Breast lift

Sometimes patients come in for breast augmentation but what they really need is a breast lift (mastopexy), or a mastopexy augmentation which is a combination of the two.  They don’t know what’s really going on with their breasts but they just know they don’t like what they see.  Pregnancy and breast-feeding can make breasts huge, stretching them out and then leaving them deflated.  There are lots of measurements that can be made to determine the need for a breast lift.  But without going into all that, there is one simple test that demonstrates the need: the pencil test.

To perform the pencil test all you need is a pencil and a breast.  If you place a pencil under your breast and your breast is able to hold the pencil without any other assistance, mastopexy may be for you!   A breast lift will tighten the skin so that putting in an implant actually will make this worse.  Will there still be some sagging in some patients especially with C cup or larger breasts?  Of course, but the breast will have a natural shape which it otherwise would not.  When an implant is put in it is usually placed under the chest muscle.  This holds the implant up and actually works as a living bra.  If the breast is already sagging, it has a tendency to slide off and create a Snoopy breast if it is not lifted (prominent nipple-aereolar complex often looks like the comic character “Snoopy”).  If it is put over the muscle, it may actually look all right for a while but it’s relatively common for the breast to sag with the weight of the implant especially if it is saline.  For the best longevity in someone who needs a  mastopexy breast lift or the combination of mastopexy and breast augmentation, I prefer a submuscular implant with a lift. What kind of lifts we will talk about in the next blog.