Breast Augmentation: Do You Need A Lift Too?
This is the most common question that I answer on Realself, an online patient and physician question and answer platform. The most common complaint from unhappy patients who have undergone a breast augmentation is that their breasts:
1) appear lateralized and falling into their armpits
2) lack medial cleavage
3) have no upper pole fullness
4) are laying on their belly
5) breasts that look oblong, described as an “eggplant”
Why these Unsatisfactory Results Occur
If you are experiencing any of these concerns, you have likely undergone only a breast augmentation when a simultaneous breast augmentation and lift procedure may have been in your best interest. To understand who needs a breast augmentation versus simultaneous breast augmentation and lift, we have to discuss breast aesthetics. First, you have to appreciate that the inframammary fold is not only the junction of your breast and abdomen but also that it defines the bottom of your breast. As such, surgeons cannot place your breast implant below the fold; ideally, it sits on your fold. Thus, in order to ensure the centering of your nipples on your newly augmented breast mound, you have to make sure that the radius of the chosen implant is not longer than your nipple to fold distance.
If you appreciate this explanation, you will soon realize that if your nipple is at your fold or lower, there is no way that someone could center your nipples on your newly created breast mound unless you undergo a simultaneous breast augmentation and lift. In fact, the most frequently disgruntled patient I see is one who had her nipples actually located above the fold, yet the distance from the fold to the nipple was not long enough to accommodate the chosen implant radius.
How to Avoid Complications
To summarize, you must limit your implant size so its radius is not longer than your nipple to the inframammary fold. This applies even if your nipples are above your inframammary fold. Otherwise, you will be risking having your nipples pointing down instead of straight ahead. When deciding whether one needs a lift, the first thing we do is figure out the desired implant size; once we pick an implant size, we make sure that your nipple to fold distance accommodates the implant’s radius; if not, you will need a lift!
Unfortunately, far too many surgeons do not feel comfortable performing implant breast augmentation and lift procedures simultaneously, and thus avoid recommending this procedure, even these combined procedures are in the best interest of their patients. Some may recommend a crescent or periareolar breast lift; however, widened areola scars and suboptimal lift plague this procedure. Today, the most effective simultaneous breast augmentation and lift procedure involves a customized, “tailor tack” vertical mastopexy procedure. This means the length of incisions on your breasts is only limited to areas on the breast that need hemming.
If you are considering a breast augmentation but are not sure if a breast lift is in your best interest or you want the a simultaneous breast augmentation and lift, complimentary consultation with Dr. Mowlavi will help clarify the ideal procedure for you.