To Lift or Not to Lift

Posted on Friday, August 31st, 2012 by Dr. Babak Dadvand

As a plastic surgeon specializing in breast surgery one of the hardest conversations to have is with a patient who comes in for breast augmentation, but who also needs a breast lift, or mastopexy. The main reason this conversation is difficult for the patient is because typically mastopexies involve additional incisions, which the patient may not be initially prepared to accept. In addition to this, the combination of augmentation with mastopexy adds a level of complexity as well as increasing the risks of the procedure. The reason for this is that the two operations basically are doing the opposite thing. Breast augmentation pushes out on the skin, while breast lift tightens the skin. So where one operation is pushing outward, the other is pushing up and inward.

How do you know if you need a breast lift? Well there are some anatomic guidelines to go by and they are based on the position of the nipple on the breast as well as the overall position of the breast on the chest. Several things can exacerbate droopiness, or ptosis, of the breasts. The most common that I see is pregnancy, followed by weight fluctuations during a woman’s adult life.

There actually is a grading system for breast ptosis:

• Grade I: Mild ptosis – Nipple is just below the inframammary fold but still above lower pole of breast

• Grade II: Moderate ptosis – Nipple is further below the inframammary fold but still with some lower pole tissue below nipple

• Grade III: Severe ptosis – Nipple well below inframammary fold and no lower pole tissue below nipple

• Pseudoptosis : Inferior pole ptosis with nipple at or above inframammary fold; usually observed in postpartum breast atrophy

To learn more about breast lift surgery and to view before and after pictures visit my website at drdadvandplasticsurgery.com.

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