What you need to remember is that “augment” means to add to, or make bigger. A breast augmentation will make your breast bigger. A mastopexy is a breast lift or breast tightening procedure that tightens up a breast that has a loose skin envelope. The two procedures are by no means mutually exclusive; in fact, we perform combined breast augmentation with a mastopexy or lift quite frequently. During your consultation, we will assess first your goals; do you want a larger breast or a higher, tighter, firmer breast? Second, as your surgeon I will tell you how I recommend we best proceed to achieve your specific goals. The use of other patient’s before and after pictures will be used to give you an idea about what can be reasonably achieved on my part, as well as help me better understand your expectations.

Symmetry in breasts is always tricky. First, no part of our bodies are mirror image duplicates of the opposite sides. Second, while asymmetry in the breasts can be the result of asymmetry in breast size, breast shape or breast position, it can also be the result of asymmetry in the chest wall, the ribs or a scoliosis (a curvature of the spine). So, whether you undergo augmentation with implants with or without breast lift, acceptable symmetry can usually be achieved. This is another fact that will be addressed in your consult. It is a funny thing, but many times we don’t notice our own inherent breast/chest asymmetries until we make the breast larger. While some asymmetries can be improved by the surgery, others may be enhanced!

In our practice, we perform three types of breast lifts (mastopexies) a periareolar or donut lift, a vertical or lollipop lift or the wise pattern or anchor lift. These are listed in order of increasing amounts of scar and which is right for you depends on your goals. The periareolar scar is best for minimal moves of the areola/nipple or for reduction in size of the areola. This lift does not affect the overall shape of the breast much, it only repositions the nipple/areola. it is a scar around the entire circumference of the areola. (A scar only at the top of the areola or crescent lift really doesn’t work to do anything but distort the areola in the long run.)

The vertical lift, which is the most popular in our practice, has a scar around the areola and straight down. This mastopexy works well to not only lift but to narrow the breast. This finesse and exacting technique required to do this lift means you need to find a surgeon experienced in its use. It really is the biggest lift for the amount of scar, or biggest bang for your buck.

Some women simply have too much skin for a vertical lift and must have the Wise pattern or anchor shaped scar. The long horizontal component of this scar is the area most likely to produce a thick highly visible scar, but as in all mastopexies, it is a trade off. More scar, less excess skin, and resulting better breast shape.
This is another example of when looking at post operative pictures can help define what is possible with your breast with each lift.

Yes, augmentation combined with mastopexy is frequently performed in our practice. Again, it should only be performed by experienced plastic surgeons.

It is possible to breast feed after breast lift as long as the nipple is left attached to the underlying breast tissue. Occasionally in lifts with tremendous amounts of excess skin it may be necessary to remove the nipple and place it back on as a free nipple graft. this is exceedingly rare. And while it is possibly to breast feed after mastopexy surgery, it is not guaranteed, there are too many variables at play.

Pregnancy can really, really change a woman’s breasts. I usually recommend that if a patient is going to get pregnant in the next year, she delay breast surgery just because the breast will be different after pregnancy. How different a breast will become is impossible to predict. That being said there is no contraindication to pregnancy after an augmentation or lift, you just run the risk of wanting a revisionary surgery.

Be very clear with your doctor what your goals are for your breast size and shape, your doctor can then tell you what she can reasonably achieve for you. Most of us would like to look great with or without a bra, whether or not that is possible depends on your body and your goals for size. The larger the breasts are the harder, faster and lower they will fall.

Depending on the amount of skin removed, most women are back at work after breast lift surgery anywhere from 2 days to 14 days after their procedure. The wide range is dependent more on what type of work the patient needs to be able to do. Heavy lifting or dirty work requires 14 days. Sedentary work requires only 2 -5 days depending on the amount of skin removed and how uncomfortable the patient feels with that degree of tightening.

A crescent lift is a poor lift that does little but distort the areola shape. a donut lift or periareolar lift has a scar all the way around the areola and is good to lift the nipple height or reduce the size of the areola. It may have the tendency to flatten the breast. a Vertical lift is the donut lift with an additional vertical scar that extends down from the areola at the six o clock position. This lift is good to not only lift he nipple and areola but to reshape the breast into a conical shape.

By definition, a breast lift includes a scar around the areola, so an areola reduction is part of the lift. You can discuss your goals for size with your surgeon.