Breast Lifts

With Minimal Scarring 05/26/03

Pregnancy and breast-feeding can significantly affect the shape and overall appearance of a woman's breasts. During pregnancy and breast-feeding, the breasts enlarge and the skin of the breasts stretches. After pregnancy, breasts that once were round and set high on the chest may appear tubular and elongated, with the nipples pointing down instead of out. This condition, which is called breast ptosis, is a natural part of the aging process but is accelerated by pregnancy. It can also occur developmentally. Some women because of genetic factors may experience breast ptosis as early as 18 or 20 years of age.

A saline-filled or gel filled-implant alone will not effectively correct breast ptosis. Effective treatment requires an aesthetic surgical procedure called a breast lift or mastopexy. Sometimes, depending on the amount of breast tissue atrophy, implants may be used in conjunction with a breast lift to give the breasts a more rounded, firmer, and youthful appearance.

In the past, the negative side of breast lifts has been the scars left from the incisions necessary to perform the procedure. Scars on the surface of the breast tend to fade and in some cases virtually disappear. Aesthetic surgeons also try to place the scars in locations that are easily concealed by a bra or swimsuit top. Still, visible scarring has always been the objectionable part of doing breast lift operations. Over the years, plastic surgeons have sought ways to create the lift effect and also minimize scarring. These efforts have been successful. Today some patients are candidates for what is called a minimal-scar breast lift procedure.

In a conventional breast lift, the plastic surgeon makes an incision at the bottom edge of the areola (the area of darker skin around the nipple) and continues that incision beneath the breast and across the fold located where the breast meets the chest wall. This procedure results in a scar shaped like an upside down T on the bottom of the breast. The minimal scarring technique eliminates the upside-down T-incision and thus the resulting scar.

With the minimal-scarring technique, an incision is made right at the edge of the nipple/areola complex, known as a "periareolar incision". The resulting scar is extremely inconspicuous because it is located in the zone of transition between the darker pigmented areola and the lighter pigmented skin of the breast. If the scars are visible after approximately one year, the patient can choose to have them tattooed by the plastic surgeon to match the color of the areola, making them virtually undetectable.

There are two techniques for actually lifting the breast. Depending on the patient, the plastic surgeon may use either one or a combination of both techniques. One technique involves using special suspension sutures in the gland of the breast to lift and support it. The other technique, sometimes called the internal bra procedure, involves lifting the breast gland into a higher, tighter position with internal stitches and then placing an absorbable mesh-like material around the gland of the breast for support. The mesh material cannot be seen or felt beneath the skin surface, and it does not interfere with mammography. This mesh-like material holds the breast in the desired shape while it heals. As the mesh-like material is absorbed, the body replaces it with collagen and scar tissue that maintain the long-term shape of the breast.

Minimal-scar breast lifts can be performed as an outpatient procedure. The surgery requires approximately four hours. Most women can expect to need a about a week away from work. Recovery for all but sports activities is usually about three weeks. Within four to six weeks, most patients can return to full sports activities.

Back to List