Body Contouring

Breast Enlargement with Breast Lift

Breast  Augmentation    in  the presence  of   breast  ptosis  or skin  droop requires correction of the excess of skin   and  the breast disproportion, in addition to enlargement of the breast volume.      True ptosis of the breast is seen when the level of the  nipple  falls  to  a  point at,  or  below,  the  level of the fold beneath the breast.    There is usually   too  much  breast skin and too little breast tissue volume in this situation,   leading to the  appearance   of    elongated  and  flattened  breasts.     A variant  is seen where there is adequate breast volume,   but  a high positioning of the lower  breast folds,  and the resultant appearance  of  low - positioned  nipple  areolae.   In either instance,  upward relocation of the nipples,  and tightening of the skin is needed, along  with  adjustment of the position of the lower and lateral breast folds.  I always prefer placement of  implants  beneath the pectoral chest muscles,  to prevent mammogram  interference,   and to prevent surface wrinkling of  the  breasts  that  is  often   seen  with  implants  above  the muscle   (directly    behind   the   breast gland  tissues).   By approaching breast implant placement via the Trans-Axillary technique (via the armpit), I am also able to prevent potential contamination   of   the  breast  implants  with  germs  that  are known to reside in the breast  tissue ducts,  and are probably responsible  for   the  frequent  finding  of  firm  scar  formation around  implants that are placed  above  the  muscle.    Also, the axillary route to  the submuscular plane  will preserve the intact  muscular  fascial  envelope  from the chest muscles to the  abdominal   muscles,  maintaining  "internal  bra - like" support.    Breast  Lift  in  concert  with  Breast  Augmentation Mammaplasty  is  a more  complex  procedure   than  breast enlargement alone, and  thus  will  require a longer period of skin  adjustment  until  the  absolute  final  result  is apparent. Mastopexy or Breast Lift at the time of  Breast  Augmentation always  requires  some  type of  incision,  or incisions,  in  the breast  skin, and  thus  there  is   a   trade-off   in  achieving improved  breast  shape  and  breast  size,   in  exchange for some  scars.    Depending  upon  the degree of sag present,  several  different  mastopexy  approaches  may  be used  to tailor the skin,  while placing the least number of scars on the surface of  the  breast.    Mastopexy seldom  leads to loss of nipple sensation by the techniques  that I favor.   Fortunately,  breast  scars,   if  necessary,   will  fade  and  flatten  out   with  the  passage  of  time.   Examples of several techniques are shown  below  and  on  the  linked  pages.

Mastpexy Type

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