Mastopexy, or breast lift, is the surgery that treats sagging breasts by removing excess skin that causes the loss of breast shape. It may be performed along with breast implants. When performed without the implants, the change in breasts volume is small. On the other hand, silicone breast implants provide stunning final results and bring out firmer and more voluminous breasts. We call this surgery breast lift with breast implants.
The breast lift surgery is recommended for small or medium breasts. The scar is smaller than the resulting scar of a breast reduction surgery, and is usually around the areola and vertical.
When there is the need to decompose the scar horizontally, a small, inverted “T” is made to prevent the scar to end up below the bikini line. It is also highly recommended for patients that lost too much weight, as in a gastroplasty or after pregnancy. In both cases, the breasts look flaccid, droopy and shapeless, which do not improve with diet and exercise but can benefit from breast lift.
By using modern techniques to improve sagging breasts, Dr. Zamarian Jr. helps the patients acquire young, conical and firm breasts through a simple procedure.
One of the most common questions, in the plastic surgeon's office, asked by patients with sagging breasts is: Why did it happen? The causes of sagging breast skin can be classified as follows:
This cause affects most patients and is present, most of the time, from adolescence and, sometimes, before pregnancy. In these cases, the thickness of the dermis, where most of the skin collagen is found, is usually thin, and is often associated with stretch marks. The mother of the patient might not show the same sagging, even though she can carry the genetic code for sagging skin. Sagging is generalised and is often visible on the breasts, arms, inner thighs, abdomen, on the flanks and on the back.
This cause of sagging breast skin normally occurs after loss of breast volume due to one of the processes below:
The bariatric surgical procedure has been increasingly performed and the results are amazing, with patients losing 60 to 70kg. Thus, the whole body volume is reduced and the skin, which has limited retraction capacity, can't adjust to the new body shape. This excess of skin occurs very often on the breasts, and the breast lift surgery with silicone implants or a breast reduction with implants are recommended. The choice of the technique will depend on the size of the breasts and the degree of sagging.
During pregnancy, the breasts grow along with the body. Most of the volume gained in the mammary glands occurs due to hormonal changes, a characteristic of any pregnancy. The baby suction stimulates the oxytocin which stimulates the hypothalamic-pituitary gland to secrete prolactin hormone that stimulates the production of more milk by the mammary glands. Thus, the glands are stimulated and filled with milk, gaining them a lot of volume during the breastfeeding period. It is very common for women to notice their breasts sag after they stop breastfeeding due to the atrophy of the mammary glands, and the loss of volume in the breasts. Breasts with silicone implants are less affected due to the volume of the silicone.
Some patients may opt for the removal of the silicone implants and never replace them. During the removal of the silicone to prevent sagging, it may be necessary to remove the skin through a mastopexy. Patients may choose not to remove the skin to avoid having scars on their breasts. As the breasts skin has been stretched by the silicone implants, the excess of skin must be removed to prevent sagging.
Aging brings many changes our body, including a reduction in skin collagen, which causes progressive skin sagging due to its thinning process. The breasts sag due to the stretching of the skin; in addition, the mammary glands change and are replaced by fat. This makes breasts lose not only volume, but support and projection. A mastopexy can be effective in treating mammary changes caused by age, with or without silicone prosthesis.
Breast skin can have little collagen, as mentioned before, and a sign of little skin strength is the presence of stretch marks - also called striae. Stretch marks on the breasts are a nightmare for any woman, and many of them ask what they have done wrong to have them.
Stretch marks have a very important hormonal component. Patients who suffer from hormone imbalance, sometime in their lives, may develop stretch marks on their breasts or on other parts of their bodies.
Striae are related to sagging skin and drooping breasts, with low areolas, sometimes even lower than inframammary folds. Sagging breasts with stretch marks tend to drop in the future and the plastic surgeon should be aware of the need to remove as much skin as possible to lift the breasts with stretch marks, in order to have longer-lasting results.
The use of silicone implants in breasts with stretch marks has two main benefits: the implants make the breasts firmer and also stretches the skin a little, reducing sagging and improving the aspect of the striae. Therefore, breasts with stretch marks improve with a mastopexy, when performed with silicone implants.
During the consultation, Dr. Walter Zamarian Jr. will evaluate the anatomy of the breasts, taking into consideration their width, volume and projection, position and size of the areolas, skin thickness and firmness, the consistency of the glands, among others. He will also evaluate the patient's anatomy, height and chest width, position of the breasts on the thorax, axillary fat and the distance between the breasts, to choose the best technique to be used in order to meet the patient’s expectations.
It is important to evaluate the content of the breasts, whether it is mostly glandular or fattty. Basically, the glandular breast is younger, firmer and more projected that fatty breast. With age, the mammary glands are substituted by fat, and the breast loses support and volume, becoming more sagging and softer. The plastic surgeon may inform the patients whether her breasts are mostly glandular or fatty and whether a breast lift with silicone implants would be recommended for more volume and firmness. The demand for mastopexy with implants has increased substantially. The use of silicone implants along with this surgery has brought even more attractive results, such as more projection of the upper pole and lower risk of new sagging over the years.
For safety reasons, the patient must take the following exams before breast lift:
Dr. Zamarian performs the breast lift surgery in the operating room, with the patient under general anaesthesia given by specialized anaesthesiologists, guaranteeing safety to the procedure.
Dr. Zamarian makes a small incision around the areola and in the inferior vertical of the breast, from which the excess of skin is removed and through which the breast is raised with little scarring. If necessary, the silicone prosthesis can be placed, resulting in firmer and more projected breasts. Like in all breast surgery, the skin is closed externally with glue, leaving no stitch marks and allowing for quick recovery. This is the technique chosen by Dr. Zamarian for most cases of mastopexy. Although it is a virtually painless procedure, with minimal trauma, Dr. Zamarian recommends that patients follow the recommendations to the letter, so that their recovery is very smooth and cheerful. After an evaluation in our clinic, Dr. Zamarian can recommend the best surgical technique for having the desired breasts.
In some rare cases, mastopexy can be performed using the Periareolar technique with silicone prosthesis. A little skin around the breasts is removed, repositioning the areolas up to 2 to 3 cm higher, while the silicone implants are introduced. This technique should be avoided in patients with significant skin sagging in the lower pole (lower part of the breast), since this sagging tends to persist after periareolar surgery.
Dr. Zamarian's recommendations for patients who have undergone breast lift surgery:
Find out how breast lift can improve the aspect of your sagging breasts. If associated with silicone breast implants, they can also be firmer and you will be fully satisfied. After all, you deserve to have beautiful breasts!
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