Breast Lift with Auto Augmentation?

Question

I am just discovering the 'new' option for enhancing the appearance of sagging breasts. A breast lift combined with an 'auto augmentation' sounds like a fantastic option for women who don't want breast implants. I had never heard of this procedure until a recent consultation with a plastic surgeon who said I had adequate breast volume that could be lifted and repositioned without the use of implants. I haven't found too much literature about this procedure and would appreciate some feedback. What do you think about this procedure? Thanks.

Otto Joseph Placik, MD · Answer

This has commonly been performed in Europe and you can look this up as the vertical mammaplasty/mastopexy performed by Dr. LeJour in Belgium.
This is a nice option, but the rearranged breast tissue, the so-called auto-augmentation, has a tendency to settle and fill out the lower half of the breast.
The only way to definitively achiev upper pole fullness is to use an implant

Jerome Edelstein, MD · Answer

A traditional breast lift may leave your breasts smaller, therefore you may want to consider augmentation to maintain your size. Implants are not necessary, however.Auto augmentation uses your own breast tissue that has been removed during your breast lift to enhance breast size.

Trevor M. Born, MD · Answer

Dear Newtatas, There are several techniques for preserving the breast tissue so that the relative volume of the breast remains the sam with a Breast Lift.  This can involve the manipulation of the breast tissue to give more projection of the breast- using the inferior pedicle of tissue which is sometimes discarded and combining with a superior pedicle for the nipple.
You can also add micro fat grafting to the breast to add volume and shape the breast.
Generally with a lift of the breast - the breasts do appear to be smaller- even if the breast tisssue is preserved.
With Warm Reagrds,
Trevor M Born MD

Michael Law, MD · Answer

Breast lift (mastopexy) surgery works well for patients who have enough existing breast tissue which allows the surgeon to build a projecting and aesthetically pleasing breast, and who do not have a severely ‘deflated’ appearance from pregnancy or weight loss.  In many patients, however, it can be difficult to create substantial, long-lasting fullness in the upper aspect of the breasts (the cleavage area, which surgeons sometimes refer to as the ‘upper poles’ of the breasts) by means of a routine mastopexy surgery alone. This is particularly true in patients who have experienced significant deflation following pregnancy and lactation, and in patients who have experienced major weight loss.This need for increasing upper pole fullness can be accomplished in one of two ways: by using the patient’s own lower pole breast tissue (‘auto-augmentation mastopexy’), or by placing a breast implant. Auto-augmentation mastopexy is a surgery in which some of the patient’s own lower pole breast tissue (from the area of the breast below the nipple/areola complex) is moved into the upper pole of the breast.  A pocket is created behind the upper pole of the breast and the lower pole tissue is advanced, with its blood supply intact, into the upper pole pocket.  This truly remarkable procedure can create a mastopexy appearance that previously has only been possible by means of breast implant placement.  Not all patients are good candidates for this procedure, as there must be an adequate volume of lower pole tissue available to produce significant upper pole (cleavage area) breast fullness.  Most patients undergoing auto-augmentation mastopexy in this practice have a full B cup to D cup breast volume preoperatively.For patients who do not have enough lower pole tissue available to allow an aesthetically ideal auto-augmentation mastopexy, or for patients who desire a larger breast volume than can be achieved by use of their own tissues, I recommend that they undergo augmentation mastopexy. This surgery combines a breast lift with the subpectoral placement of a breast implant usually of a moderate size, which produces lasting upper pole fullness.  This procedure is often the ideal choice for patients with an A cup or small B cup breast volume preoperatively, who are interested in having a C to D cup breast profile postoperatively.

Kamakshi Zeidler, MD · Answer

An auto augmentation breast lift is a nice technique for women who are happy with their breast size. This technique creates fullness in the top portion of the breast without the need for a prosthetic implant. The technique usually takes a wedge of breast tissue from the bottom portion of the breast and tucks in underneath the rest of the breast tissue, this creates fullness in the top of the breast and pushes out the rest of the breast to create projection. The result is a more compact breast which is lifted, sticks out more from the body, and is rounder on top. Sometime a small piece of mesh can help this wedge of breast tissue stay in a lifted position - sort of like an internal bra. Sometime this technique can be combined with fat transfer from another part of the body - for women who are looking for a small boost in volume without prosthetic implants.The main downside of this procedure is a visible scar on the breast. The benefit of this procedure is a lifted breast with fullness on top without a breast implant.

Curtis Wong, MD · Answer

Provided there is adequate tissue to give you the cup size you desire, this procedure works and helps you avoid implants that were tradiationally used to "fill out" the upper poles of the breast. If you wish to have more a natural appearance over the "implanted look", this will suffice. There is a risk the tissue moved upwards can lose its blood supply which will then lead to the development of a firm mass that should slowly diminish in size over time. It is a great procedure and one which I use frequently.

Pat Pazmino, MD, FACS · Answer

This is a technique and breast lift surgery where a small portion of the lower part of the breast is brought into the upper portion of the breast to re-create fullness in this area. This is a technically demanding procedure and so is very important to perform your research before embarking on this technique. Be sure that your board-certified plastic surgeon has great deal of experience with this specific procedure. The success of this procedure depends entirely on the technique that is used and the care that is given to avoid compromising the blood flow to the area that will be transposed into the upper portion of the breast

Michael C. Edwards, MD, FACS · Answer

A breast lift serves to tighten the envelope of skin around the breast and moves the nipple to a higher position on the breast. Auto-augmentation simply means the breast tissue is sewn together to lend to a perkier breast sometimes even placing a small amount of breast tissue under a sling of chest muscle. Many times a breast lift alone does not yield a lot of upper breast fullness in and of itself.
Dr Edwards

Jeffrey Zwiren, MD · Answer

The real choice to be made for you is deciding if you are happy with your existing breast volume.  If you only want to change the shape and not the volume then your existing breast tissue can be repositioned to give an 'auto augmentation' effect.  
In patient's  who have undergone a gastric bypass or have otherwise lost a good deal of weight then there are procedures that can use some of the lateral and medial breast tissue and fat as well as fat from the axillary are to build up a breast mound.  This technique has limited applications but in the right individual it works well.  
Shapes and patient desires are different from one woman to another.  There are many techniques to choose from and a skilled plastic surgeon should be able to discuss with you all of the various options with and without implants.

Peter E. Johnson, MD · Answer

A well recognized goal of breast lift  is improvement of the breast projection and fullness and correction of the nipple position. Vertical mastopexy has been with us for many years now and provides excellent correction of breast laxity. However, it is a stretch to call the improvement seen with mastopexy as "auto augmentation". It is very unlikely that the mastopexy increase your cup size. Also, despite mastopexy, there still may be a relative scoop or lack of upper fullness in the lifted breast.If you are happy with your current cup size and wish to be no bigger, then the mastopexy alone may please you. However, if you wish upper fullness and a half cup, or one cup, or even more volume, then an implant is a must. "Auto augmentation" is probably too good to be true.Best of luck,peterejohnsonmd

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