Do you stand in front of the mirror without your bra on or are you unwilling to try? For some women, it's not easy to face flat, droopy breasts that were once round and perky.
Key reasons for changes in breast shape include age, hormonal fluctuations, pregnancy, weight loss or gain and genetics, says Miami plastic surgeon Ary Krau, MD. There is no one skin or body type that causes breasts to sag. It is quite simply the changes in a woman's breast volume that cause the skin to stretch and subsequently sag. Sagging (called ptosis) results in flattened breasts with an elongated shape and a nipple/areola complex that is pointed downward. In profile views of more pronounced cases of ptosis, the nipple/areola complex of an unsupported breast hangs visibly lower than the breast crease. When breasts sag this deeply, wearing a support bra is necessary for maintaining a more normal appearance.
"The best technique used for a woman's breast lift must address several issues: shape, location of scars, quality of scars, longevity, sensation of the nipple/areola complex and preservation of lactation," says Dr. Krau. Equally important is the degree of sagging, the elasticity of your skin and the amount of excess skin that your plastic surgeon plans to remove.
To correct sagging and create a perkier breast, incisions are made to sculpt the breast to a new position, reduce excess skin and raise the nipple/areola complex. Incision patterns are typically the same as those used for breast reductions. In addition, Dr. Krau states that areola size may be reduced "to a circumference average of four centimeters."
A breast lift does not change the amount of breast tissue a woman has, but it does change the shape and position, which can affect overall breast size. To understand what final breast size may be following a breast lift, plastic surgeon Foad Nahai, MD, of Atlanta advises that patients look in the mirror and use a finger to elevate the breast until the nipple is brought to the new position, then fold any tissue hanging over the finger inward to approximate final breast size. If size is important to you, an implant can be inserted during the breast lift to enhance size or firmness. To approximate this, Dr. Nahai states, "I have the patient wear a bra without padding to assess size, then add an implant to give an idea of the final size after a breast lift with implant placement."
The new shape and position of your breasts will be visible immediately after surgery, but the new look will settle a bit over the following few weeks. Breast lift surgery is the only permanent way to restore a youthful body contour to the breasts. No amount of exercise, breast-firming cream or laser treatment has been proven to produce measurable, visible results. For most patients, a breast lift is a one-time procedure; but if another lift is necessary, the same incisions can usually be used.
You're a good candidate for a lift if...
- Your breasts are pendulous, but of satisfactory size
- Your breasts lack substance or firmness
- Your nipples point downward and are positioned below the breast crease
What you must know before breast surgery
- Your doctor is certified by the American Board of Plastic Surgery and a member of ASPS or ASAPS.
- Your plastic surgeon shares your goals for your body and your health and has thoroughly explained your breast enhancement options.
- The number of breast surgeries your plastic surgeon has performed. Ask to see several sets of photographs showing before-and-after results of exactly the same procedure you will undergo. Photographs, however, are not a guarantee that you will obtain the same result.
- The details of your breast surgery procedure with a full understanding of the technique and goals recommended for you, and where the incisions and resulting scars will be located.
- Where your breast surgery will be performed, including accreditation of the facility, the anesthesia provider and his or her qualifications, and the medical staff that will be responsible for your health and safety.
"I lost a lot of weight--more than 100 pounds. As a result, my breasts now sag. I'm only 22 years old and I've have never had children. Can a breast lift help me?"
For women who undergo gastric bypass or lose significant weight through other means, the breast is undoubtedly going to sag or change shape. By restoring a natural and youthful shape, a breast lift can be of important psychological benefit to a young woman who feels very self-conscious about the appearance of her breasts.