There are a lot of women who are not happy with the size and shape of their breasts. It can wreak havoc on a patient’s self-esteem. This is understandable. Breasts are an integral component of your torso. When they begin to deflate and/or droop, it may make you feel “dumpy”. It can also throw off your entire body contour. My breast surgery patients are often surprised by how much trimmer they look and feel after their breasts are restored to their proper place and proportion with a breast augmentation and/or breast lift.
The problem is that many women are confused as to what, exactly, each surgery delivers. They think that a breast augmentation will solve all of their problems. And this is just not always the case. A breast augmentation and a breast lift can both improve the appearance of your breasts. But they do so in completely different ways.
Breast Augmentation is About Volume
The job of breast augmentation surgery is to increase volume in your breasts. This can be accomplished in two ways with:
- A breast implant
- Fat grafting to the breast
A breast implant is able to deliver more size. With fat grafting to the breast, I can only give you about a cup of increase. However, a breast implant is a device while fat grafting is completely natural. Also, with fat grafting, the fat needs to be taken from an area of the body where you have too much so it’s really one of those twofer procedures. Some patients, however, do not have areas with enough fat to provide the volume needed for a breast procedure. In certain patients, I will use a breast implant, and fat grafting to either:
- Add soft tissue coverage in thin patients
- And/or improve the upper pole for better cleavage
The thing with a breast augmentation is that it cannot, in general, lift a breast.
Do You Need a Breast Lift?
While many women aren’t born with enough breast volume to match their aesthetic tastes and/or body proportion, most had lifted, perky looking breasts when they were young. Then, life happens:
- Hormone fluctuations
- Breast feeding
- Weight gain/loss
All of these factors can stretch the skin and tissues on your breast. Ask any mother who has breastfed whether her breasts sag more now, and the answer is always “yes”. But this is where things can get tricky. Pumping up the volume in the breasts with a breast augmentation does deliver a slight lift. Think about a deflated balloon. When you fill it up with air, it floats. But a breast implant cannot lift a moderate to severe amount of ptosis or droop in the breasts. An increase in volume does not always improve sag.
Breast Lift & Nipple Position
So, how do you figure out whether or not you have enough sag or deflation to warrant a breast lift? The best way is to schedule a consultation with a Board-Certified Plastic Surgeon in your area to be assessed in person. However, a quick “at home” test is to check out your nipple position in relation to the inframammary fold — this is the crease beneath your breasts.
If your nipples are located either at or below your inframammary fold, you will most likely need a breast lift. The best way to re-store your breasts to their proper place, higher on your chest wall, is to remove the excess sagging skin and breast tissue. Assuming that you have enough of your own breast volume, this can be a standalone procedure. However, in patients whose breasts hang, but who also want a bit more “umph” in the upper portion of the breast, I will perform a breast lift with a breast implant and/or fat grafting.
Do Not Fear the Scars
In my experience, breast surgery patients are often reluctant to embrace a breast lift because they are worried about scars on their breast. I pride myself on my surgical technique. But anytime that the skin is cut, it is going to result in a scar. The actuality, however, is that even though patients are more freaked out about breast lift scars than, say, facelift scars, the dominant portion of a breast lift incision is hidden within the crease beneath your breasts, and the border between the darker skin on your nipple and the lighter skin on your breast. Furthermore, the vertical scar that goes down the center of the breast tends to heal extremely well. This is why I always tell my patients not to fear the scar.
Important to Get it Right
The important thing is to get it right. This means choosing the correct procedure for your:
- Unique anatomy
- Desired outcome
- Ability to tolerate scars
I have found that the secret to a happy outcome for my patients is to manage their expectations appropriately. Let’s say that you are someone with a moderate degree of ptosis. Maybe your nipples hang in that grey area. They are not yet at the inframammary fold, but they do hover in the lower portion of the breast. But you are adamantly against scars. My job is to then make certain that you are clear that a breast implant alone is not going to return your nipples to the center of your breast. It always comes down to weighing the pros and cons. And it’s important to remember that this is always a personal decision. What worked for your friend may not be the right choice for you.