Breast lifts are for breasts that are droopy (ptotic). Droopy may seem like a common word with an obvious meaning, but actually it has to do with the relationship of the nipple to the fold under the breasts, i.e. the point at which the breast hits the chest wall. This is a complex subject but let me simplify it for you. If you stand in front of a mirror with your bra off and put a piece of paper under your breasts so that the top of the paper is at the point where the breast connects to the chest wall, then you can determine if you need a lift or not. If the nipple and the areolar both are above the top of the piece of paper, then all you need is a breast augmentation, i.e. a breast implant placed behind the breast muscle that, in and of itself, will lift both the breast and the nipple. If the nipple is at the level of the inframammary fold, then a dual plane mastopexy or non-scarring mastopexy plus a large implant may correct droopiness or ptosis at this level. If the nipple is below the inframammary fold, then a Benelli mastopexy with or without implants should be able to lift this level of droop or ptosis. If the inframammary fold is 2” above the nipple, then a standard mastopexy with or without implants would be the appropriate means of correcting this level of droop or ptosis.
Dual Plane Mastopexy: This is a technique popularized by several plastic surgeons across the country. In this technique, I place the implant below the muscle through an armpit or transaxillary incision, but then release the muscle from the breast tissue through the same armpit incision, but here, going above the muscle, therefore releasing in two planes, one above and one below the muscle which leads to the term dual plane. The release of the nipple areolar complex and breast from the muscle allows it to rise up to a higher position, and the implant itself raises the breast tissue. Therefore, the combination of a dual plane release plus a moderately large implant can lead to a lift with no scars on the breast itself.
Benelli Mastopexy: The next and more aggressive level of lift is Louie Benelli’s technique of lifting the breast and nipple with the final scar only being around the edge of the areolar. I lectured for 12 years at National plastic surgery meetings with Dr. Louie Benelli as his American expert on this particular surgery. The Benelli mastopexy is a good alternative to correct droopy breasts with minimal scarring.
Vertical Mastopexy: The vertical mastopexy has gained popularity amongst many plastic surgeons, but I personally feel this is not an aesthetic procedure and one that I do not offer to my patients.
Standard Mastopexy: The standard mastopexy with an incision around the areolar, a vertical line, and a horizontal line under the breast is the gold standard for breast lifts. For really droopy or ptotic breasts, this is a wonderful procedure with or without implants. The major drawback for this procedure is usually the width or the redness of the resultant scarring. To decrease the scarring, I put thick sutures in the deep tissue inside the breast, and then several layers of dissolvable sutures below the skin level to take the tension off the final closure. Tension is the number one reason for unacceptable scarring. Finally, I believe that a specific type of tape applied to suture lines from two to six months after the procedure leads to the best cosmetic result.
In breast ptosis or droop, there are four major problems: 1) the areolar is too big; 2) the areolar is too low; 3) the breast hangs on the chest wall; and 4) there is no fullness in the upper quadrant. The first three problems can be corrected with any one of the lift procedures listed above, but one needs breast implants (breast augmentation) to correct the fourth problem, i.e. giving the breast back the youthful fullness in the upper quadrant.
As you can see, the topic of a breast lift Honolulu procedure is a very complex one, and to get the best result with the least possible scarring, you need to choose a Board Certified plastic surgeon, one certified by the American Board of Plastic Surgery. Membership in the Aesthetic Society is a minimum requirement when picking the right plastic surgeon. There are several excellent plastic surgeons in Honolulu with the above credentials. We recommend you choose a plastic surgery center that shows a passion for correcting this particular problem and the expertise to give you the best results.
To find out just how passionate and experienced everyone is at Breast Implant Center of Hawaii and to set up a consultation with our board certified plastic surgeon, Dr. Larry Schlesinger, contact us today. If you would just like to find out more about our breast lift Honolulu, Hawaii procedures or have any other questions please give us a call at 808.597.8835.
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