Ask an expert: mastopexy after implants

Mastopexy and breast implant surgery are two popular breast procedures, undergone by thousands of women in the UK each year. However, some woman may wish to combine surgeries and ask themselves the question “how does this work?” Leading consultant plastic surgeon and certified cosmetic surgeon Miss Phillipa Jackson gives us a foolproof guide on what to consider and expect from combining both treatments.

What is the ideal timing for combining mastopexy with breast implant surgery?

Women who wish to undergo mastopexy after implants choose to have this surgery because they have drooping breasts and also want to have an increase in breast volume.

This can happen at any time but as surgeons, we commonly see it after significant weight loss or following pregnancy. In ideal circumstances, those wishing to undergo the procedure should have a stable weight and have a complete family, without intending to have any more children. It is crucial for the patient to be a healthy and non-smoker, with a BMI below 30.

What factors should patients consider when deciding whether to undergo both procedures simultaneously?

Performing a breast uplift involves reducing and tightening the skin while lifting the breast tissue and/or nipple. On the other hand, a breast augmentation stretches the skin of the breast. Combining these two procedures increases risks, partly because they have opposing goals and partly because an implant is a foreign object which is more likely to be infected when combined with an up lift.

Before undergoing either procedure, patients should consult with an expert who can make them aware of the pros and cons of their specific circumstances, and help them to make a decision as to whether a single or two-stage procedure is preferable/more beneficial to them.

Could you explain the potential impact of mastopexy on the position and appearance of breast implants?

The position of the breast implant is based on the footprint of the breast. A mastopexy done over the top of a breast implant aims to place the nipple on the front-facing part of the breast, ideally slightly upward facing.

The implant position does not change if the patient is having a mastopexy. However, it is possible to choose a teardrop shaped implant to push out the lower pole of the breast more.

What are some common challenges or risks associated with performing these procedures?

As previously mentioned, the conflicting goals of the two procedures make it challenging. The main risks involved are infection or poor healing, leading to loss of the underlying implant, or nipple and skin necrosis. Skin necrosis can require debridement and may also result in implant loss.

For patients who previously underwent breast augmentation and now seek a mastopexy due to changes in breast appearance, what are the main considerations?

Women who have had breast implants in place for a long time should consider replacing them, and in some cases, they may want to consider removal and uplift rather than re-augmentation.

It is essential to discuss this with the surgeon and to decide what is the best way to manage the scar tissue around the implant - the capsule - as the patient may have developed a capsular contracture in addition to a breast drop.
 

It is important to note that the breast skin will relax again in the future.

If you would like to find out more about mastopexy after implants, do not hesitate to book an appointment with Miss Jackson by visiting his Top Doctors profile today.