Woman who are generally satisfied with the volume of their breasts can have a breast lift to raise and firm them, resulting in a more youthful breast contour. Breasts lose shape and firmness over time – usually the result of pregnancy, breastfeeding, weight fluctuations or loss of the skin's natural elasticity due to ageing – and a breast lift rectifies this problem.
A breast lift, or mastopexy, is performed primarily to restore shapeliness and to lift sagging breasts, but can also be used to correct congenital breast asymmetries. Woman who want to substitute lost fullness in the breast gland or who want to further enhance the shape of their breast, may also decide to have a breast augmentation in conjunction with a breast lift.
The female breast contains several tissue components all of which are subject to changes over time. These include: 1) the breast gland; 2) the connective tissue which provides structural support; 3) the fat which provides fullness and padding; and 4) the breast skin envelope.
The overall size and shape also varies over time. The loss of glandular volume, the effects of gravity, stretching of connective tissues and reduction of skin elasticity will all weaken the biomechanical properties of the breast - thus diminishing the perkiness associated with youth and leaving the breasts increasingly pendulous.
Ptosis is the medical term that refers to drooping or sagging of the breast. Breast ptosis is a natural process, though the rate at which a woman develops ptosis, and the severity, will vary and depend on many factors. Breast size is one such factor, with large and heavy breasts becoming ptotic faster than smaller breasts.
Several possibilities for breast lift
The goal of the mastopexy is to provide long-lasting correction of breast ptosis by elevating the nipple-areola complex, restoring breast projection and shape, and tightening of loose skin. To this end a number of incisions are placed on the breast, to allow for redistribution of breast tissues and the removal of skin.
As breast shape, anatomy and ptosis vary considerably, no technique treats all - and a personalised approach is always required. As aesthetic outcome is of great importance, the ‘short scar’ and the ‘minimal scar’ breast lifts have evolved out of the necessity to reduce the length of incisions, to leave the shortest scars possible in relation to the degree of ptosis presented. As a rule of thumb, lighter degrees of ptosis (grade l - ll) resulting from age, breastfeeding and loss of breast fullness - can often be treated with either a short-scar technique that leaves reduced scarring on the front of the breast, or a minimal scarring lift- the most gentle of all techniques - that only leaves a circular scar around the areola. For pronounced or severe degrees of breast ptosis (grade lll), for example following excessive weight loss - conventional techniques with the inverted T-scar are the only ones that will provide a restoration of breast shape.
Traditional breast lift - inverted T incision technique
A traditional breast lifting consists of three incisions, a periareolar component (around the areola), a horizontal component (underneath the breast), and a vertical component (in-front of breast) to link the two. This is known as the ‘inverted T’ configuration. This technique is common in breast reductions, and also efficient in treatment of grade ll-III ptosis, where long lasting and predictable results can be achieved.
Short-scar breast lift - vertical incision technique
Vertical breast lift is a technique that is designed to produce a scar shorter than the inverted T-scar utilising two incisions: a periareolar incision (around the areola) and a vertical incision (in front of the breast). For woman requiring a moderate breast lift, this technique represents a solution inbetween traditional techniques and the minimal scarring techniques.
Minimal-scar breast lift - periareolar incision technique
The periareolar approach results in the shortest possible scar pattern of any breast lift technique, placing only one incision around the areola. By placing the scar at the border of unpigmented breast skin and the pigmented areolar skin, significant scar camouflage is obtained. Dr Sorensen usually recommends the periareolar lift for cosmetic improvement of light to moderate breast ptosis (grade l - ll) and uses a number of specialised techniques to obtain tension-free skin closure and avoid breast flatness. The ‘minimal-scar breast lift’ delivers a lift that is long lasting and natural looking with barely visible scarring. The breast lift is minimally invasive, and is designed not to affect milk ducts or nipple sensitivity.
Breast lift and breast augmentation
As one of the main causes for ptosis is age-related loss of fullness (breast hypoplasia), many woman find it desirable to have breast augmentation at the same time as the lift to restore both shape and volume.
By combining lift and breast augmentation in a one-stage procedure, less skin needs to be removed and less lifting is required - which provides better opportunities to use a minimal-scar breast lift approach and optimises the overall outcome of the breast lift. For this reason a breast augmentation in combination with the lift is recommended option for patients desiring complete breast shape restoration. In addition, the combined procedure of breast augmentation and minimal-scar breast lift is especially efficient in adjusting breast asymmetries.
In breast lifting the aim is repositioning of the breast, not to reduce its size. Breast-lift surgery does not normally interfere with the composition of the breast glands and does not usually affect the ability to breastfeed. Women who come for adjustment of congenital breast asymmetries are often in their twenties and thirties. Women who come for breast restoration due to ptosis following child birth or age-related changes in volume and shape are typically aged between 30 and 60.
1) Traditional breast lift with inverted T technique.
2) Short-scar lift with vertical technique (Lejour).
3) Minimal-scar breast lift using a periareolar technique.