Breast augmentation after pregnancy, major weight loss and in naturally droopy breasts
Quite a number of the breast augmentation patients in our practice are moms. After one or more pregnancies, most women experience a loss of breast volume combined with some ‘stretching out’ of the breast skin. In many of these patients, a breast implant of moderate size will restore a very pleasing breast contour. These patients are not looking to raise eyebrows at work or around the neighborhood – they just want to discard their padded bras, to have more options when selecting clothing and swimsuits, and to feel better about their appearance in private.
When there is mild to moderate laxity of breast skin and/or loss of breast volume that makes the breasts appear somewhat droopy or ‘deflated’, the addition of a breast implant can ‘fill up’ the excess skin and create the appearance of a breast lift (although this is not truly a breast lift or ‘mastopexy’). This situation often is a result of pregnancy and lactation, but we also see many patients with significant breast skin laxity who have never been pregnant. Breasts are often droopy and lax at the time that they first develop, and can also have this appearance in patients who have never been pregnant but who have experienced major weight loss.
In patients with more advanced drooping of the breasts (the medical term is breast ptosis – the ‘p’ is silent so ptosis is pronounced TOE-sis), particularly when the nipples are pointing downwards, a mastopexy (breast lift) needs to be combined with the breast augmentation surgery to tighten the skin envelope around the implants. In these patients adding a mastopexy to the augmentation plan allows the surgeon to achieve a result that is truly youthful and aesthetically ideal. The result of this surgery is truly liberating for most patients, as most no longer feel the need to wear a bra to bed at night, and can go bra-less in some forms of clothing if they wish to do so.
Mastopexy may also be required when the nipples are still pointing forward or slightly upwards, but much of the lower pole breast volume has dropped below the level of the inframammary folds. This preoperative condition is referred to as ‘glandular ptosis’, meaning that the nipples are not down-pointing but a significant proportion of the glandular tissue of the breasts has ‘bottomed out’ and now resides below the level of the inframammary folds.
Simultaneous breast augmentation and breast lift (mastopexy) is called an augmentation mastopexy, and the results of this operation can be dramatic and absolutely transforming. An augmentation mastopexy is required when the surgeon’s preoperative assessment is that without a lift, the likely postoperative appearance is that of a breast drooping off of an implant – which is a distinctly unnatural and unappealing breast profile. If you need a bra to hold your breasts up preoperatively, it is quite likely that you will need a mastopexy in addition to your breast augmentation procedure.