After pregnancy, weight loss, or just the changes of time many patients request a breast augmentation to restore a youthful look to their breasts. Many patients believe that a breast implant alone can restore the youthful appearance of the breast. This is sometimes the case but not always true. This page is intended to help clarify when a breast lift may be needed in conjunction with an implant, giving patients a better understanding of the process.
With pregnancy several changes come about the breasts. The breasts become engorged with milk; this stretches the skin and the ligaments of the breast as added weight is placed on both. When milk production ceases and hormonal changes subside the breasts will loose volume. The skin may not snap back as it has stretched beyond its elasticity. This creates a deflated appearance to the breast with excess skin and nipples that hang low. There are ways to address this:
- The excess skin can be removed, tightening up the breast tissue, but giving a much smaller breast. Many women enjoyed the slightly fuller look of their breasts during pregnancy and do not want much smaller breasts.
- The second option is to use a breast implant to fill out the excess skin. Depending on how much excess skin there is, the implant size will vary. In simple terms, the more sagging excess skin then the larger the implant that is required to fill it out. It is easier to fill out the excess skin with an implant placed in front of the muscle but this may not always produce the best long-term results. A large implant can produce further thinning of the breast tissue and stretch the skin because of the added weight. In addition, when the skin is thin and a large implant is placed in front of the muscle it increases the chances of implant wrinkling at the upper portion of the breast.
- The third option is the combination of a breast lift with a breast implant. If there is a lot of excess skin and the patient does not want a large implant placed in front of the muscle then a procedure to tighten up the skin and a smaller implant is used. In simple terms, the amount of skin tightening will depend on the amount of excess skin and the size of the implant. The smaller the implant, the more skin tightening and vice versa.
Many women have breasts with sagging skin and low-lying nipples despite never having been pregnant. The same thought process applies to these patients.
Other times when a breast lift and implant combination may be necessary includes what is called a tubular breast (where the breast has a pointy appearance to it) or a herniated nipple and areola where the areola sticks out separate from the breast. In order to correct this a breast lift may be required, hiding the scar around the areola to change the shape of the breast.
Breast asymmetry, unequal breast shape, or unequal areolas may be other indications for a breast implant and breast lift combination; as the breast is shaped with a skin tightening procedure so that when the implants are placed the breast shapes are similar. Remember some differences in volume can be affected by changing the implant volumes but if the breast shapes are distinctly different, then their shapes often need to be made equal then augmented.