Breast lift and shape: These are the two main concerns of women with breast ptosis or sagging who want to undergo plastic surgery to correct the condition, according to Upland Plastic Surgery Institute.
First and foremost, the postop shape is primarily determined by the incision pattern and the patient’s underlying anatomies. The goal is to create a soft rounded lower pole, a nipple area positioned a few inches above the submammary fold, and possibly a “curved” upper cleavage, as opposed to a flat sloping upper breast.
Patients who need the most amount of lift and/or adjunct breast reduction will need the standard technique to achieve the most ideal postop shape. However, the patient must accept the appearance of an inverted T scar resulting from “donut” incisions around the areola’s border, within the submammary fold, and vertically in the lower pole.
While the modified forms of breast lift result in shorter or fewer scars, due to the natural diffusion of loose skin they could lead to less than optimal shape especially in patients with large, droopy breasts.
But for the right patients, the vertical lift technique—which eliminates the horizontal scar within the submammary fold—can provide a good shape. The consensus is that it is suitable for women who only need their areola complex raised about 3 inches or less.
For the right patients, the vertical lift can provide a nice perky shape that has a “soft” rounded bottom or “moundish” look, as opposed to a boxy appearance.
“Boxier” breasts may occur after an over-aggressive surgical maneuver, which left the skin overly tight. However, some doctors have also noticed that this appearance also affects a good number of “heavier” patients with a lot of fatty tissue lateral to their breast.
Contrary to popular belief, breast lift is not just a skin operation. To hold the planned shape, the vast majority of doctors use internal sutures that reshape and support the tissue.
To further achieve a more natural shape, the stretched, large areola must be reduced as well. This adjunct procedure is particularly important if the patient will receive breast reduction at the same time.
Despite best efforts, any form of breast lift will have no or very little effect on the upper breast pole. For this reason, it is sometimes combined with round breast implants, which in essence are shaped like a flattened sphere, although once placed vertically in their pockets their contour will resemble a teardrop due to the effects of gravity.
Regardless of the surgical maneuvers used, a skilled surgeon will make every effort to create a breast mound that has upper and lower pole ratio of 45:55.