What is breast lift surgery with implants?
Combining breast lift surgery and implants, a procedure commonly known as "augmentation mastopexy," is a powerful way to improve the contours, dimensions, and elevation of the breasts, bringing back their symmetry and youthful appearance.
Augmentation mastopexy is an outpatient procedure that addresses not only drooping but also offsets decreasing breast volume, rejuvenating and sculpting breasts that have been altered by factors such as aging, childbirth, or substantial weight loss.
It's not uncommon for women contemplating a breast lift to have apprehensions about the addition of implants, particularly if their aim is for improved height and firmness without an increase in size.
Yet, for patients who have experienced significant volume loss leading to flattened and sagging breasts, a frequent occurrence post-pregnancy and breastfeeding, a lift may not be adequate to recreate form or develop cleavage, medically referred to as "upper pole fullness".
In such instances, patients lean towards a breast lift combined with minimalistic implants. This approach can subtly enhance the breasts, restoring them to their original proportions without enlarging them beyond the patient's preference.
What are the pros & cons of breast lift surgery with implants?
- A breast lift with implants is a solution that tackles multiple aesthetic concerns related to breasts in one safe surgical intervention. Implants reinvigorate the sagging breast shape, enhancing curvature and prominence, while a lift (mastopexy) reduces surplus tissue and raises the breasts further up the chest wall.
- The approach also revitalizes the size, shape, and location of the nipples and areolas, restoring their youth.
- Executing both procedures concurrently leads to increased efficiency, in both the operation and the recuperation process.
- There's also an economic advantage as you only incur the costs of anesthesia and the operating theatre once. Many surgeons offer discounted rates when you opt for combined procedures.
- Like all cosmetic procedures, outcomes may not always align with expectations, potentially leading to revision surgery. Although 91% of patientes deemed the operation as worth the money, a few were left dissatisfied.
- The cost will be higher compared to a single procedure (despite the total expense being reduced when combined).
- The duration under anesthesia will be extended compared to having a single procedure, introducing some risks.
- Any surgical procedure will inevitably lead to scarring, which, however, tends to diminish and fade over time.
- The outcome of a combined breast lift and implant surgery is not always enduring. Recurrence of sagging may arise due to aging or fluctuations in weight.
How much does breast lift surgery and implants cost?
Average Cost: $14,250
Range: $7,450 - $23,800
The cost you incur will be contingent on the specifics of your operation, including the kind of implants chosen, the proficiency and experience of your surgeon, the geographical location of their clinic, the anesthesia administered, along with several other crucial elements.
What are the risks and side effects of a breast lift with implants?
While a breast lift with augmentation is generally a safe operation, it's important to note that all surgeries have potential risks.
Complications that may arise from a breast lift with implants include:
- Capsular contracture
- Temporary numbness (usually subsides after several months)
- Asymmetrical breasts or nipples
- Potential nipples or areolas damage, leading to difficulties with breastfeeding
A study published in the Plastic and Reconstructive Surgery journal stated that the complication and revision rates for a combined breast lift augmentation were no higher than for each procedure done individually.
After undergoing a mastopexy with implants, it's vital to inform the technician conducting your periodic mammograms about your implants. Specific mammography views must be taken to visualize both the breast tissue and the implant. Considering that implants can obstruct the visibility of breast tissue by up to 25% during imaging, patients with implants need 4 additional screens, in addition to the 4 standard views taken during diagnostic mammography.
In these supplementary X-ray images, known as Eklund views or implant displacement (ID) views, the breast implant is moved back against the chest wall while the breast is drawn forward. This technique improves the imaging of the front area of each breast.
These implant displacement images can be less effective in women with capsular contracture (tissue hardening around the implant) and are most successful when the implants are positioned under the chest muscle.
Who is a good candidate to get a breast lift with implants?
The ideal breast lift and augmentation candidates are non-smokers in good health who maintain a steady weight (excluding pregnancy-related changes) and exhibit one or more of the following breast symptoms:
- Nipples that are downward facing or descend below the inframammary crease
- Breasts that have become elongated or flattened over time due to drooping (ptosis) or volume loss
- Skin that has expanded from aging or weight loss
Not all individuals require both a breast lift and implants, however, if you're experiencing both sagging breasts and volume loss, a combined approach can effectively tackle both concerns.
You might also find your outcome more satisfying than if you just chose a single procedure. A 2018 study on quality of life post-breast augmentation found that patients receiving a breast lift in conjunction with implants reported significantly higher levels of satisfaction than those who had only a standard breast lift.
It's important to note that implants alone are not an alternative to a breast lift. If the breast tissue has weakened, the skin is stretched, and the nipple is pointing downward, merely introducing a larger implant won't miraculously provide lift. Often patients with large, heavy breasts can be misadvised that a larger implant will 'lift' the tissue. While the thought of reducing surgery and minimizing scars may seem attractive, this kind of misleading advice generates unrealistic expectations and often paves the way for future complications.
To some degree, an implant can elevate the nipple, provided the breast tissue still maintains elasticity and the patient only has minor sagging. However, inserting larger implants into sagging breasts will only exacerbate the weight. The most suitable course of action would be a breast lift, with or without the use of implants.
For those seeking more elevated yet smaller breasts, combining breast lift surgery with a breast reduction may be optimal.
What happens during your consultation for a breast lift with implants?
Schedule a consultation with at least one board-certified plastic surgeon to ascertain whether a lift combined with implants will produce your desired outcome.
You're encouraged to bring along aspirational images that represent what you have envisioned. The inclusion of pictures can be highly beneficial, as descriptions like ‘natural’ or ‘DD cup’ are interpreted differently by various individuals.
It's vital to divulge your entire medical history, any medications or supplements that you are currently on, any prior surgeries, medical conditions, and your general health status.
Your surgeon will conduct a physical examination of your breasts, measure them, and take photographs. Subsequently, you'll discuss the surgical approaches available. Your operation will be customized to your body shape and personal preferences concerning scarring.
Your plastic surgeon will also guide you when choosing implants, saline or silicone, and your desired size and shape. You'll deliberate over whether the implants will be positioned above or under the muscle; both options come with their respective advantages and disadvantages.
Once your surgical details have been finalized, your potential surgeon should provide a comprehensive cost breakdown, inclusive of anesthesia, facility charges, supplies, and other expenses (not only the surgeon's fee).
Melon Hint: Your health provider may recommend undergoing a baseline mammogram before surgery and another one post-surgery to assist in identifying any subsequent changes in your breast tissue. Mammograms are crucial for any woman aged 40 and over. Post breast lift and augmentation procedure, you'll need to wait a few months (up to 6) for your incisions to heal and scars to set before undergoing another mammogram.
What happens during a breast lift and implant surgery?
This same-day operation typically lasts between two and four hours. Most patients will be under general anesthesia (completely unconscious & numb), although some surgeons may perform the augmentation and lift using local anesthesia with intravenous sedation.
The surgeon will employ one of the following incision methods:
- Lollipop or Vertical lift: This involves a circular areola incision and another running down from the areola's base to the breast crease (known as the inframammary fold), creating a lollipop-like shape.
- Anchor or Inverted T lift: An incision is made encircling the areola and then straight down the centre of the breast (forming the previously mentioned lollipop pattern), followed by a horizontal incision across the breast fold, resulting in an anchor shape. This approach is particularly suited to patients with excessive sagging or post-substantial weight loss.
- Periareolar, Donut or Benelli lift: A circular incision is performed around the areola's edge (commonly used for drooping or resizing the areola). This raises the breast by only 2cms. To gain additional lift, one of the above-mentioned methods would be necessary.
- Crescent Lift: A single incision is made on a portion of the areola, resembling a crescent moon. This method is ideal for light hanging correction or nipple repositioning. This scar is quite visible on the top of the areola.
Subsequently, your surgeon will remodel your breasts, eliminating extra skin and tissue while moving and potentially resizing the nipples and areolas.
They will then insert the implants either on top of or under the chest muscle, based on the decision made during your consultation.
The final stage involves the placement of internal sutures to provide support to your breast tissue. The incisions will be sealed with stitches, adhesive, or surgical tape.
You may also have surgical drains installed to gather surplus blood or fluid. You will be provided with instructions on how to operate the drains and monitor the fluid levels.
After the effects of anesthesia have worn off, you'll be discharged with your breasts securely bandaged and potentially while wearing a surgical bra.
You'll likely feel drowsy due to the anesthesia, so ensure you have a friend or family member on hand to drive you home and stay with you for at least the first-night post-surgery
How long does it take to recover from breast lift with implants surgery?
Expect to fully recover from a combined breast lift and augmentation in roughly 6 weeks, beginning with an initial rest period of a week.
The following will outline what you can anticipate during this period:
- Prescription pain relievers will be provided to help manage discomfort during the first-week post-surgery.
- Your chest may feel tense, and it's not uncommon to experience swelling, bruising, and tenderness. Sleeping in an upright position can minimise swelling.
- Numbness in your nipples or across the entire breast is possible and can persist for a period of 4 to 6 weeks.
- In the event that surgical drains were used, these will typically be removed by your surgeon during your first follow-up appointment (1st week of recovery). Your bandages will likely be refreshed or removed at this time as well.
- Activities such as reaching or lifting anything over 3kg should be avoided in the first week, and you likely be keeping your arms by your sides.
- After the first week, discomfort can generally be managed using over-the-counter pain medication.
- Typically, your doctor will give you permission to return to work after one week, particularly if it's a sedentary role.
- Most patients won't be ready to engage in rigorous activities, like gym workouts, for at least 4 to 6 weeks.
- Once your incisions have healed, you will see scars. Although they should be fairly small, they can appear raised, red, or differ from your natural skin tone.
- With time, scars will gradually fade and become smoother. Silicone scar gel can be used to lessen discolouration and reduce raised scars, though this process may take several months.
Melon Hint: Prepare for recovery a week prior to your breast surgery by organising prescriptions and supplies, including antibacterial soap and arnica cream, a home remedy that can help decrease bruising. Consider investing in a backrest or travel pillow for sleeping upright; this not only helps diminish swelling but also protects your breasts during the healing process, it can even help you get out of bed.
When can you see results from a breast lift with implants?
After a breast lift with augmentation, you can expect immediate improvements, fuller breasts and diminished sagging.
There are instances where the breasts might initially appear higher than their final position; they undergo a "drop and fluff" process over the course of 6 months. To assist this process, your surgeon may suggest self-massages.
The results of this surgery are enduring, but they will not last forever. Aging and changes in weight can alter your breast size and shape. Consequently, some women decide to have their implants replaced or removed years later.
Melon Hint: Doctors advise postponing breast surgery if you're currently pregnant, breastfeeding, or planning to conceive. Although it's not dangerous, the transformation breasts undergo during pregnancy and nursing can be significant, so it's advised to wait at least 6 months after concluding breastfeeding.
What are some alternatives to a breast lift and implants?
There are few procedures that can replicate the same outcome as a breast lift with implants.
If sagging is your sole concern, a standalone breast lift might suffice, whereas breast augmentation primarily restores volume. If your sagging issues are caused by the weight of your breasts, a breast reduction could be the solution.
For those who prefer not to have implants, breast augmentation via fat transfer is another available option. This procedure harvests fat from areas like your hips, thighs, or abdomen using liposuction and injects it into your breasts.
Sources & Studies
Calobrace, MB, Herdt, DR & Cothron, KJ 2013, ‘Simultaneous Augmentation/Mastopexy’, Plastic and Reconstructive Surgery, vol. 131, no. 1, pp. 145–156, viewed 12 July 2023, <https://journals.lww.com/plasreconsurg/Abstract/2013/01000/Simultaneous_Augmentation_Mastopexy__A.26.aspx>.
Kalaaji, A, Dreyer, S, Brinkmann, J, Maric, I, Nordahl, C & Olafsen, K 2018, ‘Quality of Life After Breast Enlargement With Implants Versus Augmentation Mastopexy: A Comparative Study’, Aesthetic Surgery Journal, vol. 38, no. 12, pp. 1304–1315, viewed 12 July 2023, <https://pubmed.ncbi.nlm.nih.gov/29481590/>.
Rinker, B, Veneracion, M & Walsh, CP 2010, ‘Breast Ptosis’, Annals of Plastic Surgery, vol. 64, no. 5, p. 1, viewed 12 July 2023, <https://journals.lww.com/annalsplasticsurgery/Abstract/2010/05000/Breast_Ptosis__Causes_and_Cure.16.aspx>.