Fifth in a series of then and now reports on cosmetic procedures coinciding with ASAPS’ 35th Anniversary year
In today’s society, as in most cultures throughout history, the firm uplifted female breast symbolizes youth, health and vitality. However, with age, weight loss or childbirth a woman’s breasts may lose volume and tone, so that the breast tissues begin to sag and eventually the nipples point downward.
Cosmetic plastic surgery offers women the option of modifying their breast shape through techniques proven safe and effective over many years. Statistics from the American Society for Aesthetic Plastic Surgery (ASAPS) report that 60,142 Mastopexies (breast lifts) were performed in 2001. In the past five years, the number of breast lifts has increased 203%.
A breast lift can improve the appearance of the breasts in several ways. It elevates the breast tissue, repositions the nipple and areola (pigmentation around the nipple), and enhances breast shape. If the areola have been stretched over time, they can be reduced in size. Women who undergo a breast lift may also seek to increase their breast volume. If this is the case, an implant can be placed behind the breast tissue or chest muscle to enlarge the breasts.
The following discussion of breast lift techniques is not all inclusive, nor does ASAPS endorse any particular technique. Women considering mastopexy should keep in mind that the experience with limited incision techniques is far less than with more traditional methods; some of these techniques are controversial with regard to the typical quality of results they provide.
Techniques for the correction of breast ptotis (sagging) have evolved over many years. The traditional “inverted T” technique of breast lift surgery is widely used today, because some surgeons feel that it consistently produces the most aesthetically pleasing breast shape. The technique involves three incisions: One is made around the areola; another runs vertically from the bottom edge of the areola to the crease underneath the breast; and the third incision follows the natural curve of the breast crease. Breast tissue is elevated and excess skin is removed. Skin formerly located above and to the sides of the nipple area is brought down and together to reshape the breast.
The scars resulting from the “inverted T” technique are visible on the breast, though in the majority of cases the incisions heal well, scars fade to some extent over time, and patients are highly satisfied with the final results. However, the goal of aesthetic plastic surgery always is to achieve the best result with the least visible scarring. This has led to the search for newer techniques to lift the breasts.
Recent developments have sought to decrease visual scars while achieving the aesthetic goals desired for a more youthful appearance. Limited incision breast lift techniques are gaining wider acceptance among plastic surgeons and their patients. Many surgeons feel, however, that they are most effective in a smaller subset of patients.
One limited incision technique used for breast lifting is dubbed the “lollipop” because the incision is made around the nipple area with a line extending vertically down the breast. The “lollipop” technique eliminates the third incision, along the crease underneath the breast, used in the traditional procedure. In this technique, the breast tissue is “coned,” bringing in breast tissue from the sides and middle of the breast and resulting in improved projection. Lipoplasty (liposuction) can also be used in conjunction with the vertical technique during a breast lift, not for volume reduction but for final shaping.
Another limited scar technique that is used for lifts is sometimes called a “donut lift.” This nickname comes from the circular incision that is made around the areola and used to remove a donut shaped area of breast skin.
Additionally there is the “crescent” technique that involves removing a crescent-shaped piece of tissue above the areola and resuturing the tissue higher. This creates a minor lift for patients who have slight sagging.
Breast surgery techniques continue to evolve, with modifications of those described above. It is important to remember that a breast lift can improve the position, shape and distribution of existing breast tissue, but it cannot make the breasts larger; breast augmentation can, however, be performed simultaneously with breast lift.
A breast lift is usually considered a cosmetic procedure; therefore, in most cases, it is not covered by insurance. The usual time needed before a patient can return to non-strenuous work following breast lift surgery is one to two weeks.
It is ASAPS’ position that, when considering breast lift surgery – as with the consideration of any cosmetic plastic surgery – patients should be fully informed of the risks and benefits of the procedure. Well-trained and experienced plastic surgeons will be able to determine the technique best suited to a patient’s particular body type and aesthetic goals. Careful selection of a qualified plastic surgeon is of utmost importance. Patients would be well advised to look for a surgeon who is certified by the American Board of Plastic Surgery (ABPS) and is a member of the American Society for Aesthetic Plastic Surgery (ASAPS).