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Breast Lift

Breast Lift McAllen

RGV Cosmetic Breast Lift - actual patientOver the years, breasts can lose their shape and firmness. Contributing factors are pregnancy, nursing, loss of skin elasticity, and the natural process of atrophy of the breast tissue after the childbearing years, or as a result of weight loss. These factors may cause the breasts to sag and lose their shape, appearing “deflated” – especially in the upper breast. Simply, there is too much skin relative to the remaining volume of breast tissue. Breast Lift surgery, or Mastopexy, is a surgical procedure that restores a more youthful appearance and perkiness to your breasts by raising and reshaping them. This procedure reverses the effects of aging and gravity on your breasts. It can also reduce the size of the areola, the darker skin surrounding the nipple, which often becomes wider after breastfeeding. If needed, a breast implant can also be used to add or restore the necessary volume to the upper breast for a fuller look.

Do I need a breast lift?

If your breasts have lost their shape and fullness due to pregnancy, breastfeeding, weight loss, or any other reason, you most likely need a Beast Lift as opposed to a breast augmentation without a lift. A breast lift restores your breast shape. Please review the Figure below that illustrates a normal, youthful breast (no breast ptosis/droop), Grade I ptosis, Grade II ptosis, and Grade III ptosis. Grade I ptosis can often be corrected with an implant alone, but Grade II and Grade III require a breast lift in addition to an implant to avoid a droopy breast and a Snoopy Nose deformity. Grade II breast ptosis can often be corrected with an appropriately sized implant and a circumperiareolar donut mastopexy (see illustration below). Grade III breast ptosis, however, requires a formal vertical Lejour mastopexy with a circle and a line scar pattern (see below). Patients are advised to examine the illustration and their degree of drooping to aide in understating realistic expectations.

Degrees of Breast Ptosis (DROOP)



Illustration Adapted from Spring MA, et al. Aesthetic Surg J. 2014;34(7): 1018–1040

When performing Breast Lifts, I incorporate the patient’s expectations with the physical characteristics of her breasts to determine the best treatment for that particular circumstance. Breasts that are larger and heavier (more breast tissue volume relative to the amount of excess skin) may qualify for a breast lift without augmentation. The upper fullness of the breast may be restored using the breasts’ tissue instead of an implant. However, “empty breasts” (those with extreme excess skin and poor elasticity relative to the volume of breast tissue) will likely require an implant in addition to the breast lift for optimal results.

It is important to have realistic expectations because breasts continue to change over time due to the effects of gravity, loss of breast tissue volume, and loss of skin elasticity. Even after surgery, patients should not expect the results to be permanent.

Your Consultation

It is important to find an experienced cosmetic surgeon who can successfully perform your breast lift surgery and not try to force you into implants. You don’t want breast that are too big to compensate for a surgeon’s inability to perform a breast lift. Do your homework. Review your surgeons’ before and after photos of their breast lift patients. Ask if the photos are of the surgeon’s patients versus example photos. Pay attention to the scars in the photos. Women rightly worry about the scars on their breasts. Scars result from your own body’s wound healing, which I cannot control; but also from a combination of surgical technique and the quality of suture materials used, which I can control. Also, patients must realize that scar maturation takes a full 12 months and that scars are redder during the first 3-4 months, the Proliferative Phase of wound healing. (Click here to see a typical example of my breast lift scars at three months post-op).

During your consultation, I will take a complete medical history and conduct a thorough examination to evaluate your overall health. Ideally, the Breast Lift and Augmentation patient has no health problems, no pre-existing breast disease, and wishes only to improve the shape and appearance of her breasts. I will also perform a detailed analysis of your breasts’ symmetry and appearance. We will discuss all of your options, taking into consideration your preferences, the physical characteristics of your breasts, and whether the use of implants is advisable. The location of the incisions will also be discussed, as well as the potential risks and complications. To minimize the possibility of excess bleeding, you will need to stop taking drugs containing aspirin two weeks prior to surgery. You will receive detailed instructions and a complete list of medications and supplements to avoid before surgery during your formal pre-op visit two weeks before your scheduled procedure. You will also be advised to shower with an antiseptic soap for a day or two prior to surgery.

Photographs are taken before and after surgery. Most patients over 35 will be required to have a normal mammogram performed within six months prior to the procedure.

The Breast Lift Procedure




Before & After

Dr. Rodriguez performs his breast lift procedures either in a certified outpatient surgery center or a hospital under general anesthesia combined with local anesthesia and tumescent to ensure your ultimate safety and comfort. The local anesthesia

administered during your procedure also minimizes any post-operative pain. A breast lift can take between 2 to 5 hours, depending on the amount of excess skin that needs to be removed. We will determine how to approach your breast lift procedure based on the degree of sagging, or ptosis, which exists. It is natural for patients to want the shortest scar possible, and some patients find it difficult to understand why longer scars are sometimes needed. The length of the scars is directly related to the degree of breast ptosis and amount of excess skin that needs to be removed to achieve the perky breast that is desired. Generally, the more the breast has descended, and the more excess skin that exists requires a more extensive surgery and a longer a scar. I always strive for the shortest scar possible, and typically utilize one of four techniques:

  • The circumferential periareolar (i.e. “donut”) mastopexy removes a small circle of skin from around the areola (the more darkly pigmented skin surrounding the nipple). This lift is indicated for patients with Grade I or Grade II breast ptosis (see Figure), or who simply want smaller areolas. I move the nipple and areola to a higher position on the breast by tightening the skin around the now smaller areola using a permanent, purse-string suture. Moving the nipple and areola to a higher position results in a lifted, perkier breast, preserving the nipple-areolar sensation and blood supply. The circumferential periareolar mastopexy results in a circle scar around the areola, and is only appropriate for select patients with a small degree of sagging who require only a small lift (3cm maximum). (Click here to see an example of a Donut Lift with Implants.)

  • The “crescent” lift is not actually a breast lift. It is a useful adjunct for a periareolar breast augmentation for women with minimal sagging but with slight asymmetry in the position of the nipples on their breasts. For a crescent lift, a small ellipse of skin (like a crescent moon) is removed from around the areola to raise the nipple-areola (1cm maximum) to enhance the symmetry between breasts. The resulting scar is an almost invisible semi-circle at the junction the areola and skin. (Click here to see an example of a periareolar breast augmentation with a crescent lift.)

  • The vertical LeJour (i.e. “lollipop”) mastopexy is the most powerful incision I use for breast lift surgery. Vertical LeJour mastopexy is for patients with Grade II or Grade III breast ptosis (see Figure). Grade II and Grade III breast ptosis are not correctable with an implant alone, and such patients are at high risk for a Snoopy Nose deformity without undergoing a vertical LeJour mastopexy. The Vertical LeJour mastopexy procedure utilizes an incision that encircles the areola and then descends vertically to form the namesake lollipop shape (i.e. the circle and a line). The addition of the vertical incision allows for additional skin and tissue removal from the lower part of the breast. The nipple and areola are positioned higher on the breast mound, and the skin surrounding the areola is then brought together to reshape and tighten the breast. This method allows for the correction of moderate or massive sagging and results in a perkier and less boxy breast than the traditional anchor-shaped Wise pattern mastopexy. If patients have severely sagging breasts with a lot of excess skin, then this incision is extended along the infra-mammary fold as needed to achieve the desired result with minimal additional scarring. (Click here to see examples of a Vertical LeJour Mastopexy, both with and without implants.)

  • The extended LeJour mastopexy results when I have to extend the vertical mastopexy widely along the lower fold of the breast to achieve the necessary lift. The extended LeJour Mastopexy adds a curved scar on the underside of the breast extending along the side of the chest. This technic removes excess skin that can result from massive weight loss after bariatric surgery. Also, this adds a side-body lift, or even a full upper body lift around the back, to the extended LeJour Breast Lift. (Click here to see a complex revision breast augmentation with Redo Extended LeJour Breast Lift and Upper Body Lift in a post-bariatric patient.)

In a Breast Lift, several layers of hidden sutures are used, and the final incisions are covered with special surgical tape, which protects the incisions for the first two weeks. I hardly ever use suction drains for my breast lifts, but sometimes may be necessary for extensive upper body lift procedures. These drains are usually removed within 2 to 5 days.

Recovery

Of all the surgical procedures I perform, my breast lift patients are often the happiest, and their recovery proceeds very quickly. Patients who undergo a breast lift without implants experience almost ZERO pain because the surgery only involves manipulating the skin and breast tissue. Even if we perform a breast lift with implants, patients recover very quickly, the difference is they may feel a little tightness from the chest muscle being stretched by the implant for the first few days. If implants are used, you will be placed into the Bandera implant stabilizer during your first post-op visit. We will instruct you on how to perform the implant displacement and skin redraping exercises at your 2-week follow-up. All patients are wrapped in an ACE wrap overnight immediately after surgery, and then we have our breast lift patients wear a comfortable sports bra for the first six weeks. Your breasts may be slightly bruised or swollen initially, which is normal. Over the counter, Aleve and Tylenol are usually all that are needed for comfort, and we also prescribe pain medications and muscle relaxants. You may experience either temporary nipple numbness or hypersensitivity, which is normal from the initial swelling and sutures. Nipple numbness or hypersensitivity typically lasts a few months; a normal nipple sensation usually returns after three to six months. Permanent nipple sensation loss is extremely rare, and in my hands is less than 1%.

To ensure proper healing, follow the detailed instructions given to you at the time of your pre-operative consultation. Most patients may return to normal daily activities within 24 to 48 hours. You may resume non-strenuous work within one week or less following the surgery. You should avoid lifting heavy objects for 3-4 weeks. If implants were used, do not lift anything over 5 pounds for the first five days, anything over 10 pounds for the first ten days, and anything over 15 pounds for the first fifteen days. You may gradually resume strenuous physical exercise after approximately three to four weeks. Women with subpectoral implants are advised to avoid any exercises that directly engage the chest muscles (such as bench press, push-ups, and pectoral fly exercises) permanently, for the rest of their lives. Directly engaging the chest muscle with exercise may cause lateral displacement of the implants.

Your New Look

Most of our patients find a mastopexy to be an extremely “uplifting” procedure. They are enthusiastic about the restoration of a more youthful appearance to their breasts, which often appear to have aged disproportionately to the rest of their bodies. In many cases, patients wear more revealing clothing and select from a wider and more appealing variety of bra styles.
Also, many patients report feeling more self-confident and confident in the appearance of their breasts when not wearing clothing. In summary, the great majority of patients are very pleased with the results of their Breast Lift, especially when they are well informed regarding their options and are realistic in their expectations.

Risks

Anyone considering any surgery should be aware of both the benefits, as detailed above, and the possible risks. Breast Lift surgery is much more complex than a straightforward breast augmentation. It is extremely important that patients select an experienced cosmetic surgeon for their breast lift procedure to minimize their surgical risks and optimize their results. Every year, thousands of women undergo successful breast lifts, and significant complications from breast lift surgery are rare when performed by an experienced cosmetic surgeon. Potential risks of breast lift surgery, as with all procedures, include bleeding, infection, and reactions to anesthesia. On rare occasion, there may be tissue loss and delayed wound healing along portions of the incision. This may cause the scars to widen and may occur when the lift or reduction has been extensive (gigantomastia requiring the nipple/areola to be raised more than 10cm), or in smokers and diabetic patients. A breast lift does leave permanent scars. I strive for the most aesthetically appealing scars, placing scars within natural skin folds as much as possible and ensuring that most scares can be covered by a bra or bathing suit. The appearance of the scars can be expected to improve with time, and scar maturation evolves over the first 12 months after surgery. (Please visit my Scar Care page for more information.) Occasionally, the scars will require revision at a subsequent procedure if they have healed poorly. Problems with the shape or position of the nipples or permanent loss of sensation or loss of tissue in the nipples, or breasts, may occur on rare occasion. Breast implants complications may include deflation (saline), silent rupture (silicone), capsular contracture, palpable rippling, asymmetry, and interference with mammography, among others. (Refer to Breast Augmentation on this site.) Breast lift surgery does not typically interfere with the ability to breastfeed if future pregnancies are anticipated.

Most of the risks associated with a breast lift can be lessened and managed by carefully following the recommendations and instructions you will receive during your consultation and pre-op visits. As well, your questions and concerns will be addressed at that time.

Moving Forward

As with any cosmetic surgery procedure, it is critical that you choose the most qualified breast surgeon with the highest levels of training, experience, and patient satisfaction. Dr. Filiberto Rodriguez is a double-board certified cosmetic surgeon, specializing in cosmetic breast surgery, including: breast lift; redo breast lift; breast augmentation; complex transumbilical breast augmentation procedures (the Belly Button Boob Job); and complex revision breast augmentation surgeries. We invite you to review our before and after photo gallery. Please click here to contact us and schedule your private consultation to discuss your breast lift surgery, or call 956-687-8346 in Edinburg or 956-350-6561 in Brownsville.

Submitting your information to be contacted by RGV Cosmetic Surgery & Vein Care, does not constitute or establishes a physician-patient relationship with the physicians or nurse practitioner of RGV Cosmetic Surgery & Vein Care.

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141 Paseo del Prado, Suite 101
Edinburg, TX 78539

956-687-8346

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5700 North Expressway 77, Suite 102
Brownsville, TX 78526

956-350-6561

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