Breast Augmentation VS. Mastopexy

A frequent scenario in my office is the woman who is not sure whether to have a breast lift (mastopexy) or a breast enlargement (augmentation) or both.
The answer to that question really lies in what her goals are. The anatomy of the individual person’s breasts also makes a difference.

If a woman’s breasts are moderately droopy, as may occur naturally or following childbearing or weight loss, we can sometimes provide a very natural-appearing breast with more volume by simply adding an implant. This has the effect of pushing the breast away from the chest wall, giving some lift and adding fullness. The nipple-areola position does not change in this technique.

If a woman’s breasts are droopy but of satisfactory size (they fill her bra up to a volume and appearance that is pleasing) the better option is a breast lift (mastopexy). The concern that many have about breast lift is the presence of scars. In order to lift the breast we do two main things: 1) the nipple-areola is moved (not detached) to a higher location on the front of the breast and 2) the breast tissue is packed into a smaller, higher skin envelope (like a built-in bra). The only way that can be accomplished is to reduce the skin in the lower part of the breast. This requires incisions and the associated residual scars. It is important, however, to realize that these scars will mainly be in the lower part of the breast and that they will typically become much less noticeable in the months following the procedure. The breast lift has the advantage of not requiring placement of an implant, which means that mammography will be more accurate and there is never concern about whether the implant is intact. The risk that the breast might become too firm is also much lower.

Finally, there is a group of women who have breasts that droop too much to correct with augmentation alone and which are too small to be satisfactory after a lift alone. There are also some women who want very “perky” breasts. These women are best served by a combination of breast lifting and augmentation. That combination procedure requires managing both breast position and volume, so it is more technically challenging, but usually can be accomplished in one operation.

The only way to really find out which procedure is best for the individual woman is for her to come in to see us for a consultation and exam.

It is important to remember that there is the possibility of need for secondary operations after any cosmetic breast surgery, but that the satisfaction rate is high.

Next blog – an exciting time to be fat (cells)