I don’t like the way my breasts look. Am I a candidate for a breast
augmentation or a breast lift? What is the difference between the two?
Due to a patient’s natural morphology, changes associated with pregnancy,
weight fluctuation, or with natural aging in the presence of our friend,
gravity, many women are unhappy with the shape or appearance of their breasts.
mastopexy (or breast lift)
are two distinct surgical procedures that create different changes in a breast.
Breast augmentation involves placing an implant underneath the breast tissue
and/or the muscle to increase the volume of a breast. This gives the breast
mound more projection and makes it appear fuller. This surgery is best
suited for women who want to be bigger. Even with a supportive bra the
patient wishes her breasts were larger and is unhappy with her current
volume. Most of my patients who have had a breast augmentation have felt
their breasts were small their entire lives, or noticed significant deflation
Mastopexy, or breast lift, is a surgery that aims to decrease the amount
of excess skin on the breast, while maintaining its current volume. It
also places the nipple in a higher, more forward-pointing position as
some patients may have noticed their nipples “moving” lower
and lower on their breast mound over time.
I always ask my patients if they are happy with their current breast size
when they are wearing a supportive bra. If their answer is “yes,
but I would like for my nipple position to be where it was when I was
younger,” then that patient would likely benefit from a mastopexy.
If the answer is, “No, I would prefer to be bigger/have more volume,”
then that patient would likely benefit from a breast augmentation, with
or without a lift.
What if I want my breasts to be more youthful and bigger?
Some women notice both sagging and deflation of their breast tissue after
weight loss or pregnancy. These patients desire a more youthful position
of their breasts and are unhappy with their volume of breast tissue while
wearing a supportive bra. These patients are candidates for augmentation-mastopexy,
which involves placement of an implant under the breast tissue while at
the same time performing a breast lift. This may be performed in a single
operation safely for many patients. In some situations, it is safer to
separate the two procedures by about 3 months. This decision is made based
on the volume of breast tissue a patient already has as well as the extent
to which the breast needs to be lifted.
If my breasts appear saggy, can an implant make them look perkier?
Yes….and no. If the main cause of the sagging appearance is deflation
and the breast is in a good position with respect to the rest of a woman’s
body, an augmentation can restore volume in a deflated appearing breast
and make it appear “perkier.” However, the amount of elevation
of the nipple position by performing an augmentation is mild. For patients
who have had significant descent of their breast tissue and have significant
amount of excess skin, it would take too large of an implant to create
a “lifting” effect. The key to deciding between an augmentation
vs. a mastopexy is an open dialogue between the patient and the plastic
surgeon. Good communication will allow for a clear definition of the specific
concerns a patient has regarding her breasts, which allows for an appropriately
selected treatment plan.