Posted by Dr. Hardesty on April 19, 2019
Also referred to as a “boob job with a lift”, “masto-aug” and “aug-lift,” this is a procedure that increases breast volume, shapes the breasts by removing excess loose skin, lifts the nipples, and reduces the areolae (when desired) in one operation.
There are several options when it comes to improving breast size and shape, allowing one to wear certain clothes like backless gowns, halter tops, or certain bathing suit tops with confidence.
Breast implants alone are not a solution to sagging breasts. While implants do add volume to the breasts, which can improve minimal sagging caused by a loss of breast volume, they don’t do anything to correct the underlying causes of sagging. The problem is that the ratio of breast skin to volume is too high. Saggy breasts are not uncommon and are seen most often after pregnancy, weight loss, or developed that way with age. The ratio of breast skin to breast volume being too high also results in nipple areolae complex (NAC) falling. When the NAC is at or below the breast crease/fold adding breast implants without a breast lift can actually make the problem worse. This is referred to as the “waterfall” effect when the excess skin and NAC rotate over a larger implanted breast mound. Unfortunately, the final result is bigger, saggy breasts. If you have sagging, don’t assume that breast implants alone will fix the problem. You may need a breast lift too!
REMEMBER: Saggy Breasts + Implants = ONLY Bigger, Saggy Breasts
"I researched multiple doctors in the area for a breast augmentation... When I met Dr. Hardesty I knew he was the one! He and his team are incredibly friendly, professional, and helpful. They truly made me feel comfortable throughout the entire process. My overall experience from the consultation to my six week post-op was exceptional and I could not be more happy with my results! I highly encourage anyone seeking a doctor for a breast augmentation to set up a consultation with Dr. Hardesty." -Verified Google Review
The best way to determine if you need a breast lift with your breast augmentation is to have an examination from a board certified plastic surgeon in Riverside CA like Dr. Hardesty. During your consultation, he’ll examine your breasts, take measurements, evaluate your skin elasticity and help make the determination. If you’d like to get a rough idea of whether a lift is needed, you can examine your nipple (NAC) position in relationship to the breast fold/crease. If your nipple (not the areola, but the raised nipple) is lower than the fold of the breast, a lift will most likely be needed to obtain the result you desire.
Depending on the amount of sag (excess breast skin to breast volume ratio), progressive amounts of skin will need to be removed along with repositioning of the nipple (NAC). The three types of techniques are used depending on what shape of the breast and amount of excess breast skin you have after performing the breast augmentation. The most common are:
- “Donut”, peri areolar or circumareolar final incision – This technique is limited to mild breast sagging. A breast lift with a donut incision may be performed to reduce the size of the nipple (NAC) alone. This incision is made around the areola. Once healed, it can be very difficult to see.
- “Lollipop” or vertical mastopexy resultant incision – For moderate sagging this procedure adds a vertical component to the donut incision. An incision is made around the areola and vertically from the bottom of the areola to the base of the breast the excess skin is removed in a vertical fashion and the NAC elevated to the proper position. This allows for significant removal of excess skin to create a more rounded, youthful, and natural breast shape.
- “Anchor” or inverted T mastopexy (lift) technique – For significant sagging, an anchor incision removes excess sagging vertical breast skin in both the vertical and horizontal breast, resulting in a rounder shape and the nipple (NAC) in the normal position. This results in the same incisions as a lollipop incision, but also adds a horizontal incision at the base of the breast hidden in the breast fold. This technique provides the most significant and dramatic change to the very saggy breasts.
A common concern of most women is the resultant scars. Our findings are that those women who follow our preventive anti-scar reduction program are happy and delighted with the resultant hidden scars that are traded for their new shape and size.
Women who need a mastopexy with augmentation should expect the breast volume to remain the same after their procedure. However, over time based on the original need of a mastopexy (because of loss of skin elasticity), the breast may again sag If precautions are not taken.
The basic rule of thumb is the bigger you go, the faster you will drop. I’d recommend that all mastopexy with augmentation patients wear double sports bras when they are involved in the high impact exercises such as running or Zumba-like activities. In addition, a good support bra should be worn most of the time. The occasional times that you would like to go braless, wear a bathing suit, or wear a backless or halter top, should not affect the re-sagging to a significant degree.
Before & After
Most women are back to work within 7 to 10 days, as long as they don’t require strenuous upper body movement. Exercise is allowed after six weeks without restrictions. See our blog on Recovery after Breast Augmentation, Mastopexy or Augmentation/Mastopexy for details.
Unfortunately, there are not any significant alternatives to remove the excess skin of the breast and elevating the nipple to the correct position without performing a mastopexy.
While the size and shape can be improved significantly, the elastic properties of the individual skin cannot be changed, and because of the increase in size and weight of the breast, the skin may stretch again.
Yes. The most common (but not limited to) plastic surgery procedure that is performed with the breast lift, breast augmentation is the abdominoplasty (tummy tuck). This combination of procedures is also known as the mommy makeover.
Are There Any Risks/complications With a Breast Mastopexy and Breast Implant Placement at the Same Time?
Besides the generally very low risks of any surgical procedure such as bleeding, infection, and anesthesia, there is an additional uncommon risk of decrease blood supply to the nipple (NAC). This unusual complication can result in partial or complete loss of the nipple (NAC).
The cost of breast augmentation with lift is based on the anesthesia fees and the facility (outpatient operating room or hospital setting). All pre and post-operative care is included in this cost. Some preoperative laboratory analysis may be required, but these are usually covered by your medical insurance.
The most important factor to consider is seeking the opinion and services of a skilled, experienced and Board Certified Plastic Surgeon who are experts in breast augmentation with mastopexy techniques. The Imagine Plastic Surgery team uniquely provides the full array of both non-surgical and surgical alternatives, thus filling our motto of “One Goal, Many Options.” For more information, call our office and schedule a consultation.
One Goal, Many Options
The most important factor to consider for your procedure or treatment is seeking the opinion and services of a skilled, experienced and Board Certified Plastic Surgeon who are experts in techniques. The Imagine Plastic Surgery team uniquely provides the full array of both non surgical and surgical alternatives thus filling our motto of “One Goal, Many Options.” For over 30 years Dr. Hardesty, an award winning, Board Certified Plastic Surgeon, has proudly been serving Riverside and San Bernardino counties of the Inland Empire and the communities of Rancho Cucamonga, Ontario, Upland, Corona, Chino Hills and Redlands. For over 30 years Dr. Hardesty and the Staff of Imagine Plastic Surgery have provided comprehensive Cosmetic Plastic Surgery services and procedures to Riverside and San Bernardino counties of the Inland Empire and the communities of Rancho Cucamonga, Ontario, Upland, Corona, Chino Hills and Redlands.