What exactly is an ultimate breast lift?

Question

What is an ultimate breast lift? Are there many doctors doing this procedure, because I haven't heard much about it? What does an ultimate breast lift usually cost? Is healing time the same as an implant and/or a lift with an implant?

Richard H. Tholen, MD, FACS · Answer

This is a trademarked "named" procedure (coined by a Texas plastic surgeon) for what the rest of the plastic surgical world would call a horizontal bipedicle skin flap breast lift. Its design involves no vertical scar, which is one that causes many patients concern, despite it being one of the least visible scars in any type of breast lift or reduction.Only certain types or severities of sagging breasts can anatomically allow the nipple/areola complex to be transposed high enough to avoid a vertical scar. For those (relatively few) women who have substantial breast droop to allow this type of skin tailoring operation, it is a clever design, and one this plastic surgeon has decided to utilize, champion, and ultimately (ahem) trademark.Although I too (and many of my plastic surgical colleagues) have certain specific ways of performing several operations, I have chosen not to trademark any of them, and have freely shared techniques and innovations with my colleagues rather than trademark them and self-promote (at least any more than I am doing right now as I write this answer.)No, I don't think it's wrong or unethical to coin a clever name for a procedure (or a surgical tool, etc.), but I do feel it's too bad we now have "Lifestyle Lifts", "Ultimate Breast Lifts", "Brazilian Butt Lifts", and "Smart Lipo" when we should just have short-incision facelifts, horizontal skin flap breast lifts, buttock fat grafting, and laser liposuction. Using terms like "Smart Lipo" make it almost seem as if "regular" liposuction is "Dumb Lipo!"I get it; why drive JUST a car . . . when you could be driving a JAG YOU AH? It's marketing. Nothing wrong with the technique, or the doctor that promotes it; just the fact that an un-knowing public has been led to believe it somehow applies to every or most cases, and is something special and proprietary, when in fact it's one of many breast lift designs, each designed to best apply to certain types of breast anatomy. Most plastic surgeons learn several of these techniques, and many become quite adept at the surgical steps and details of these specific techniques, and some prefer one technique over others. The mistake is thinking that every woman can have superior results if they just undergo one of these "special" techniques. Vertical mastopexies (breast lifts) reduce the skin brassiere in one dimension (taking out skin horizontally and creating a long vertical scar). The ultimate breast lift takes out skin vertically and leaves only the long horizontal (crease) scar and the circular one around the areola. Both of these techniques share a similar limitation, however. They only address the breast skin laxity in one dimension (interestingly, one chooses vertical and the other horizontal). Last time I checked, pants came in waist and length, not either/or. So I don't find it too hard to understand why both height and width need to be taken into account when we're talking about tailoring breast skin.I, and a majority of my colleagues, still prefer the artistry and precision of a breast lift technique that allows tailoring the excess breast skin in BOTH horizontal and vertical dimensions--the Wise (anchor-pattern) mastopexy. This remains the most versatile and allows the most beautiful breast skin tailoring possible in a majority (not all) of women, but at the cost of both a horizontal (crease) scar, and a vertical scar. If sutured precisely, the scars are almost always acceptably minimal. This allows final shape to "trump" short or only one-dimensional scars.The biggest disadvantage of the Wise (anchor) technique is the difficulty some surgeons have with the measurement, drawing, and execution of the design, often leading to healing problems or poor scars that they blame on the technique rather than their ability to perform the technique. That will never change, and is the main reason others seek something different. (The problem must be the incision design; it CAN'T be my surgical ability!)But is different always BETTER? The majority of plastic surgeons have already answered that question. ALL of us are pretty smart (usually top of the surgery class) and well-trained, so learning any new technique is not that hard. If any new technique was really a quantum leap forward, we'd all be learning it and doing it. That's how progress is made.But there is also that herd mentality of not wanting to be "left behind" that sometimes spurs surgeons to do something just because other are doing it--not because it's inherently superior. So it's up to the paying patient to decide. The ultimate choice is yours to make. (Sorry for the same pun twice in one answer!) Click on the web reference link below for an example of an old-fashioned, "standard" anchor--er, "THOLEN POWER LIFT." Best wishes! Dr. Tholen

Gary M. Horndeski, MD · Answer

The Ultimate Breast Lift(TM) is a proprietary technique developed by Gary Horndeski, M.D.  This technique uses measurements of the patient’s breast plus known dimensions of the breast they desire to precisely calculate the optimal solution for each breast.  A blueprint is made with the construction parameters of the flaps required to re-engineer the breast.  The technique results in elevation of the breast mound on the chest wall, not simply elevation of the areola on the breast.  The shape of the breast is changed creating upper pole fullness and moved medial to increase cleavage.  This technique avoids the ugly vertical scars of the lollipop or boat anchor shaped incisions, preserves nipple sensation and the ability to breast feed.  This technique was developed out of necessity because of dissatisfaction of patients with the current techniques.  The vertical scar is particularly unacceptable in dark skin individuals because the scars frequently hypertrophy, cannot be hidden and may not fade.  The result is stable long term because the weight of the breast is transferred to the underlying muscle using an internal bra technique.  Currently I am the only physician doing this procedure because I developed it.  The cost of The Ultimate Breast Lift(TM) is $10,000 and covers facility, anesthesia and physician fees.  The healing time is identical to other lift techniques.  Also, this technique does not require an implant since upper pole fullness is created by the technique.  This eliminates complications with implants such as leakage, capsular contracture or infection.  Best Wishes,Gary Horndeski, M.D.Response to other physician comments:The Ultimate Breast Lift(TM) is trademarked.  I could have named this “The Horndeski Technique” but others would probably criticize me for being egotistical.  This technique is NOT a horizontal bipedicle skin flap technique.  There are other no vertical scar techniques, however, this technique is unique in its design not just a suave marketing ploy.  This technique is universal and I have done this on patients from size B to size 44 M.  I never encountered a ptotic breast that could not be re-engineered using this technique.  Comments were made about treating the breast skin laxity in only one direction.  In the ptotic breast, the greatest excess is vertical not horizontal.  Often the patients have a narrow horizontal width and horizontal resection is not necessary.  This eliminates the vertical scar of the lollipop and boat anchor shaped incisions.  There were comments of the artistry and precision of techniques.  This technique is quite precise and has exact calculations for each breast.  It does not depend on artistry but depends on engineering principles.  The breast is redesigned so it is more mechanically stable by transferring the weight of the breast to the underlying muscle.  Active muscle lift maintains breast position better than the passive elastic recoil of skin.  Comments were also made that vertical scars are “almost always acceptably minimal”.  Anybody who has looked at results, particularly on dark skin individuals, will notice that the vertical scar is not minimal and often totally unacceptable.  Plastic surgeons never use vertical scars on breast augmentation yet routinely use them on lifts and reductions.  Lift and reduction patients deserve the same quality of care as breast augmentations and avoiding the vertical scar is essential for an optimal esthetic result.  Many women refuse lifts or reductions because of the ugly vertical scars and this technique is an acceptable alternative.    I agree that plastic surgeons are smart, are at the top of the surgery class, well-trained and can learn new techniques.  This technique is a quantum jump in our knowledge of surgery and will be learned by others in the future.       Respectfully, Gary Horndeski, M.D."Great spirits have always encountered violent opposition from mediocre minds.  The mediocre mind is incapable of understanding the man who refuses to bow blindly to conventional prejudices and chooses instead to express his opinions courageously and honestly."  - Albert Einstein

Christopher J. Davidson, MD, FACS · Answer

This term is not a medical term but instead the term coined y a business savy plastic surgeon for the benefit of marketing.

What exactly is an ultimate breast lift?

Answers (3)

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