Breast Lift (Mastopexy with Implant):

Women are candidates for breast lifts if their breast gland is too low on the chest, if the gland folds over and rests on the chest, or if the nipples are too low. The addition of an implant is indicated when more upper breast fullness, or a larger cup size is desired. This is a valuable procedure in breast augmentation revisions.

Child bearing with or without breast feeding is the most common cause for these changes in breast shape, however weight loss, genetic "soft collagen" and advancing age can all cause or contribute to breast sagging. It is not unusual for women in their 20's to need lifts or implants. Depending on the type of implant (saline or silicone) and thickness of breast tissue, the implant may be on top or underneath the chest muscle, but usually underneath.

Dr. Gordon will discuss the variety of surgical procedures, depending upon what changes are desired. Prior to surgery, pre-medication to relax the patient is administered and breasts are carefully marked to indicate where the incisions are to be made and the correct placement of the implant. Regardless of the type of lift selected, our patients have the option of choosing saline implants or silicone gel.

When a woman has breasts which are shaped like sweet potatoes (tubers) this condition is termed tuberous breasts and is sometimes treated by a type of lift, which circles the areola and is termed a circumareola lift. A circumareola lift is also good for the treatment of large areolas, mild forms of nipple asymmetry. Added implants enhance lift results.

In cases in which there is good nipple position on the breast mound but poor gland position, then a lift of the gland without disturbing the nipple position can be done using a vertical incision, which passes between the bottom edge of the areola and the inframammary fold. We call this lift an abbreviated vertical scar mastopexy (AVSM). Cup size is increased with implants.

In the typical advanced cases of nipple and gland malposition we need to lift both the nipple and the gland. The incision circles the areola, (often reducing the areola to a more appropriate size) and continues down to the inframammary fold. We call this lift a vertical scar mastopexy or VSM lift. This is the most common lift we do and in our hands provides the best results for the common varieties of breast and nipple sagging. Most of the time we simultaneously add implants.

Dr. Gordon has a special interest in cosmetic breast surgery and has made significant progress in bringing the combined augmentation/lift procedure to its current level. We are now working to improve the results with patients who have drastic differences in breast size and shape with some very encouraging results. In most cases of breast lift with augmentation Dr. Gordon prefers to do both procedures simultaneous.

BEFORE SURGERY
Prior to surgery, a complete medical history is taken in order to evaluate the general health of the patient. Dr. Gordon will do a thorough examination of the entire patient as well as the breast to determine the most effective surgical approach. He will describe the type of anesthesia to be used, the procedure, what results might realistically be expected, and the possible risks and complications.

Mammograms or x-rays may be taken as well as digital photography.

FOLLOWING SURGERY
After surgery, the patient may temporarily have a drain and will need to wear an absorbent pad over the stitches for a day or two. A bra should be worn to aid in breast shaping.

Pain connected with the procedure is significant but is controlled with oral medication. Daily showers and antibiotics will be continued to prevent infection. Instructions for the day of surgery include bed rest and limited activities. Dr. Gordon will determine when normal activities can be resumed; however, weight training and aerobic exercise must be avoided for two weeks.

Sutures, if necessary (most cases use dissolvable sutures), are removed in about two to three weeks at which time Dr. Gordon may recommend massage to keep the breast supple. Numbness around the treated area may occur, but this condition is usually temporary. Swelling and discoloration disappear in a few days, and scars from incisions, although permanent, fade significantly with time.