Deciding between breast lift (mastopexy), breast augmentation or breast lift with augmentation.
You should have this discussion with your board-certified plastic surgeon to determine which procedure will best meet your goals. Breast tissue that is "deflated" after weight loss or pregnancy may benefit from a lift and an implant together. Breast tissue that is ample but has become "droopy" or in which the nipple position has dropped will likely require a lift alone whereas breasts that are smaller than desired but where the nipple position is still higher than the breast fold may need an implant only. You should discuss with your surgeon if you would like to have a different size breast or a different shape breast or both. Looking at pictures together can often help this discussion.
Where are the breast lift scars?
Depending on how much “lift” is required, the scars may be placed in the border of your areola (colored portion of the breast) and breast skin. They may also extend down from the areola to the base of the breast (vertical lift) or may also extend and be hidden in the fold of the breast (anchor pattern). This decision is made on the basis of how much skin will need to be removed and how far the nipple has to be elevated on the breast mound. All of these types of lifts can reduce the size of the areola, as well.
How does pregnancy affect a breast lift (mastopexy)?
Pregnancy can affect what procedures are recommended for breast lift, or mastopexy, surgery as well as the timing of a breast lift. This is because pregnancy has a highly variable affect on the appearance of the breasts and the physiology or function of the breasts from the normal, to the pregnant, to the lactating and then the post-pregnancy state.
Pregnancy and what breast procedure is chosen. Breast lifts are best suited for women who have excess breast skin in relation to their breast size. Pregnancy will temporarily increase breast size, causing the breast skin to stretch a variable amount. While breast size decreases after pregnancy and lactation, the breast skin rarely shrinks to the same degree, leading to a relative excess of breast skin compared to the remaining breast size. For this reason, many women who may have been candidates for a breast augmentation before having children are better candidates for a breast lift, or combination breast lift-breast augmentation, also known as augmentation-mastopexy, after they have had children. Small-breasted women who have not experienced a significant change in breast skin characteristics after pregnancy may still be a candidate for breast augmentation without a breast lift.
Pregnancy and timing of breast lift. If you are an appropriate candidate, a breast lift can be performed before you become – or are actively planning to become – pregnant. If you are interested in breast lift surgery after pregnancy, then you will need to delay surgery for several months after you are finished lactating. This is to reduce the risk of infections and cysts after breast lift surgery. If you are between pregnancies, and are planning to have more children in the not-too-distant future, then you may choose to hold off on breast lift surgery until you are finished having children. This is because subsequent pregnancies are progressively more likely to change the shape of your breast even after breast lift surgery. By waiting, a more long-lasting result can be achieved, and may save you from wanting “touch-up” surgeries that ultimately add recovery time and cost.
How pregnancy affects longevity and outcomes of breast-lift surgery. Your surgeon cannot guarantee that a future pregnancy won’t negatively impact the results of your surgery. After a breast lift, you need to understand that a breast lift will not protect against the natural changes that may occur to the breast after pregnancy. For example, if you have a breast lift, then become pregnant or gain weight for any reason, your breasts may increase in size. After you have lost weight, it is possible that your breasts could droop again.
Breast lift surgery and breast feeding. Any surgery on your breasts can affect your ability to breastfeed in the future. With that said, because of its technical aspects, breast-lift surgery may be more likely than breast augmentation surgery to affect your future ability to breastfeed. If you are unsure about your future desire to breastfeed, you should discuss this with your board-certified plastic surgeon.