Can You Perform an Internal Mastopexy with Breast Implants and Not Cut Around the Nipple? (photo)

i was told by my surgeon i would pay $5,000 for implant and $2,000 for a lift plus $1,000 for facility. so i paid $8,000 and now have a double bubble with that one little incision(example in picture) i went back and he told he did an internal incision funny because just before the nurse said what lift was performed and so i questioned the DR. and he replied she does not know what she is talking about! did he perform a breast lift with this incision?

Doctor Answers 12

Can You Perform an Internal Mastopexy with Breast Implants and Not Cut Around the Nipple

Without some preop and postop photos, and a copy of the operative report, no one will be able to answer your primary question--did you have a lift or not. 

A fold incision alone is certainly not a typical lift incision. Most "lifts" done without incisions around the areola use mesh, and that would be in the operative record. 

If you are doubtful about what your surgeon actually did, a second opinion would be  in order before making any decision about repair of the double bubble. 

Thanks, best wishes.

Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Internal Mastopexy?

    Internal mastopexy may have been done, and I do not think this should be dismissed.  This may not work for severe grade II or III ptosis, but this may work for lesser degrees of grade II ptosis.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Breast lift and implants?

 A lift is usually performed by raising the nipple areola complex and sutures are used to perform this.  I am not sure what your surgeon did.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

"Internal mastopexy" via breast augmentation incision only?

There are internal suture mastopexies described in the plastic surgical literature, and some involving mesh or dermal matrix slings, but most ABPS-certified plastic surgeons will utilize external skin incisions in order to "tailor" the sagging breast skin to a more youthful, uplifted shape (with or without implants).

Some surgeons feel that adding implants to somewhat ptotic breasts can "lift" and reposition a drooping nipple/areola complex, but what is really happening is the implant dropping downward and behind the breast center (nipple), creating the appearance of a "higher" nipple (actually a "lower" breast mound).

When large(r) implants drop too low below the woman's native breast creases, a "double bubble" results. A "real" mastopexy is often required to correct the double bubble.

I am concerned by the verbal interchange overheard between your doctor and his nurse. (If your doctor says she doesn't know what she's talking about, who hired her and trained her?) Actually, it sounds as if she had the same (understandable and probitive) question you did--just how is a "lift" done without "lift incisions?" Why the defensive and degrading reply--why not a teachable moment?

To find out what really happened to you I would want the following information: is your surgeon an ABPS-certified plastic surgeon? If not, STOP, do not pass GO, go directly to a "real" ABPS-certified plastic surgeon. Take the following information--your pre-operative photos, a copy of the operative report (your surgeon is obliged to give you a copy of this information), and yourself for examination.

Unfortunately, if your surgeon is not reputable or ethical, the operative report could be entirely falsified, but only legal action and subpoena of OR personnel would be capable of finding the truth. Let's hope you chose a reputable surgeon and not a "cosmetic surgeon" who has little or no training in plastic surgery and certification by a non-ABMS "board" like the American Board of Cosmetic Surgery. (Click on the web reference below for more information about this.) Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Breast Lift Performed?

Thank you for the question.

Unfortunately, without a more thorough evaluation of your preoperative and postoperative situation, it is not possible to make a accurate/fair determination. For the best advice, consider seeking a second opinion in person with board-certified plastic surgeons in your area.  It would be helpful for you to have preoperative pictures and a copy of your operative report as well.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,502 reviews

Can You Perform an Internal Mastopexy with Breast Implants and Not Cut Around the Nipple?

Something sounds not right here. An internal mastopexy is a very difficult operation with poor results. If you needed lifting the vast majority of boarded PSs use some sort of external incision. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Clear Communication Critical To Good Outcomes

It is difficult to answer your question without full information.  Breast implants alone through the inframmmary approach using a dual plane technique can address cases with minor breast ptosis.  Mastopexy is typically performed with  either a peri-areolar, lollipop, or anchor incision.  I suggest you have further discussions with your surgeon to clarify the miscommunication that has occurred. Best of luck.

Robert F. Centeno, MD, FACS
Columbus Plastic Surgeon
4.9 out of 5 stars 77 reviews

Internal lift through incision in the fold under the breast

Hello.  It sounds like there may have been a miscommunication between you and your surgeon.  If the breast is just a little settled, then the placement of an implant will fill out the breast structure and give the sense of a lift.  If there is significant overhang in the lower portion of  the breast with the nipple sitting low relative to the fold under the breast, some sort of a lift will be required.  At the very least, this will result in a scar that runs around the border of the areola.  If you now have a double bubble effect, it is most likely that a lift will be required to bring the breast structure back into balance.

John Q. Cook, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 12 reviews

What Lift?

Unfortunately, clear communication with your surgeon prior to your procedure may have avoided this situation...  Breast implants by themselves can sometimes have the affect of "lifting" the breast by increasing its volume and raising the breast and nipple slightly higher, especially if performed with the "dual plane" technique.  However, if the nipple position relative to the sternal notch and the breast fold is TOO LOW, then the only choice is a procedure that involves an incision around the areola and positioning the breast higher.

Eric Sadeh, MD
Manhattan Plastic Surgeon
4.2 out of 5 stars 57 reviews

Nipple position

Usually people who need a lift have their nipple below the inframammary line, thus they may need an implant to fill the volume, but also the nipple needs to be raised. Thus at least they need an incision around the nipple, if the sagging is severe they may need a full anchor incision. The incision you show is just to put an implant in. You get minimal to no  lifting with it.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

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.