Subglandular Implant - Lollipop Lift Now or Later?
Doctor Answers (13)
Subglandular Implant - Lollipop Lift Now or Later?
You have several issues to address, asymmetry, droop and inadequate volume. In my practice I would not suggest trying to correct all of these on the same day. I suggest doing a lollipop scar lift and allowing it to heal for a few months before doing a sub muscular augment. The scars will heal better, and you are far less likely to need a touch up or revision later. After healing your augment can be done just as it would be for any other patient.
Mastopexy with implants
If you do not want a mastopexy, implants should go subglandular or you will have what we in the plastic surgery industry call the "double bubble effect." Ideally, for perfect breasts, I would advise a mastopexy (lollipop or anchor, not periareolar) with an implant either subglandular or submuscular but you have to realize that breasts drooping is genetic, they're probably going to drop again regardless of where the implant are located. If they're subglandular, the implant will go with the breast. If they're submuscular, the implant won't drop.
What are the option for sagging breasts after breast feeding.
It seems that you have significant sagging of your breasts as well as the asymmetry. You appear fit and trim, and you stated your breasts were C/D cup currently.
For an optimal result, this combination of findings usually requires a breast lift with a lollipop style incision at a minimum.
You need a consultation with a plastic surgeon who can examine you and discuss the treatment options that will best meet your needs.
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Lift with implants
Thanks for all the great info. You may be able to have implants with a periareola lift. But then again a small vertical incision may be required if the breasts appear too loose. An exam would be helpful, but the photos and info help. You look very thin, and I would definitely go under the muscle to help minimize the risk of rippling superiorly.
Lift now or later?
Thank you for posting the photographs, it is very helpful. Looking at the photos, I would say that you need a lift now as implants alone will not be able to tighten the skin adequately. The type of scarring - periareoloar, lollipop or inverted T - is down to the individual surgeon to some extent and the degree of lift needed. Whatever technique you have, it will leave you with a scar around the nipple, which is the most obvious one. Good luck.
Add the vertical scar
Subglandular placed implants in attempt to address ptosis in my personal opinion is a bad idea. Eventually as you astutely have noted, the implants will droop. A vertical scar mastopexy with submuscular implants is what I would reccomend. On my website you will find an animation video explaining the technique. Good luck.
Breast lift with augmentation
I think the first surgeon's recommendation is better. You have a degree of ptosis (sagginess) that can't be corrected with just impants (or a periareolar lift). If you want enhanced volume with implants, you need also to have a lift like the vertical scar ("lollipop") lift.
Subglandular implant - lollipop lift now or later?
However, more important than the financial aspect, your plastic surgeon will have to determine for you if the viability of the breast as well as nipple-areolar complex may be placed at jeopardy if done at the same time. If for this reason, it would be wise to stage these procedures. You must take caution when having a subglandular implant and lift at the same time, as the vascularity can get compromised much quicker than a submuscualr implant/lift. Without an examination, it is difficult to tell you what to recommend.
Certainly it is you decision as to whether you have your procedures performed in one or multiple stages, but your surgeon will give his/her recommendations. Consult with a plastic surgeon well-versed in breast surgery who will discuss and examine you, while assisting you to decide which procedure will be the best option for you. I would discuss your concerns with your surgeon and see what your options are - sometimes multiple consultations with board-certified plastic surgeons is helpful for you to decide. Hope that this helps! Best wishes for a wonderful result!
Sub-Muscular Implant Placement with Lolli-Pop Lift
A variety of strategies have been utilized to avoid scarring that is frequently associated with breast lift surgery. In many cases these alternate strategies compromise the patient’s aesthetic goals.
The correction of breast sag requires the removal of excess skin. The more severe the breast sag, the greater the amount of excess skin and consequently the greater the need for extensive incisions. It’s important to realize that every patient is unique and because of this, treatment needs to be individualized.
In this particular case, placement of a breast implant on top of the muscle would avoid excess breast scars. Unfortunately, this treatment option is often associated with significant secondary problems. In most cases treated in this manner, breast sag isn’t totally corrected by implant placement alone. In addition, implants placed in this position don’t have the support that’s typically provided by sub-muscular placement. Over the course of time, they tend to drift in a downward direction, thinning the skin and breast tissue as they drop.
Eventually, a large percentage of these patients will need breast lift surgery. Under these circumstances, a much more extensive procedure will probably be required and result in even more scarring then was originally contemplated. In addition, the potential for scarring and complications is often increased because the soft tissue has been stretched and thinned.
Under these circumstances, sub-muscular implant placement with a lolli-pop lift is probably a better option for you. Although this procedure might be associated with longer scars, it avoids the large droopy breasts that concern you. It also avoids the potential for even more problems at a later date.
Submuscular Breast Augmentation and Mastopexy?
Thank you for the question and pictures.
Given your body type and goals, I would suggest a sub muscular (dual plane) breast augmentation (preferably with silicone gel implants) along with a vertical mastopexy. This can be done in a single or 2 staged procedure; I generally make this assessment/recommendation after examination of the quality of skin present.
This is not a question agreed-upon by all plastic surgeons. There are good plastic surgeons who will insist on doing the procedures separately and there are good plastic surgeons who can produce excellent outcomes in a single stage.
The combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increase with breast augmentation / mastopexy surgery done at the same time.
In my opinion, the decision to do the operation in a single or two staged fashion becomes a judgment call made by a surgeon after direct examination of the patient. For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).
Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks are greater with a 1 stage procedure and the patient does have a higher likelihood of needing revisionary surgery.
I hope this helps.
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.