I know I want some form of tummy tuck and breast augmentation. However, I don't know if I just need implants or if I will also need a breast lift. How can I tell? I'm a 26 year old mother of three. I'm 5ft. and 115lbs.
How to Know if Breast Lift is Needed?
Doctor Answers (11)
Nobody puts Babe in the corner
I know, it's "baby". A consultation with your board certified plastic surgeon will determine whether you need a lift or not with your implants. You will get a lift effect from the implants alone and if you only need a small lift, a larger implant might be enough to avoid the lift scars. Good luck!
How to Know if Breast Lift is Needed?
To Lift Or Just To Augment
The way to determine whether you need a lift or not is to stand in front of the mirror with your top off, hold a piece of paper under your breast at the fold where the breast meets the chest wall, and a second piece of paper at the same level in front of your breast.
1. If your areolar but not your nipple is below the fold, I recommend what is often called an internal lift, also known as a DUAL PLANE MASTOPEXY. This lift can be accomplished through an armpit incision, leaving no excess scars when done along with a breast augmentation.
2. If your nipple is below the fold but less than 1" down, I recommend a BENELLI MASTOPEXY. This leaves the only scar at the edge of the areolar and can be done with or without an implant.
3. If your nipple and areolar are significantly below the inframammary fold, I recommend an ANCHOR OR FULL MASTOPEXY with our without breast implant.
The trick with the mirror and the pieces of paper give you some idea of what may be necessary. You, of course, need an in person, in office consultation with a Board Certified Plastic Surgeon who is experienced in all aspects of breast lift and breast augmentation surgery.
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Breast lift with implants
Some degree of a lift can happen with implants alone. However, if your nipple is at, or below the fold under your breast, you might consider doing an actual lift as well.
In general, I tend to recommend only doing the implants unless the amount of sag is significant. If you have the implants and later decide you want to have more lift, you can still perform that procedure at a later date without having burned any bridges.
Nipple position and volume changes determine if breast lift is needed
The determining factor for the need for a breast lift is the position of the nipple on the chest. A "normal" breast has most of the fullness above the crease and the nipple is also above the crease at the bottom of the breast. Not uncommonly, with pregnancy or weight changes, the breast will lose volume and the nipple will droop down and hang below the crease at the bottom of the breast. If this is the case, a breast augmentation will not fix the problem. You may end up with a "double bubble" situation where the implant is high and the breast tissue is low. To prevent this, a lift would be performed at the same setting to create a more youthful breast shape. The incisions can range from a concentric mastopexy, just around the areola, to a full mastopexy that has an anchor type scar on the nipple and breast.
Breast Rejuvenation with implants, a lift, or both
There are different techniques that can be employed to improve upon the shape and appearance of the breasts. These may include tightening of the skin and repositioning of the breast tissue, insertion of breast implants, or a combination of both techniques. Which technique is used is based mostly on the individual patient. In general, if the nipple "hangs" more than an inch below the breast fold, some type of lift will be needed.
The procedure is usually done as an outpatient procedure to help augment a woman's breasts or replace volume that has been lost after childbirth, breast feeding, through normal aging or weight loss. This may sometimes require more than one operation if both a lift and implants are needed. The best way to figure out whether you need a lift and whether this should be done in one or two operations is by having a consultation with a board certified plastic surgeon.
Breast lift or not?
A breast lift is usually needed if the nipple areola are in a much lower position than where they started. If the nipple areola complex is on the lower pole of the breast and pointing downward, then more than likely you will need a lift. The same goes for the breast tissue position. If the lwoer pole ofthe breast sits very low on the chest and is very loose, then you probably will need some form of lift procedure.
When is a breast lift needed
This is not a very easy question to answer without seeing you. Generally speaking if the nippleas and breasts are pointing down, you will need a breast lift. If the nipple is pointing forward but is well below the level where the skin of the chest and the skin of the breast meet under the breast you will probably need a breast lift. The rest depends on size of implant, and degree of tolerance of drooping vs scarring. All these things need to be considered when it comes to thinking about doing a breast lift.
Is a Breast Lift necessary?
There are several factors that help determine the need for a breast lift at the time of augmentation. These include the location of the nipple relative to the fold beneath the breast, the location of the breast gland relative to the fold, and the relationship of the existing skin/soft tissue envelope and the planned size and shape of the implant. Many times it is obvious to the patient and the evaluating surgeon that a lift is necessary to get a good result, eg if the nipple-areola complex is pointing straight down, or if the majority of the breast gland is sitting well below the fold of the breast. The descent of the gland is referred to as "glandular ptosis", the N-A descent is sometimes called "nipple ptosis". The position of the gland itself, as well as the relative position of the N-A complex are both important. For example if you are standing in front of a mirror, and the nipples are pointing straight down and most of the breast itself is below the line that your underwire makes---you would benefit from some type of lift.
Its really important to have great communication with your surgeon in the case of mild ptosis. There may be decisions to make that involve certain"trade-offs". For example it may be that adding a lift, which may involve additional visible scarring, improves the shape and quality of the result. You and your surgeon will discuss whether the anticipated improvement is enough to justify doing the lift.
In some cases placing the implant alone will help improve the appearance of a mildly ptotic breast without adding a lift. The spectrum of "lifts" starts with a limited incision, leaving a scar around the areola, next could be the circular scar with a vertical component(sometimes called a lollipop or tennis racket shape), and a traditional "full lift" with the inverted "T" scar. A consultation with an experienced plastic surgeon will help sort out all the options.
Pencil test for Breast Lift
There are certain features which make some patients better candidates for a lift. Probably the single most important factor in determining if you are a good candidate is the degree of ptosis (sagging).
This is classified according to the nipple position in relation to the crease beneath the breast (where the underwire sits). Some people use the pencil test; standing in the upright position, place a pencil horizontally beneath the breast crease and let the breast fall on to the pencil thereby holding it against you chest, if the nipple rests at or above this horizontal line, then you are a good candidate for the liposuction procedure. If it rests below this horizontal line, liposuction of a large breast may result in a large empty hanging sack appearance. If this is satisfactory for you than you can proceed with the operation in either condition. Obviously, it is very difficult to describe over Email and more easily performed during a consultation.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.