Breast reduction with lift accomplishes two goals: shrink the breasts to make them more proportionate to the body, and improve their shape by elevating some of the tissue of the lower pole.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says breast reduction and breast lift have different goals, the former is often considered a medical necessity (to eliminate systemic discomfort that comes with overlarge, heavy breasts), while the other is viewed as a purely cosmetic procedure. Nonetheless, it always makes sense to combine them as they share the same incisions.
In a recent Snapchat video, Dr. Smiley says large, heavy breasts are almost always pendulous.
Dr. Smiley has recently performed breast reduction with lift on a patient. He also did a simultaneous areolar reduction to further ensure more proportionate and natural results.
Due to the significant breast ptosis (droop), Dr. Smiley elevated the nipple area by around 7 cm. The goal was to create a decent distance between the areola and the submammary fold; of course, the ideal distance primarily depends on the final breast size.
But before he was able to elevate the nipple, he removed the epidermis of the skin, a process called de-epithelialization. He was careful not to go deeper (ensuring that the dermis remained relatively intact) to minimize bleeding and to prevent inadvertent injury to the blood vessels.
By preserving most of the blood supply, Dr. Smiley says the risk of infection and healing problems is significantly reduced. Of course, lab screening prior to surgery is also critical to ensure that the patient is “healthy enough” to tolerate the operation and its ensuing recovery, he further explained.
Thereafter, he removed some breast tissue to reduce its size before elevating some of the lower pole tissue to give the patient more upper pole fullness and to correct the drooping appearance.
Instead of relying on skin tightening, Dr. Smiley says his breast reduction with lift depends more on internal lifting to ensure that the results can resist the effects of gravity and progressive aging.
After reshaping the internal structure of the breast, he closed the anchor-shaped incisions with multiple rows of sutures. The actual skin, meanwhile, was not included in the process and instead its wound edges were just allowed to “kiss” each other, similar to a jigsaw puzzle, to promote the best scar possible.
Reducing tension on the skin is the key to thin, faded scars, says Dr. Smiley.