Cosmetic breast surgery that combines two or more procedures has become a common routine nowadays. In some situations, this is even a more preferable approach than having two separate surgeries in order to produce more natural results.
Today, the most common “combo” procedures are breast augmentation with lift, and breast reduction with lift, according to the California Surgical Institute website.
Breast augmentation with lift prevents a specific deformity called Snoopy due to its close resemblance to the profile of the classic cartoon dog.
When implants are used in sagging breasts without a simultaneous breast lift, their bottom edge might become visible beneath the lax skin, and thus there will be an appearance of two pairs of submammary fold.
But with a simultaneous breast lift, the implants will not “herniate” as the internal support and the actual breast tissues are reinforced with sutures. In addition, the south-pointing or low-lying nipple area is positioned higher to further achieve a proportionate result.
Breast lift is also commonly incorporated with breast reduction, a procedure that produces a smaller “cup size,” which in turn can provide instant relief from back pain, rounded shoulders, postural problems, and other ill effects of overlarge, heavy breasts.
Large breasts are susceptible to the effects of gravity (i.e., causing their skin to lose their elasticity), thus it always makes sense to incorporate some type of breast lift during the surgery.
Meanwhile, breast lift does not always entail a simultaneous breast reduction unless the patient specifically requests for a smaller cup size as well.
Cosmetic breast surgery involving combination procedures aim to produce a more natural-looking and youthful appearance—i.e., conical shaped, 45:55 breast ratio (i.e., most of the volume should be in the lower pole), proportionate nipple diameter relative to the breast size, and “ample” distance between the areola and the submammary fold.
A slight lateral bulge is also deemed ideal, although all efforts are made to prevent it from becoming excessive and thus giving an illusion that the breasts are too wide apart.
Also, it is ideal to produce a ski-slope appearance in the upper pole. In fact, one study has suggested that the ideal breast profile should have a 45:55 ratio, with the areolar complex serving as the delineating mark between the lower and upper breast poles.
Of course, good symmetry between the left and right breasts must be achieved during cosmetic breast surgery. For this reason, some patients may need different sized implants, or require more tissue removal or additional elevation on one side.