Mild Pseudoptosis, to lift or not to lift? Can I avoid lift scarring? (Photos)

Question

I am a 27yo female, looking to get implants and desperately want tot avoid lift scars, as most do. I have a 7yo who I breastfed for 15 months and lost some of my upper pole fullness, however my drooping is mild and more along the lines of Grade 1 Psuedoptosis. My goal is to fill out my upper pole more, while keeping a natural look and avoiding scarring. I have also heard of techniques that can help support, an internal lift, mesh, and or a suture lift, all of which could possibly lift a little without the need for a T scar. 27 years old, 5'7, 130lb, 25" waist, 37" hips

Ted Eisenberg, DO, FACOS, FAACS · Answer

No lift needed. I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Matthew S. Kilgo, MD · Answer

Hello and thank you for your question.

As you correctly pointed out, you do have a mild to moderate degree of pseudo ptosis. Your nipple areolar complex position is favorable. It is difficult to determine whether or not you need skin resection without a physical examination, specifically to determine skin quality, the distance from nipple inframammary fold both at rest and on stretch, and the mobility of the inframammary fold. Significant loss of skin elasticity would require either skin resection, placement of mesh (internal bra) or combination of the two to prevent bottoming out.

Importantly, you should  choose a surgeon certified by the American Board of Plastic Surgery with extensive experience in breast augmentation.

I hope this helps. Good luck.

Sean Fisher, MD · Answer

This is a very common sentiment for many patients considering breast surgery, especially younger patients. The biggest determining factor is where the nipple is in relation to the breast fold, degree of tissue laterally, and desired breast size. The angle of the photos make it difficult to say with certainty, however in patient's who have relatively preserved nipple position, but with redundant tissue that is isolated to the lower pole- an augmentation with a horizontal wedge excision can give an excellent result. This involves an incision that extends the length of the fold, but no vertical incision or incision around the nipple. The best way to confirm a plan that is tailored to your anatomy is to be evaluated in person by a plastic surgeon. 
Sean Fisher, MDAesthetic Plastic SurgeonSeattle, WA

Milan Doshi, MS, MCh · Answer

Hi madilynfairFrom your photos, this appears consistent with mild pseudoptosis and upper pole volume loss, with relatively good nipple position. In cases like yours, implants alone can often achieve a fuller upper pole and improve shape without the need for a formal lift scar.
However, implants do not truly “lift” the breast &mdash; they add volume and fill the upper pole. Techniques like internal suturing or mesh support can provide some added stability, but they are not a replacement for a lift if skin laxity is more than mild.
Another important point: in a breast lift, lower pole tissue can be reshaped and redistributed to enhance upper pole fullness, but that does involve lift scars. Since your goal is to avoid scars, a well-selected implant (size, profile, placement) is likely the most reasonable first approach, with the understanding that the result will be natural and fuller, but not dramatically lifted.
This is a great question. I would recommend consulting with a board-certified plastic surgeon to further discuss your goals and evaluate you in person.

Mild Pseudoptosis, to lift or not to lift? Can I avoid lift scarring? (Photos)

Answers (4)

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