Piedmont Plastic Surgery & Dermatology

Often patients will want larger breasts, consult with a plastic surgeon and are told they will also require a breast lift or mastopexy. They may be disappointed with the need for additional scars as well as the added cost of the breast lift. However, simply making the breasts larger when a lift is needed will not improve the appearance of the breasts. So when is an augmentation not enough to improve the look of the breasts?

Aging, pregnancy, breast feeding and large fluctuations in weight will cause the breast skin to stretch and eventually cause the breasts to lose shape. This may in time lead the nipple to lie lower than the fold of the breast or inframammary crease. The initial stages of breast descent or ptosis will respond to breast augmentation or breast implant placement only. However as the nipple position falls below the crease level and as the skin becomes more stretched and less elastic there is a greater need to tighten the skin envelope of the breast. Depending on the severity of the drooping and the skin stretch, there are options with regard to the scars necessary to do the breast lift.

When the descent or breast ptosis is minimal, a simple donut type excision, or donut mastopexy, of skin around the nipple and areola suffices. This will result in a circular scar around the areola that is often times very imperceptible. As the ptosis or drooping worsens we may need to add a vertical scar to the circular scar that will extend down to the breast crease. In the most severe cases, a full mastopexy will be necessary to remove the excess skin. This type of breast lift will have a scar around the areola, one from the areola to the crease, and another one on the crease. Most patients will consider the scars a good trade off for the improvement in shape.

The incisions used to lift the breast allow us to simultaneously make the breast larger and to improve the shape. Implant size and shape selection will be critical in order to obtain the best cosmetic result. It is important to understand that breast skin thickness and elasticity will limit the extent to which we can ultimately enlarge the breast. It is important that a patient understand there are limits to the extent that their breasts can safely be enlarged.

The choices available to patients when undergoing breast augmentation make it very important to seek consultation with a Board Certified Plastic Surgeon. The patient must be guided during the decision making process so that they have realistic expectations and fully understand the nature and limitations of the procedure. The anatomy as well as the quality of the skin and tissue of each patient will ultimately determine the best size, shape and placement of the implant.

Patient safety is our primary concern at PPSD.  Each office has two certified operating rooms, and maintains the highest standards of care.  Procedures are performed at PPSD by Board Certified Plastic Surgeons who have been well trained in cosmetic surgery.  Patients need to be aware of the fact that many non-plastic surgeons, who have little to no training, are doing cosmetic procedures. It is important that patients consult with a qualified physician who has the proper training and expertise.  Additionally, you should be sure that your physician has hospital privileges and the experience to handle any complications, should they arise.

If you are considering a plastic surgery procedure, the surgeons at PPSD will be happy to meet with you to determine which procedures are best suited to help you meet your goals.