Breast Lift

As a woman ages, factors such as pregnancy, nursing, the force of gravity, weight loss, and environmental effects such as smoking and sun-induced skin damage all combine to cause breasts to sag. Breast lift, or mastopexy, is designed to remove excess sagging skin, thereby rejuvenating the breast shape and elevating the nipple to a more youthful position. The procedure can also narrow the areola diameter. The vast majority of women also choose to have a breast implant placed in conjunction with the breast lift in order to restore breast volume and to gain more upper breast fullness.

I just got a breast lift with a silicone addition at this place... The best experience ever, from my consolation with Dr. Doan and Leydin to the day of surgery. I'm two days post op and I couldn't be happier, I finally got the results I've wanted for the last 8 years of my life. Dr. Doan was very knowledgeable about everything dealing with the procedure, Leyden was a sweetheart and gives you her honest opinion about whatever you ask. The Anesthesiologist was great no pain no discomfort and very sweet. I would recommend this cosmetic center to anyone who wants a flawless job done and recovery time is remarkable. So again come here if you're looking for as close to perfection as you can get and great customer service... and thank you again Dr. Doan and your staff !!!!

Katrina W.

The Breast Lift Surgery

The operation takes 1 ½ to 2 hours to perform and you will be monitored by an anesthesiologist throughout the procedure.
Equally important factors include the technical expertise of the surgeon and the amount of correction needed. Your surgery may take longer if other procedures are being performed in conjunction with your breast lift such as breast reduction or non breast-related procedures.
The basic elements of any Breast Lift involve making an incision around the new areola to make the new circumference smaller. This also serves to free up the areola from surrounding skin so that it can be moved upwards. If a breast implant is being used for augmentation or to correct asymmetry, it is inserted through the areola incision at this point. The actual breast lift incisions are then made according to the markings shown in the diagrams below. After the premarked incisions are made, the loose flaccid skin is removed from underneath the breast (for an anchor or lollipop lift) or from the central portion of the breast (for a donut lift) depending on the technique being used. The cut skin edges are drawn together and closed with absorbable sutures, lifting the breast to a new higher position. The areola is also elevated to a higher, more youthful position.

Recovery From Breast Lift Surgery

You will likely feel achy pain, stretching of the skin, and a pressure feeling over your chest for several days after the surgery. You should be up and about the next day to prevent blood clots from developing in the veins of the legs. You will be prescribed medication to control the pain, nausea, and possible chest muscle spasms. You will also be prescribed antibiotic pills to prevent infection. You need to wear a soft surgical bra for six weeks. Doctor Doan will instruct you on breast massage and will outline the activity limitations. The sutures are absorbable and do not need to be removed. Most women will be able to return to work in 5 to 7 days and will be able to return to their normal exercise routine by 4 to 6 weeks. Complete healing with resolution of the swelling and descent of the implant to a more natural position takes 2 to 3 months. The scar requires 12 to 18 months to fade, flatten, and soften. Doctor Doan and his staff will guide you through the entire recovery period to make sure that it is as smooth as possible.

Options for Breast Lift

The type of Breast Lift procedure that a woman may need depends on several factors that cause the breast to sag. These factors include:

How much firm, dense breast tissue has been replaced by fat from aging and pregnancy
Thinning of the skin with stretch marks caused by repeated skin stretching
How large the areola has stretched
How far down the nipple has descended
The degree of asymmetry of the breasts in size and sagginess

The single most important measurement that determines which breast lift technique will be necessary is the distance between the areola and the inframammary fold (IMF). This measurement is not absolute, but it does give a good indication of what will be necessary for correction. Keep in mind that a concurrent breast augmentation will stretch extra skin and, therefore, will decrease the need to remove a lot of the skin envelope. This may make it possible to perform a less extensive breast lift.There are four common breast lift techniques:

Before and After

Patient #1A: This is a 32 year old Caucasian female who has 3 children and has significant breast asymmetry from breast feeding. Her right breast is a very saggy D cup size and her left breast is a mildly saggy C cup size. She expressed a desire to have fuller, perkier, and more symmetric breasts that look good in a low-cut dress. She is 5 ft. 5 in. tall and weighs 150 lbs. She chose to go with 350cc round, high profile silicone gel implant on the right and 375cc on the left to get a softer, more natural feel. She had an anchor pattern breast lift. She is now a perky, symmetric full D cup size.

Patient #1B: This is a 38 year old Caucasian female who has 4 children and is a preoperative small D cup size. Her breasts are even but they are severely saggy with the nipples pointing downwards. She wished to have perkier breasts with more upper fullness so that she wouldn’t have to wear a push-up bra. She is 5 ft. 6 in. tall and weighs 145 lbs. She chose to go with 325cc round, high profile silicone gel implants to avoid the rippling of the skin associated with saline implants. She had an anchor pattern breast lift. She is now a perky, full D cup size.

Patient #1C: This is a 28 year old Hispanic female who has 2 children and is a preoperative large D cup size. Her breasts are even but they are flat on top and very saggy due to breast feeding. She wished to have much larger, rounder, and perkier breasts to restore her confidence and self-esteem. She is 5 ft. 4 in. tall and weighs 135 lbs. She desired to go one cup size larger and chose to go with 300cc saline implants. She had an anchor pattern breast lift. She is now a perky, double D cup size.

Patient #2A: This is a 29 year old Hispanic female who has 2 children and is a preoperative C cup size. Her breasts are even but they are flat on top and saggy due to breast feeding. She desired slightly fuller breasts with more perkiness. She is 5 ft. 4 in. tall and weighs 150 lbs. She wanted to go one cup size larger and chose to go with 350cc silicone gel implants for a softer, more natural feel. She had a donut pattern breast lift. She is now a perky, small D cup size.

Patient #2B: This is a 25 year old Caucasian female who has no children and is a preoperative C cup size. She lost 30 lbs. and went from a full D to a C cup with sagginess of her breasts. She wanted to go up another cup size with more perkiness because she loves to wear a bikini top by the poolside in the summer. She is 5 ft. 7 in. tall and weighs 140 lbs. She chose to go with 400cc round, high profile silicone gel implants to get softer feeling breasts with minimal skin rippling compared to saline implants. She had a donut pattern breast lift. She is now a perky, full D to double D cup size.

Patient #2C: This is a 38 year old Caucasian female who has three children and is a preoperative B cup size. She complained that after her last pregnancy, her breasts were too saggy, too small, and her areola were too large. She wanted larger, perkier breasts because she loves to wear low-cut dresses on date night with her husband. She is 5 ft. 6 in. tall and weighs 145 lbs. She chose to go with 375cc round, high profile silicone gel implants which have a much lower leakage rate than saline implants. She had a donut pattern breast lift. She is now a perky, full C to small D cup size.

Patient #2D: This is a 27 year old Caucasian female who has two children and is a preoperative B cup size. She used to be a perky, full C cup size before pregnancy but has lost a lot of breast tissue with moderate sagging of her breasts. She is 5 ft. 4 in. tall and weighs 125 lbs. She chose to go with 450cc round, high profile silicone gel implants for a more natural, ripple-free feel. She had a donut pattern breast lift. She is now a perky, large D cup size.

Patient #3A: This is a 30 year old Hispanic female who has three children and is a preoperative small D cup size. She used to be a full D cup size but lost significant breast tissue after her pregnancy and developed very saggy breasts. She is 5 ft. 4 in. tall and weighs 130 lbs. She chose to go with 300cc round, high profile silicone gel implants to get a softer, more natural feel. She had a vertical breast lift (lollipop pattern). She is now a perky, large D cup size.

Patient #3B: This is a 40 year old Afro-American female who has one child and is a preoperative full D cup size. She is 5 ft. 7 in. tall and weighs 135 lbs. She wanted to go just slightly larger with more perkiness. She chose 275cc saline implants with a vertical breast lift (lollipop pattern). She is now a, perky full D cup size.

Patient #3C: This is a 29 year old Hispanic female who has one child and is a preoperative large B cup size. She is 5 ft. 2 in. tall and weighs 125 lbs. She chose to go with 375cc round, high profile silicone gel implants. She had a vertical breast lift (lollipop pattern). She is now a perky, large C cup size.

Patient #3D: This is a 35 year old Hispanic female who has two children and is a preoperative large B cup size with lots of stretch marks and very thin skin. She is 5 ft. 3 in. tall and weighs 140 lbs. She chose to go with 400cc round, high profile silicone gel implants to minimize rippling through her thin skin. She had a vertical breast lift (lollipop pattern). She is now a perky, large C to small D cup size.

Patient #4A: This is a 20 year old female who has no children and developed large breasts in her early teens. She lost 20 lbs. after puberty which led to severe sagginess of her breasts. The sagginess of her breasts affected her self-esteem and ability to date young men. She was happy with her current cup size and desired breast lift to rejuvenate her breast shape without implants. She had an anchor pattern breast lift with no implants. She is now a perky full D cup size.

Patient #4B: This is a 25 year old Hispanic female who has no children and developed very large breasts in her early teens which got even bigger and more saggy as she entered her early 20’s. She finds it embarrassing to wear a bikini top or tank top. She wanted to keep her current cup size and desired breast lift to rejuvenate her breast shape without implants. She had an anchor pattern breast lift with no implants. She is now a perky double D cup size.

Patient #4C: This is a 42 y.o. Caucasian female who has full D cup breasts but experienced slowly worsening sagginess of her breasts with each pregnancy. She has been wearing tighter push up bras to get the lifted, perky look to her breasts. She loved the size of her breasts and only desired a breast lift to feel better about herself. She had an anchor pattern breast lift with no implants. She is now a perky full D cup size.

Patient #4D: This is a 35 y.o. Caucasian female who has two children and was once a very perky full C cup size in her younger years. Her breasts sagged after pregnancy which made her feel ten years older and less attractive. She wanted her breasts lifted but didn’t want implants for various reasons. She had an anchor pattern breast lift. She is now a much happier and confident, perky full C cup size.

Breast Augmentation with Crescent Lift

Depending on the size of the implant used, breast sagginess can sometimes be corrected by augmentation alone when the nipple is at least at the level of the breast crease or above. If the nipple is lower than the crease, some form of lift will most likely be necessary. If the lower breast skin is tight but the nipple sits low on the breast mound, then a crescent lift of the areola may be all that is needed to elevate the nipple by 1.0 to 1.5 cm to get a more youthful looking breast. The crescent lift is also very useful to correct nipple asymmetry.

This type of lift, though, has limited applications and tends to be overused by plastic surgeons to minimize scarring when a more dramatic breast lift should have been used to achieve the desired results. Depending on the amount of excess skin that needs to be removed and the position of the nipple, improper application of any breast lift for the sake of skimping on scarring will leave the breast still saggy.

Breast Augmentation with Donut Lift

The donut (or peri-areola) mastopexy is best used when the nipples are no lower than 2 cm below the breast fold. The nipples should also not be pointing downwards.

This procedure involves excising the appropriate amount of breast skin around the areola (usually 1.0 to 2.0 cm) and then closing the skin around the new areola. This will tighten the breast skin and elevate the nipple-areola complex over the center of the breast mound. This procedure creates a small amount of rippling at the incision but this usually goes away within months after surgery. It is also an excellent procedure to make the areola smaller after pregnancy and breast feeding.

Breast Augmentation with Vertical Breast Lift

When the nipple descends greater than 2 cm below the breast crease, it is often necessary to incorporate a vertical incision because of the additional skin that must be removed. As breasts sag, they tend to flatten at the top, lose cleavage, and take on a rectangular shape at the bottom.

In these patients, a donut breast lift may elevate the nipple to the right location, but it will not address this saggy, rectangular appearance of the breast. The vertical incision breast lift will remove the excess lower breast skin and create a much more rounded, attractive, youthful appearance of the breast.

Breast Augmentation with Anchor Breast Lift

When the skin excess in the lower breast is greater than even the vertical incision can remove to achieve a round and perky shape, then it is necessary to remove the rest via a transverse incision into the crease of the breast. The length of the horizontal incision is determined by the amount of redundant skin.

Complications of Breast Lift Surgery

If you are a healthy candidate with no pre-existing disorders or diseases which may inhibit healing, the general risks of Breast Lift surgery are very low. However, since it is indeed surgery, there are inherent risks you must consider before choosing to undergo a procedure such as this. Potential complications associated with Breast Lift surgery may include the following:

Infection: Infection can occur if bacteria are introduced during surgery by contaminated implants or instruments. It can be caused by normal skin surface bacteria that survive the anti-microbial scrubbing of the skin. Infection can also occur if bacteria are introduced through an open incision or from pre-existing infections in the body (including disruption of mouth plaque).

Bleeding: Bleeding may occur 48 hours after breast augmentation if a blood vessel opens up spontaneously and begins to bleed. The other possibility is that the muscle or capsule is torn by sudden heavy lifting too soon after surgery and begins to fill the breast pocket with blood.

Rippling: Rippling can occur when there is either not enough saline filling the implant to stretch the shell, insufficient tissue to cover the implant, or internal scar tissue which is visible through thin breast skin.

Capsular Contracture (CC): When an implant or any foreign body is surgically implanted, your body forms a normal layer of scar tissue around the object. This is your body’s natural way of decreasing inflammation. Some materials create significant inflammation, and others create very little, like the silicone shelled implants. Capsular contracture is when the body produces a thick layer of scar tissue around the implant. When this tissue contracts, the implant is distorted and it can also cause pain and even rupture of the implant.

Deflation of the Implant: An implant can deflate due to severe blunt or sharp trauma to the chest or a failure of the implant shell. The risk is very low and would require replacement of the implant.

Breast Tissue Atrophy: This is when the natural breast tissue shrinks due to the pressure of the breast implant. It is usually only noted if the patient chooses to have the implants removed and not replaced.

Bottoming Out: Bottoming out occurs when the skin and the underlying breast tissue at the breast crease separate. This can cause the implant to drop below the natural crease of the breast and form a second, unnatural crease.

Double Bubble: Double Bubble often occurs when a sub-muscular augmentation was performed without a much needed breast lift. The breast implant is held securely under the muscle higher on the chest wall. However, the natural breast tissue and excess breast skin sag below the implant. This creates the appearance of an augmented breast sitting above the natural breast.

Extrusion: Extrusion is very rare. This is caused by the breast basically pushing out the implant. The underlying cause is usually a very large implant in a very tight breast pocket causing internal pressure against the incision or an infection of the breast that causes the skin to open up.

Keloid and Hypertrophic Scars: This is usually hereditary and is based on your genetic potential for healing. This occurs when the scar tissue forms outside the area of the wound. It can result in thick, elevated, and wide scars.

Asymmetry: This occurs when one breast or nipple may appear higher or larger than the other breast.

Loss of Sensation (Numbness): Loss of sensation is common right after surgery. Nerve endings are cut during this surgery, so you must be patient until they regenerate and sensations begin to return. This can take up to a year but usually only takes several months for the sensation to return. However permanent sensation loss in the areola (nipple) area or breasts, in general, can and may happen.

Wound Separation: The separation of the wound edges may be an issue in some cases. If this occurs, keep the area very clean and contact your surgeon as soon as possible. Revision surgeries are rarely necessary but may be required in some cases. The healing process will take longer for a patient with wound separation than it would be in a patient with normal wound healing.