Mastopexy, or breast lift surgery, is the most difficult of all breast cosmetic surgeries. Breast lift surgery is a procedure to correct sagging or change the size of the breast using breast implants. The operation is performed on patients who desire to have higher or fuller breasts.
What causes sagging breasts?
Breasts have three components: glands, fat and skin. The differences between breasts from one woman to the next are due to the percentage of the components. There are breasts with a lot of gland and little fat tissue and others which have more fat than gland tissue.
Gland tissue weighs more than fatty tissue; therefore, a very glandular breast will have more tendency to sag than a breast with a higher fat content. Additionally, the quality of the skin around the breast is very important.
Although there are ligamentous elements of support of the breast, these are closely related to the type of skin of the breast, so breasts with thick skin will sag less and more slowly than breasts with thin skin.
Two factors heavily influence the fall of the breasts:
1. Female hormones linked to pregnancy and lactation increase the size of the gland, and this adds weight and stretches the skin. Repeated pregnancy and breastfeeding increases the effect and will be most evident on thin-skinned breasts, causing them to droop and fall.
2. Significant eight changes have a similar effect: When weight is lost from the breasts – through a reduction in gland or fatty tissue – and where the skin is thin an empty, fallen breast results. Young women may experience fallen breasts if they have very fine skins and have had fast breast growth.
Are all sagging breasts the same?
There are different degrees of breast ptosis (sagging breasts): minimum, medium and significant.
In addition to assessing the degree of ptosis of the breasts, a surgeon will assess the quality of the breast tissue. This is important for the surgeon to know because, for example, a breast which has a medium degree of sag but has a very fine skin will be more difficult to treat than an equally sagging breast but with thicker skin.
It is important that the diagnosis of degree of fall and skin thickness is made correctly as this is the first step in the surgical process of breast lift surgery, and the determinant of correction in an effective and lasting way.
What is a breast lift with prosthesis?
The surgical technique of a breast lift is to rebuild the breast in a higher position than they currently are, giving them a more rejuvenated form. During breast lift surgery, a cohesive silicone gel prosthesis (breast implant) is added to increase the size of the breast. Once the shape and position of the breast has been changed, it is necessary to remove any excess skin. In doing so, the areolas are practically always lifted and reduced in size, adapting them to the new breast shape.
How is the size of the prosthesis decided?
The size of the breast desired by the patient is taken into account but it is important to consider all the alternatives.
Whether the prosthesis is placed before or behind the pectoral muscle, and if it has a weight that must be supported by the existing skin should all be taken into account prior to breast lift surgery.
Breast lift surgery does not change the fabric of the breast, thus, for lasting results, it is important to not use very large breast implants. Many women think prostheses do not fall. This is a common misconception regarding breast lift surgery: the bigger a breast implant is, the bigger the risk of fall.
Where are the scars of a mammary lift with breast implant made?
In the case of a minimum degree of sagging breasts, full projection anatomical prostheses are implanted in the sub-mammary sulcus of each breast with an incision of only 4.5 cm in length.
For medium grade ptosic breasts there are two options, according to the quality of the skin.
If the skin is of good quality, the anatomical prosthesis will be implanted as in cases of minimum ptosis, through a 4.5 cm incision in the submammary sulcus, and the excess skin is excised around the areola decreasing it in size and leaving a scar around the areola.
If the skin is of poor quality, more of it will have to be removed and there will also be a vertical scar from the areola to the sub-mammal furrow.
Finally, in the case of significant degree of sagging or ptosic breasts, when the lower pole of the breast rests completely on the rib cage and the quality of breast tissues is not the best, there is no alternative other than to remove as much skin as possible. The resulting scar will be an inverted T or an anchor shape.
The patient will need an extensive consultation to assess all variables including the pros and cons.