Which to do?

Cosmetic plastic surgeons are often faced with the situation of having to give recommendations for the best cosmetic surgery for patients with small and droopy breasts about breast lift and-or breast augmentation surgery. Here are some articles about breast lift surgery and breast enlargement:

Cosmetic breast lift surgery

Saline implants and silicone implants

Some patients need both breast augmentation and a breast lift!

Breast lift

A mastopexy, or breast lift surgery, is a surgery to elevate the nipple areolar complex as well as the whole of the breast mound to a higher position on the chest wall.

Plastic surgeons have specific criteria of measurements to determine whether there is truly a breast droop. The distance from the nipple to the sternal notch (the curved segment of bone at the top of the breast bone and bottom of the neck) is supposed to be 21 cm. If the distance is greater, the cosmetic patient is determined to have a droopy breast. Most enlarged breasts are also droopy.

Breast lift surgery, mastopexy, is a surgery that takes about 1-1.5 hours and is performed under general anesthesia as an outpatient procedure. I typically use the Lejour method (lollipop scars) for better shape and less scarring than the traditional anchor scar technique.

Breast enlargement/augmentation surgery

The goal of a breast enlargement surgery with saline or silicone breast implants is to enlarge the size of the breasts. The surgery does not change the shape of breasts. So, if patients have droopy breasts, breast augmentation will produce… large and droopy breasts.

In patients who have a little drooping of the breasts (nipple at 22-23 cm from sternal notch under the neck), a breast augmentation alone may be sufficient to give a respectable result without extra scars, healing time and the cost of a breast lift. In such cases, the cosmetic plastic surgeon can modify the technique to place implants half under the pectoralis muscle and half over it, and under the skin for a more natural look.

Breast lift and enlargement at the same time

Some patients who have lost a great deal of breast tissue, as happens commonly after breastfeeding, may need both a breast lift and a breast augmentation. Breast lifts elevate the breast and augmentation corrects volume deficiency in smaller breasts.

Breast lift surgery with or without augmentation can improve a woman’s breast shape and size significantly and restore a shapely breast.

Morad Tavallali, M.D., FACS