, but the addition of the breast implant provides additional support for the lower pole of the breast and can enhance the visual improvement. A periareolar augmentation mastopexy is also helpful for correcting the tubular breast deformity. Click here to read more about Tubular Breast Deformities.
- Breast Augmentation Mastopexy Vertical Lift (Vertical Augmentation Mastopexy): The vertical breast lift is so named because is has a vertical scar below the periareolar scar. The two shapes drawn together give the lift is nickname – the lollipop lift. The periareolar scar (a circle at the top) and the vertical scar (a vertical line extending downwards) form the candy and the stick of the lollipop respectively. It is variation on the inverted-T technique that is absent the IMF scar. Since the lower aspect of the incision is closed side-to-side, there is no downward drag. The side-to-side closure pinches the lower pole of the breast and helps push the nipple-areolar complex further up on the breast.
- Horizontal Lift (Horizontal Augmentation Mastopexy): The horizontal breast lift gets its name from the horizontal IMF (Infra Mammary Fold) scar that is added to the periareolar scar. The horizontal breast lift may be the least commonly used mastopexy technique. It requires a long narrow breast. It is variation on the inverted-T technique that is absent the vertical scar. In order to not have the vertical scar, the nipple must be moved more than 7 centimeters (about 3 inches). Since no skin is removed between the areola and the new inframammary fold, this breast lift works best when the breast is narrow. Since the IMF scar is low in the breast, it tends to be hidden in the curve at the base of the breast, giving a more aesthetic result.
- Inverted-T Lift, Anchor Lift, Keyhole Lift (Inverted-T Augmentation Mastopexy, Anchor Augmentation Mastopexy, Keyhole Augmentation Mastopexy): The inverted-T breast lift gets its name from the inverted capital T shape of the scar that is added to the periareolar scar. The other names arise because the overall shape of the scar makes an anchor shape, and the shape of the upper portion of the resection looks like a keyhole before is it closed. This is be far the most versatile breast lift as it can reshape even the severely overstretched or deflated breasts. The peri-areolar and vertical components of the scar, allow the nipple to be moved as high needed. The horizontal (IMF) portion of the scar, allows for removal of excess skin at the base of the breast. Tightening this area reduces the ability of the breast tissue to descend and sag onto the abdomen. This type of lift helps with both true ptosis and pseudoptosis, while the implant can increase the breast size and provide upper pole fullness.
Breast Augmentation Video Presentation
Breast Lift Video Presentation
If the areola is too large an Areola Reduction may be seamlessly incorporated into all the lifts above (except the crescent lift). The lifting procedure will position the areola, while the areola reduction decreases the amount of pigmented skin surrounding the nipple. Areolar reduction can also be performed without a lift. The scar is hidden along the edge of the areola. More information on areola reduction is located on the Specialty Breast Procedures page.
Breast Implant Warranties
The three major breast implant manufactures in the US are Natrelle (Allergan), Mentor (a division of Johnson & Johnson) and Sientra (Silimed). All stand behind their unique breast implant product lines with generous warranties, including lifetime replacement of your implant should you experience a deflation. Breast implants leaks which occur within 10 years of your initial breast augmentation surgery may qualify for additional financial assistance to defray the cost of Breast Implant Deflation Replacement Surgery, i.e. replacing your old breast implants with the new breast implants. For your convenience, warranty details are available here. Breast Implant warranties are frequently updated, so be certain to check your breast implant manufacturer’s web site for the latest information.
To compare Breast Implant warranties visit the San Francisco Breast Breast Implant Warranties Page.
Every effort is made to keep the breast implant warranties listed on this site up-to-date; however, manufacturers may change them without notice. Be certain to check your manufacturer’s website for the latest information