The breast augmentation internal lift might be a good alternative to the standard breast lift technique in which the extent of scarring is often perceived as a major concern.
In standard breast lift (which is often combined with breast augmentation via implants), the scar goes around the areola’s border and within the submammary fold; hence it is well concealed. However, the main concern is the vertical scar that goes from the nipple down to the breast crease because it is placed in a more obvious location.
The patient shown in the video had pseudo ptosis, which means that the breasts were sagging and the upper pole appeared deflated, but the nipple area had not drooped below the submammary fold.
Dr. Smiley created a U-shaped scar at the lower border of the areola to create an implant pocket. He also used internal sutures (they were vertically oriented) in the superficial fascia of the breast, particularly above the nipple area to elevate the tissue along with the areolar complex.
The vertical internal sutures that hold the nipple area and its surrounding tissue also give some fullness and tightness in the upper poles.
Precise pocket dissection is also a critical part of breast augmentation internal lift technique. Dr. Smiley says the goal is to prevent inadvertent implant displacement that may lead to sagging or bottomed-out appearance and excessive lateral bulge.
Despite the benefits of breast augmentation internal lift, Dr. Smiley says the technique is only suitable for patients with very minimal sag—i.e., their nipple does not require more than 3 cm elevation.
Meanwhile, patients with significant sagging—i.e., their nipple has drooped way below the submammary fold—will need the standard breast lift technique (with or without implants) to achieve the most desired results, says the celebrity plastic surgeon.
Regardless of the type of breast lift utilized at the same time as breast augmentation, Dr. Smiley highlights the importance of “respecting the skin to promote the best possible scar.”
While closing the U-shaped incision, Dr. Smiley is seen closing the wound in which the dermis beneath the skin was sutured while the actual skin edges were just allowed to kiss each other.