A woman will undergo breast augmentation surgery when she decides to surgically increase her breast size. This involves the placement of a silicone or saline breast implant to add volume to the breast. Sometimes, however, Baltimore plastic surgeon, Dr. Daniel Markmann, will recommend a lift if there is any sag associated with the breast. Patients who wish to have fuller breasts but have sagging due to weight loss or pregnancy, may benefit from a breast augmentation with a lift, which is actually two procedures combined into one. During surgery, Dr. Markmann brings the breast to a more elevated, higher position, and then increases the size with an implant.
During this procedure, Dr. Markmann will insert implant sizers first then perform the lift. This begins with the surgeon removing excess skin residing on and around the breast in order to reshape it. The skin and underlying tissue will be pulled tight and lifted so that the breast sits in a higher position. In addition, the nipple is usually repositioned. For excessively large breasts, the colored part around the nipple (known as the areola) will need to be surgically reduced. The surgeon will remove the outer circle and reposition the skin. The permanent implant is then inserted.
Breast lifts are performed with varying incision patterns. Some common incision patterns include:
Breast augmentation with a lift can usually be performed as a single surgery. However, some patients will choose to have this broken into two separate procedures. Some women are unsure of how large they want to go or how they will feel about their breasts' appearance after the lift has been accomplished. If it has been decided ahead of time that an implant will be placed during the lift procedure, it is usually positioned below the pectoralis muscle. This adds additional support to the breast and acts as an internal bra, which results in a longer-lasting outcome.
Breast augmentation with a lift is performed under general anesthesia in an accredited surgical facility. Because this is a combination surgery, the recovery time can last a bit longer than a lift alone. Most patients are able to return to work within 1-2 weeks, but exercise and aerobic activities should be eliminated for at least 2-4 weeks. It will take a few months for the breasts to settle fully into their new position and assume a soft, natural look. Women who have lived with sagging, deflated breasts are thrilled with their new breast appearance.
**After surgery, we ask patients to come back for several postoperative appointments. The first of these normally takes place in 1-3 days after surgery, then numerous times over the next few weeks. More appointments will be spaced out over the next several months, and then up to a year later. At Metamorphosis, we have all breast implant patients return for a follow-up visit once every year for life, at no charge.
Breast augmentation surgery will help with size, but will not lift a sagging breast. If there is moderate to severe sagging, women should be leery of any surgeon who recommends implants alone. Patients who are happy with the size of their breasts, but want to correct the sagging, will usually benefit with a breast lift procedure (without the placement of implants).
During your consultation, the incision placement will be discussed after your breasts have been thoroughly assessed. Women with smaller breasts will usually benefit from an incision that circles the areola only. Larger breasts, or those that have severe sagging, may need the anchor-shaped incision in order to garner the best results.
Breast lifts are designed to last a very long time. As long as you do not experience a huge weight gain or become pregnant, the results can last for years. The implants are surgically placed in a way that protects the breasts from sagging. Age and gravity are unavoidable elements that will create some natural sagging throughout the years.
Unlike breast augmentation alone where the incisions can be carefully hidden, it is hard to conceal the incisions that are made during the lift procedure. The number of scars and their location will depend on the surgeon's incision strategy. Every effort is made during surgery to minimize scarring. With proper scar care and an avoidance of sun exposure, the scars will fade and become thinner over time. Most women feel that the physical results following this surgery far outweigh the scarring left behind.