What Is Breast Ptosis?

A woman's degree of breast sagging (ptosis) will determine whether or not she needs a lift, an implant, or both. Plastic surgeons use a grading scale to categorize and rank ptosis on a scale of 1 - 3 with a separate category for a condition called pseudoptosis.

• Pseudoptosis: the nipple is positioned above the breast fold with the majority of the breast gland or tissue below the nipple
• Grade I Ptosis: the nipple is positioned at the same level as the inframammary fold or breast crease
• Grade II Ptosis: the nipple is positioned below the inframammary fold or breast crease, but above the lower breast contour
• Grade III Ptosis: the nipple is positioned below the inframammary fold or breast crease and at the lower breast contour

In many cases, ptosis is paired with your plastic surgeon's assessment of involutional changes in the breasts, where the amount of breast tissue has diminished. For normal-sized breasts, breast lift surgery by itself may be sufficient to meet a patient’s expectations or goals. However, in many cases, the combination of a breast lift with breast augmentation may be necessary to both lift AND fill the breasts.

Combining a breast augmentation with a breast lift can provide better shape by augmenting the upper pole and medial portions of the breast giving more roundness, cleavage, and upper pole fill.

Should I Get Breast Implants with My Lift?

There is no tried and true measurement to determine if breast augmentation surgery is also needed but there are several general rules to help make this determination.Patients who are happy with their breast size often state that they are happy with the way their breasts look when they wear a supportive bra. Generally, patients who have at least a C cup will be candidates for just a breast lift.

Patients who feel deflated or have a lot of excess skin generally need both a lift and augmentation. These patients often want more upper pole fill, cleavage, and round shape. They often say that they like the way their breasts look when breastfeeding and bemoan the loss of breast volume after pregnancy-induced changes have occurred. These patients typically have A or B-cup breasts with excess skin and a general deflated look to the breasts. In these cases, both a lift and augmentation is the best option.

Types of Breast Implants To Pair With A Breast Lift 

Saline breast implants

Saline implants are used the less often than their gel alternative.
These implants are filled with sterile IV saline at the time of surgery.
They can ripple more and feel less natural.

Silicone gel breast implants

 Over 90% of implants placed today are silicone. These implants are semi-solid in structure. When these implants are cut the gel inside stays put and does not leak out. This characteristic is similar to the gummy bear candy which is where the name “gummy bear” implants comes from.

Implant Placement Options

Implants can be placed either above or below the chest muscle. When a breast lift is combined with a breast augmentation the safest option is to place the implant under the chest muscle. This preserves the breast blood supply and provides more coverage over the implant giving a more natural result.

Combining Breast Augmentation With A Breast Lift: How Is It Done?

There are several breast lift techniques to choose from, depending on how much lift is needed and how much excess skin needs to be removed:

Crescent Lift

A crescent lift uses an incision around the upper part of the areola extending upwards slightly to remove excess skin. Initially, about 1-2cm of lift can be achieved but this is very short-lived. Placing asymmetric tension around the areola can also distort the round shape of the areola giving it a more oblong or oblique appearance. In general, this method is a way to remove a small amount of excess skin but won’t truly lift the breasts.

Peri-areolar Lift

Similar to the crescent this lift uses the areolar to hide the lift scar but goes all the way around the areola. More skin can be removed but any lifting effect is very short-lived. The areola is placed under tension and with time generally enlarges so that the areola is often larger than desired

Vertical Lift

 This lift uses an incision around the areola and from the areola to the breast crease. This lift does not incorporate the hidden incision in the breast crease. The problem with this approach is that there is a lot of tension on the vertical scar causing it to stretch, moving the areola up and increasing the distance from the areola to the breast crease.

Anchor Lift

This is the tried and true method where the incision is placed around the areola, the vertical incision from the areola to the breast crease, and the incision in the breast crease. This allows for an even distribution of forces and gives the best overall shape with the most lift.

Which Is First? The Lift or The Implants?

With this procedure, plastic surgeons always perform the mastopexy followed by the augmentation. In theory, this is a difficult procedure because a breast lift removes excess skin and makes the breast skin envelope tighter. The augmentation procedure does the opposite because adding the implant makes the breast bigger and stretches the skin. These are opposite or opposing forces. Dr. Burns does the breast lift first and establishes the new breast shape and position. Next, Dr. Burns places a temporary saline "sizer" implant to determine the proper volume and fill without overstretching or separating the breast lift incisions. Once size has been determined the permanent implant is placed and the incisions are then closed. This is a very precise way to get a perfect lift and implant size every time with no guesswork.

Before and After Breast Lift with Implants in Dallas, Texas

Reinforcing Results with An Internal Bra

 In cases where patients have either poor skin quality or have a recurrence of their breast ptosis, an “internal bra” can be placed to support the breast keeping the tension off the skin and incisions. Common products used are Durasorb or Galaflex which are synthetic mesh products that dissolve over time and are not permanent. The mesh is wrapped around the breast tissue and secured to the chest wall. The mesh holds tension off the skin and incisions prevent elongation of the vertical incision and stretching of the skin and tissue. This gives a longer-lasting result by providing more support to the tissue.

Will My Scars Be Visible After My Breasts Are Healed?

Surgery scars go through a very predictable progression as they heal. Fortunately, anchor incision scars heal very well. Scars are typically very visible during the early stages of the healing process and gradually improve. The first 6 months are the most critical but scars do fade for up to 24 months after the procedure. The end result is typically a fine white line that blends well with the surrounding breast skin.

Scar Revision Therapy

All of our breast surgery patients are referred to our laser and skin care center called EpiCentre which is located on site. Each patient will receive scar care gel; either Skin Medical Scar Recovery Gel or BioCorneum. We also recommend using silicone tape or sheets to cover the scar during the initial healing phase.

We also offer laser scar therapy at EpiCentre which helps fade and improve the scars.

Procedures That Compliment Breast Rejuvenation

• Liposuction: Many patients will have areas that would benefit from liposuction. Areas around the breast such are arms, axilla (armpit area), and upper back/bra fat are the most popular. Other popular sites for liposuction are the neck, abdomen, love handles/flanks, and thighs.
• Tummy Tuck: Patients who need a breast augmentation and breast lift are typically women who’ve undergone at least one pregnancy. The abdomen is also affected meaning that a tummy tuck is a popular procedure to combine with the breasts. A tummy tuck will remove excess skin and fat from the lower abdomen and tighten the abdominal muscle. The combination of breast and a tummy tuck is sometimes referred to as a “mommy makeover.”

Frequently Asked Questions

How much is a breast lift with implants?

Cost will vary depending on exactly what type of implant is chosen but the average cost of lift with breast implants is about $12,000 for everything.

When will I see my final results?

In most cases, the final result is official when the surgical incision site his the 6 month mark. You can expect to look very good initially but improve as swelling gradually dissipates and the implants assume their permanent resting position. As stated above the incision gradually improves with time and treatment.

How painful is a lift with implants?

During surgery, Dr. Burns will inject a long-lasting local anesthetic to numb the chest muscle and incisions. Typically patients feel pressure from the implants and tighter skin envelope. Pain medication is rarely needed beyond the first several days.

Can you get a breast lift with existing implants? 

Yes. If you are happy with your current implants and the implants are relatively new then replacing them is not absolutely necessary. Implants last on average about 10 years before they need to be replaced.

Before and After Breast Lift Near Me in Dallas Texas by Dr. John Burns

Can I Finance My Breast Surgery?

Yes, you can finance your plastic surgery procedure. We offer simple third party financing options through CareCredit, PatientFi, or Alphaeon. Many of these plans offer no interest options. We are happy to help you guide you through the process during your consultation.

Schedule Your  Consult with Top Plastic Surgeon,
Dr. John Burns

Schedule your private consultation with Dr. John Burns.  Dr. Burns offers both virtual and in-office plastic surgery consultations for women considering a breast lift with implants in Dallas, throughout the United States, and the world.