Advanced Art of Cosmetic Surgery     Thomas M. DeWire, Sr., MD, FACS    Specializing in Cosmetic Plastic Surgery     Richmond, Virginia, USA





Body Contouring

Augmentation Mastopexy:

Breast Enlargement with Breast Lift 


Breast  Enlargement with Breast Lift or Augmentation Mastopexy:

Breast  Augmentation in the presence of breast ptosis or skin droop requires correction of the excess skin capacity and correction of the breast tissue volume disproportion, by reducing and tailoring the breast skin while enlarging the breast volume with implants. 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, or when the lower pole of the breast becomes stretched and excessively overhangs the breast fold.  There is usually too much breast skin and often too little breast tissue volume in this situation, leading to the appearance of elongated  and  flattened  breasts with nipples that have fallen too low because of tissue stretch.  A variant is seen when there is adequate breast volume, but a high positioning of the lower  breast folds relative to the nipples, and thus the appearance of low-positioned nipples. In either instance,  upward relocation of the nipples, and tightening of the breast skin, is needed to correct the geometric relationship of the nipples to the breast folds.  I always prefer placement of  breast implants beneath the pectoral chest muscles (subpectoral; submuscular), to afford additional implant support and to prevent mammogram interference.  This also prevents most of the tendency to  surface wrinkling and rippling of  the implants that is often seen with implants that are placed over the muscle (directly beneath the skin).  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 gland and ducts,  and are the likely cause of breast capsule contracture, which is the formation of firm scar around an implant that has been contaminated with inflammatory material such as germs.  Also, the axillary route to the submuscular plane  will preserve the intact muscular fascial support envelope that surrounds each muscle and extends  from the pectoralis chest muscles to the rectus abdominal muscles below, maintaining "internal  bra-like" supportBreast  Lift in concert with Breast Augmentation is a more  complex procedure than  breast enlargement alone, and  thus may require a longer period of skin adjustment until the absolute  final result is apparent.  Post-surgery recovery time is similar to that of breast augmentation alone, however, as the skin and glandular procedure of breast lift is generally not very painful. Most of my augmentation mastopexy patients can resume normal activity within 24 hours after surgery, aided by the post-op massage protocolMastopexy or Breast Lift at the time of Breast  Augmentation always requires some type of breast skin excisioin, and thus there is a trade-off in achieving improved  breast shape and volume, in  exchange for the  breast skin incision.  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.  Over the years, I have developed a non-destructive minimal skin undermining approach to improve the results of most breast lift procedures, while reducing the extent of the incisions necessary (the limited scar approach).  This minimal scar mastopexy approach often eliminates the need for any incision in the fold beneath the breast, which is the zone most prone to unfavorable scarring.  Mastopexy by the approach that I use, seldom  leads to loss of nipple sensation, although there may be a brief period of hypersensitivity.  Fortunately,  breast scars, if  necessary, will fade  and flatten  out over time, but it is still desirable to limit the extent of breast lift scars whenever feasible.  Examples of several techniques are shown via the linked pages below, along with discussion of each breast lift variety.


 Follow the  Links below to Photo Illustrated explanations of each mastopexy technique:

Mastopexy Type

Degree of Ptosis to be Corrected Synonyms and similar procedures
Crescent Mastopexy Mild apex sag Grade - I Nipple lift
Link to Crescent Mastopexy and Photos--Caution Clinical photos with partial nudity
Benelli Mastopexy Mild to moderate sag - Grade I-II Donut mastopexy; apex lift
Link to Benelli Mastopexy and Photos-Caution Clinical photos with partial nudity
Vertical Mastopexy Moderate sag - Grade II Modified Benelli, LeJour, Lollipop
Link to Vertical Mastopexy and Photos-Caution Clinical photos with partial nudity
 Full Anchor Mastopexy Severe sag - Grade III Inverted-T,  Weis Pattern Lift, Full Mastopexy; Anchor Lift
Link to Full Anchor Mastopexy and Photos-Caution Clinical photos with partial nudity


Related  Breast Augmentation Links:   To Other photo Illustrated Procedures:

Important  Information  About  Implant  Breast  Enlargement

Trans-Axillary Breast Augmentation
Trans-Axillary Breast Incisions Scars
Breast Augmentation Shape Evolution
Breast Augmentation Shape Determination
Cleavage Determinants
Post-Op Implant Massage Technique
Implants Over versus Under the Muscle
Special Considerations in Augmentation
Breast Surgery in African American Women
Breast Augmentation FAQs
Breast Augmentation with Mastopexy or Breast Lift
Revision Surgery for Augmentation Problems
Important Information about Silicone Breast Implant Use
Nipple Reduction/Shaping
Mastopexy or Breast Lift

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Thomas M. DeWire, Sr., MD, FACS
Advanced Art of Cosmetic Surgery
3974 Springfield Road
Glen Allen, VA 23060
Richmond, Virginia, USA
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ęCopyright 1997-2013  Advanced Art of Cosmetic Surgery:  Thomas M. DeWire, Sr, MD, FACS   Revised:   September 19, 2013 07:44 AM