Breast Lift + Implants
A woman's breasts often define her femininity, and with the vast differences in shape, size, and appearance, breasts further help to define a woman's individualism. The breasts undergo changes in response to factors such as genetics, aging, pregnancy and breast feeding, weight gain or loss, and hormonal fluctuations. All of these factors can cause the breast size and shape to change. These changes can be dissatisfying and can make women feel as if they are losing some of their femininity and youthful vitality. Breast augmentation alone cannot restore the shape of the breasts. For those women who would like to increase the size of their breasts as well as restore a firm, more upright position, a breast augmentation in combination with a breast lift can improve body contours and revitalise their appearance.
Before you learn how a breast augmentation with a breast lift can help to correct breast appearance, it is important that you understand the underlying anatomy. The breasts are composed of different types of tissue known as glandular, fatty, and fibrous tissue, which lie over the pectoralis muscle, along the chest wall. The glandular tissues are composed of lobules and milk ducts. Together, lobules and milk ducts are responsible for producing and transporting milk to the nipple, respectively during lactation. The glands within the breast are surrounded by a layer of fatty tissue that gives the breast its shape and soft form. Suspensory ligaments, which are made of fibrous, or connective tissue, are intertwined amongst the breast glands and milk ducts. These suspensory ligaments attach the breast to the chest wall and allow it to remain suspended, but move freely with the body.
What Causes Breasts to Change Shape?
Although there are many factors that can contribute to sagging of the breasts, the aging process and the effects of gravity play a primary role in these changes. Just like facial skin, the skin around the breast loses its elasticity in response to a gradual breakdown of the skin’s support network, which causes it to become lax. In addition, the suspensory ligaments that attach the breast to the chest wall weaken and stretch in response to gravity.
The breasts enlarge during pregnancy and breast feeding, which further causes the skin to stretch. As the breasts reduce in size following pregnancy, the skin that was once stretched, is now loose and sags. Lastly, fluctuations in your weight and even hormonal changes can cause your breasts to change in appearance. In combination, these factors can cause the breast to droop and sag, or in some cases rotate in a downward direction.
How a Breast Lift with Implants Works
One of the primary reasons that breast augmentation procedures are performed in combination with a breast lift is that breast augmentation alone cannot correct sagging or drooping breasts. Simply increasing the volume, or size, of the breast will only cause the breast to sag more with time. When performed as a standalone procedure, breast augmentation can increase or balance the size of the breast, restore the breast volume, and restore the shape of the breast after partial or total loss.
In contrast, during a breast lift procedure, loose, excess skin is removed and the remaining skin is tightened. As a result, the overall shape of the breasts is improved, and they are lifted to a new, more upright position. In combination, breast implants and a breast lift result in total rejuvenation, not only increasing the size of the breast, but restoring a firmer, perkier appearance as well.
Breast Augmentation and Lift Techniques
As you may know, there are three general incision techniques used during breast augmentation, known as the areolar, inframammary, and transaxillary incision. In addition, there is a variety of different breast lift incision techniques used to correct varying degrees of breast ptosis. These techniques include the periareolar, circumareolar, vertical, and anchor technique, and are used to treat increasing breast ptosis severity, respectively. Dr Miroshnik will help you choose the incision that is best for you based on your preferences, anatomy and the position of your implants. To learn more about the different techniques view the 'breast implant' and 'breast lift' animations.
A breast augmentation in combination with a lift may last approximately two to four hours, depending on the complexity of the procedure and surgical technique that is used. Prior to the start of your procedure, the treatment area will be cleansed and anesthesia will be administered. Most likely, this will be a general anaesthetic, in which you are asleep for the entire procedure. Prior to surgery, Dr Miroshnik, will draw guidelines along the incision site.
It is beyond the scope of this animation to show you all the various ways that a breast augmentation with lift can be performed. So, for the purposes of this educational session, we will now show you one of the simpler techniques.
To begin the procedure, Dr Miroshnik will make an incision along the predetermined line. This animation depicts the inframammary technique in which a small incision is made along the inframammary fold of each breast. Using a cautery device, he will open the incision in order to gain better access to the breast tissue below. Although the incision will be made as inconspicuously as possible, its length and appearance may vary depending on the type and size of the implant and your body contours.
Breast Tissue Dissection
Dr Miroshnik will continue to separate the breast tissue with a cautery device in order to expose the pectoralis muscle. With the aid of a breast dissector, he will then carefully create a pocket in which to place the breast implant.
As you may know, breast implants can be placed in two general locations, known as subglandular and submuscular placement. This animation depicts subglandular placement in which the breast implant is placed in a pocket formed beneath the breast tissue, but above the pectoralis muscle. In contrast, submuscular placement refers to an implant that is placed in a pocket partially or completely beneath the pectoralis muscle, against the chest wall. During your consultation, Dr Miroshnik will discuss the benefits of the different implant placement options in more detail.
Breast Implant Placement
You probably know that there are two general types of breast implants known as saline-filled and silicone-filled implants. Dr Miroshnik greatly favours the use of modern silicone implants, due to their proven safety record, natural feel and consistently excellent results. In fact, very few saline implants are used in Australia for the purposes of breast augmentation at present. Dr Miroshnik will insert the implant into the pocket and visually inspect your breasts to ensure that they are symmetric. He may then need to adjust the pocket and the position of the breast implant itself to ensure that the desired look is achieved.
Breast Lift Incision
Prior to starting the 'breast lift' part of the procedure, Dr Miroshnik draws incision guidelines to indicate the areas of skin that will be removed to facilitate the desired amount of lift. This animation demonstrates the vertical technique. If you are interested in learning about the different breast lift techniques, please view our breast lift animation.
Using a scalpel, Dr Miroshnik carefully makes an incision along the pre-marked lines. The area that extends beyond the areola marks the new upper border of the areola. The v-shaped area below the areola will be pulled together and tightened, resulting in a more upright breast position.
Using a variety of surgical instruments, Dr Miroshnik lifts the skin and separates it from the underlying tissues below. The areola and nipple are left intact, as the areas of surrounding skin are removed. In order to ensure that the breast has complete mobility, a cautery device may be used to undermine, or remove, tissue along the perimeter of the incision line.
Repositioning the Areola
Once the excess skin has been removed, Dr Miroshnik will suture the uppermost border of the areola to the outermost perimeter of the incision. In doing so, the areola and breast tissue are lifted to a new, more upright position.
Dr Miroshnik will then proceed to close the incision by placing internal (dissolving) sutures along the vertical midline and inframammary fold, as well as around the perimeter of the areola. Prior to closing the incision completely, he may place a surgical drain inside each breast, however sometimes this may be avoided.
Lastly, steri-strips and gauze bandages will be applied in order to protect the incision sites as you heal.
Breast Lift plus Implants Recovery
You may need to wear a type of compression garment following your procedure. This tight-fitting garment will help to reduce swelling by preventing fluid build up, as well as provide comfort and support as you heal. You will likely have to wear the compression garment for several weeks. If surgical drains are present, they along with any bandages will likely be removed within a few days.
You may experience some minor pain, bruising, and swelling, as well as numbness around the areola-all of which should subside in several weeks. Although you may feel well enough to return to work in approximately one week, you should continue to avoid strenuous activity such as exercise for three or four weeks after your procedure to allow your body sufficient time to heal.
Breast Lift plus implants Results
You will be able to notice a dramatic difference in the shape and position of your breasts immediately following your procedure. You may continue to notice a change in the appearance of your breasts as swelling subsides and they settle into their new positions. In fact, it may take up to one year before the final results from your procedure are apparent. Although you will have permanent scars following a breast lift, the scars will slowly fade to thin, white lines with time.
It is important to realise that if you become pregnant after having a breast lift, the effects of pregnancy and breast feeding may compromise the results, and cause your breasts to sag and change shape. Although the procedure cannot stop the aging process, it can help you not only improve the position of your breasts, but restore the fuller, shapelier appearance that you desire for years to come.