What are the implant shape options with a full mastopexy? Am I a good candidate for a mastopexy with augmentation?

Question

I've always had low saggy breasts and wanted a lift. After my 35lb weight loss, I want augmentation. Currently 34D with moderate ptosis. I think I need the full anchor scar, as previously advised. I want high breasts with more of a ski slope profile shape than a bowl shape. BONUS QUESTION- As my breasts have always been saggy (as opposed to stretching out over time) does that mean I have a better chance of them retaining their shape long after surgery?

Jed H. Horowitz, MD, FACS · Answer

A #mastopexy or breast lift operation is designed to improve the shape and position of the breasts without reducing their size. It is the most suitable for #breasts which sag or droop (ptosis) as a result of  development,  aging, pregnancy, breast-feeding and weight loss. This can also be combined with a minor breast reduction to reduce the breast width if desired. Some patients will experience better  results  to restore superior fullness if an #implant is used at the time of mastopexy; better known as #Augmentation/Mastopexy. #FatGrafting is another option to using #breastimplants and requires a small amount of liposuction to obtain the fat which is the prepared and transferred to the breast.  A hybrid operation may use both an implant and fat to provide the best contours of the lifted breast. Altogether, the surgery will create an elevated, more youthful breast contour. Also, the nipple and areolae of the desired size and  correct heightmay  also be addressed.

Vaishali B. Doolabh, MD, FACS · Answer

Hi IslandElizabeth.  Thank you for your question and for sharing photos.  Examination of your breast tissue, movement and measurements is necessary to know for sure.  Placement of a round implant underneath the pectoralis muscle or use of an anatomic shaped implant are two methods of achieving upper sloping.  A lollipop scar can be completed with beautiful results and is an advantage because you don't need the full anchor.  Use of a full or high projection implant will assist the lifted appearance.  In general, sagging breasts have loose soft tissue envelopes but if your weight is stable, long term maintenance of shape should occur.  Be sure to consult an ABPS certified plastic surgeon for more information.  Good luck!

Thomas Trevisani, MD · Answer

You appear to be a good candidate for mastopexy with implants - utilizing dual plane placement in order to achieve the normal teardrop looking breasts. The major factors affecting long-term position and shape are repeated pregnancies and large weight gain/loss- fluctuations in weight. Skin texture then must be assessed in person. Hope this helps

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your question
and provided information as well..
The breasts may lose their elasticity and firmness which can be caused by
different factors such as pregnancy, massive weight loss, lactation and aging.
To reaffirm the breasts and restore the natural look your surgeon can perform a
mastopexy or breast lift. A
breast lift restores a firmer, perkier, and more aesthetically pleasing shape
to sagging breasts. This not only can improve a patient’s appearance by
restoring her youthful, feminine proportions, but also help bras and
swimsuits fit more comfortably and attractively. By removing excess, stretched
out skin, reshaping the breast tissue, and raising the nipple & areola into
a more forward position, a cosmetic surgeon can create a more youthful breast
contour. Stretched, large areolae can also be reduced during breast
lift surgery, creating an overall better proportioned, natural looking breast,
your surgeon will determine on a personal consultation how your scar’s going to
be and where. Hugs!

Tom J. Pousti, MD · Answer

Thank you for the question and  pictures. Based on the photographs, I think that you are starting out at a good place and should have a very nice outcome with breast augmentation/lifting surgery. Generally speaking, patients undergoing this combination operation should understand that it is significantly more complex than breast augmentation surgery only and that it is associated with a significantly higher risk of complications and need for additional surgery.
Also, generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work. 
2. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C or D cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. The use of computer imaging may be very helpful during this communication phase.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery. The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best breast implant size/profile relatively easy.I hope this, and the attached link, helps. Best wishes.

Gaurav Bharti, MD, FACS · Answer

It appears that you were a good candidate for breast augmentation as well as a breast lift. There are multiple options for deciding on what type of implants utilize. Deciding on this is a dynamic process that you and your plastic surgeon will be able to decide after in person evaluation. Good luck

Peter A. Aldea, MD · Answer

The Breast Lift Technique determines the scars and the type of implant used shapes the breast.If you wish to have a tear drop breast shape, your surgeon can easily lift the breast over a tear drop implant and create that shape. All you and your surgeon need to do is pick the best implant for your body and that shape is then tailored in the operating room after the implants are placed. I would suggest you consult with a surgeon who uses a 3D digital imaging like the VECTRA by Canfield which allows you to actually see what your breasts may look like with each implant.Good LuckPeter ALDEA, MD

Robert E. Zaworski, MD (retired) · Answer

You should expect a lovely result from the lift with implants.  The breast lift will reshape the breast and the implants will add volume.  Once your breast heal and settle you should have the shape you desire.  Express all your concerns to your surgeon prior to surgery.

What are the implant shape options with a full mastopexy? Am I a good candidate for a mastopexy with augmentation?

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