Breast Mastopexy

This female in her late 30’s at first was thinking of doing a breast lift without an implant, however I explained that it’s the implant that gives just a little upper pole fullness and she did want that. We used Allergan style SSM silicone gel implants 255cc on each side placed completely submuscular. A Brazilian lift was done on top of that giving her a small C cup, however she also requested liposuction of her front underarm area that she felt bulged out of her bra.

This young woman in her mid-20s had one child and was unhappy with the shape and size of her breast. She decided on a breast lift without implants to be able to exercise more easily. This is her over four months later with her scars still slightly pigmented, but very happy.

This 56-year-old female decided after 26 years to remove her implants and have a breast lift, which is becoming more and more common. She had saline implants 380cc. We removed her implants and did a Brazilian lift making her a B cup, and she said it was one of the best decisions she ever made! 

 A breast lift with an implant can be one of the more challenging cosmetic operations. Trying to keep the implant and breast tissue uphill after surgery is not so simple. As a surgical resident I noticed that many breast lift patients might look up and supported two months after surgery, but 4 to 5 months later, either the breast tissue or implant had dropped too low. By utilizing techniques, I learned in Brazil, I think there can be a much higher degree of long-term success!

This 43-year-old patient told me she never had the breast shape she ever wanted. As soon as she hit puberty they started to droop! For her, just a straightforward mastopexy was all she needed. She wanted to reduce the size of her areola and have them face more forward. She had good breast tissue density, so it gave her good upper pole fullness, almost like having an implant!

This patient presented with a breast lift and implants 15 years prior. She had 400cc silicone gel implants and now presented wanting her breast tissue tightened and her areola made smaller. During surgery I discovered she had a silent rupture of her right implant. I removed the rupture, changed her implants to 400cc silicone gel on the right and 375cc on the left, and resized her areola and redid her lift. She is shown now seven months postoperatively.

This is the type of operation where money surgeons would do this in 2 to 3 stages. I did this in one surgery. This is one of the more challenging surgeries because she presented with 20-year-old saline implants above the muscle with no records. She always felt they were too big and too heavy. For our surgery, I removed her old implants from above the muscle, placed new Allergan style SCM silicone implants 310cc under the muscle and did a Brazilian lift on top of that.

This 41-year-old patient originally had saline implants placed in 1997. She felt they were overfilled and gave her too much upper pole fullness and was looking to be smaller and lifted. Her left implant also moved too far to the outside. At surgery I did a left capsulorrhaphy, changed her overfilled saline implants to silicone 345cc and did a Brazilian breast lift, again changing all three breast revision components.

This patient presents with one of the more challenging scenarios in cosmetic reconstruction. I often talk to patients of the three components of revision surgery being capsule, breast tissue, and implants and in this patient, we changed all three. Her original implants were saline, then later changed to 600 cc silicone implants with a lift. Now seven years later she desired to be smaller, breast tissue lifted and more upper pole fullness.

This 57-year-old patient had a long history of breast implants going back to saline implants which were later replaced with textured silicone. She now felt too full in the upper pole, too big overall and felt that her breast tissue was too low. A straightforward way to reduce upper pole fullness is with a smaller implant and we went from a 360cc down to a 250cc Allergan style SCLP. To address the drooping breast tissue, we tightened her up using a Brazilian lift.