For many patients a breast augmentation alone will not correct the size and shape issues affecting their breasts. Women who are wanting to increase the volume of their breasts with an implant may sometimes also require a lift (Mastopexy) of the breast along with an Augmentation to create a pert full breast. This most commonly occurs after pregnancy, breastfeeding, or significant weight loss. In this situation often a replacement of the lost volume with an implant is required, and also a reduction in the amount of skin and elevation of the nipple is required to achieve the desired breast volume and shape. However, in many cases, it may be recommended to perform the two procedures on two separate events in order to create a result where the breast is initially uplifted to create the correct orientation and position of the nipple and the second surgery to create fullness by inserting the implant.
- Who is a candidate?
- What does the process involve?
- Types of implants
- Staging the procedure
- What can you expect after the operation
- Post-operative activity?
- What are the potential risks?
Who is an appropriate candidate for breast augmentation with mastopexy?
Women who desire larger, more shapely breasts but are not suitable for a breast augmentation on its own.
What is involved in the operation?
A breast augmentation with mastopexy is a much more complicated operation than either a breast augmentation or a mastopexy alone. It involves placing the implant and adjusting the the breast tissue and skin in order to create an appropriate firm envelope around the implant with an appropriately placed nipple.
The aims of the procedure are:
- To place the nipple in the correct position.
- Fill the breast, particularly the upper pole with an implant.
- Tighten the breast in the horizontal and vertical directions and try to keep this as a stable situation.
What is involved in the operation?
A breast augmentation with mastopexy is a much more complicated operation than either a breast augmentation or mastopexy alone. It involves placing the implant and adjusting the breast tissue and skin in order to create an appropriate firm envelope around the implant with an appropriately placed nipple.
The aims of the procedure are:
- To place the nipple in the correct position
- Fill the breast, particularly the upper pole with an implant
- Tighten the breast in the horizontal and vertical directions and try to keep this as a stable situation.
The operation is performed under general anaesthetic, generally as a day case and takes several hours. In most cases the tightening of the breast envelope will require a scar around the nipple and vertically down the breast, and, not infrequently, horizontally in the crease.
There is the occasional individual who is borderline for a mastopexy, in whom a peri-aerola mastopexy can be performed, leaving just a scar around the nipple, along with the small scar in the crease to place the implant.
What implant should we use?
Generally, for breast augmentation with mastopexy Dr Craig Layt—our experienced plastic surgeon—uses a round, textured, silicone gel implant placed under the muscle. The size of this can be determined using our Vectra imaging software. This enables us to take a 3-dimensional image and manipulate that image to perform a lift and then place an implant. This can help the decision-making process with regards to an implant size combined with a dimensional planning approach.
The best way to think about this is to consider it like building a house. The base of the breast is like the basement of the house and obviously needs to fit on the land, that is the chest. Once we have worked out the basement of the implant then the volume really comes from how many floors we place on it. This analogy is a good way to think about both breast augmentation and the implant in breast augmentation with mastopexy. This will be discussed at some length during your consultation.
Breast implants are not lifetime devices and will require replacement or the patient may wish to replace for a variety of reasons.
Breast Augmentation & Lift Photos
These before and after photos are of patients that have had surgery performed by Dr Layt. These patients have consented to the photos being shown. These are actual photos and have not been altered or digitally enhanced. Every patient is an individual and therefore final surgical results will vary from patient to patient.
Staging the procedure?
Classical teaching with regards to a breast augmentation and mastopexy was to stage the procedures and perform a mastopexy first, and subsequently return and augment the breasts. In some cases this can be done as a single procedure safely and with predictable results. Because, in some ways they are the “opposite procedures” (that is, tightening the tissues and placing a weight in them), there is obviously an incidence of revisionary surgery being required to further tighten the tissues to achieve the desired result. However, with many cases, the patient and surgeon will decide on a staged approach –
1. Lift the breast and correct the nipple position, followed by
2. Augmentation to increase the volume of the breast.
This will be discussed during your consultation.
What can you expect after the operation?
You will awake feeling a little tight in the chest but generally comfortable. No drains are used in most cases. You will have a bra on and some light dressings. We will either see you at the practice or talk to you on the phone the next day to answer any questions you may have. We will then see you seven days later for a change of your dressings.
Post-Operative activity?
We encourage some gentle stretching exercises (see video in this section) for your pectoral muscles in the post-operative period and this helps relieve the tightness that sometimes happen. Apart from those exercises you should limit yourself to walks for the first week. At one week you can increase your activity to walking on a treadmill and leg workouts. These activities can be slowly increased until full aerobic/weight training at approximately eight weeks.
Breast implants or not, all women and men should self check their breasts and see their GP if there are any changes or concerns regarding their breasts.
What are the potential risks?
Modern surgery is safe. There is, however, no such thing as “risk free” surgery. The important things are to understand potential risks, minimise their occurrence, and treat them early to avoid small issues becoming more severe. Please see Breast Augmentation and Breast Lift for further information.