Should I Have Mastopexy to Treat My Sagging Breasts?

Mastopexy, or more commonly known as breast lift, is usually the first one that comes to mind for those with breast ptosis or sagging.  However, you should bear in mind that the exact appearance of your chest determines if this procedure is the right one for you.

A board-certified plastic surgeon can help you determine the extent of the sagging and choose the surgical technique which can provide the most desirable result.

But take note that having a flaccid breast does not automatically qualify you for breast lift surgery.  To know if you can benefit from this procedure, first you should understand the three types of breast sag:

* Ptosis

This condition warrants a breast lift.  It is manifested by having nipples that fall within the breast crease (Grade I); nipples falling below the breast fold (Grade II); and nipples reaching below the crease and pointing downward.

The degree of the problem determines the type of breast lift technique is used.  But the rule of thumb is that the more sagging you have, the more extensive the incisions will be.

If your breasts are very large and/or your breast ptosis falls under the category of Grade III, you would likely need the anchor lift technique which places incision around the areola complex, within the breast crease, and vertically between the areola and crease.

But if your ptosis falls under the category of Grade I and/or if you have a small- to medium-sized breast, the incision within the breast crease can be removed, thereby leading to quicker recovery. 

If you have a small sagging breast that lack volume in the upper cleavage, you may benefit from breast augmentation performed at the same time of your breast lift surgery.  Take note that be combining these two procedures, your plastic surgeon will use fewer incisions, leading to lower risk of visible scarring.

* Empty Sac Syndrome

The condition happens when the breasts have lost their fullness and roundness, giving an impression of sagging.  But if you will look closely, the nipples have not yet reached the breast crease.

For empty sac syndrome, the best approach is breast augmentation surgery particularly with the use of round implants to create fullness.

* Pseudo-ptosis

This is almost the same with empty sac syndrome, although the difference is that the upper cleavage is the only area which lacks fullness and roundness.  For this reason, placing round breast implants can correct the flaccid appearance. 

Octavia Spencer Planning Her Plastic Surgery

After winning the Best Supporting Actress at the 84^th Annual Academy Awards, The Help star Octavia Spencer said that she is planning to undergo plastic surgery, particularly with a procedure called breast lift.  It is surprising that while many celebrities tend to deny going under the knife, she admitted her plans without batting an eyelash.

In an interview with Parade magazine, the 39-year-old actress said she wants breast lift surgery which she views as her first gift to herself.

“I want my boobs where they were when I was 17,” Spencer quipped.  

The star said her breast lift surgery would likely take place in November since she will be busy working out of the country to shoot a movie until early fall.  In this way, she said that she can enjoy a long vacation until January next year.

Meanwhile, breast lift surgery is the only permanent solution for women with a real case of breast ptosis or sagging.  This aesthetic problem is manifested by a nipple falling below the breast crease while the areola complex is pointing downward.

One of the most common reasons why breast ptosis happens is pregnancy.  As the body prepares itself from childbirth, the ligaments, tissue, and skin are stretched, sometimes to the point that they can no longer retract to their original position, thereby leading to the sagging and flaccid appearance. 

Contrary to popular belief, breastfeeding does not cause sagging.  In fact, several studies have suggested that pregnancy alone—even if a mother will breastfeed her baby or not—can cause the problem.  Meanwhile, the drooping appearance can be further aggravated by weight fluctuations.

Going back to Spencer, she may be a good candidate for breast lift as long as she is no longer considering getting pregnant.  But to further ensure that the result will be long lasting, it is important that she is near her ideal weight at the time of surgery.

(Being near the ideal weight means that a person should not be more than 25-30 lbs. heavier than her recommended weight.)

Some breast lift patients need implants to create fullness particularly in the upper poles, however, women with large a bust size like Spencer may forego the additional surgery. 

But the good thing about combining breast lift and breast implants is the fact that plastic surgeons use less and shorter incisions, thereby reducing the risk of visible scarring, and potentially shortening the recovery period.

Saline Breast Implants—Pros and Cons

Saline breast implants are filled with a sterile saltwater, for this reason, a leak will not result to serious health problems although patients will need revision breast augmentation to correct the deflated-looking bust.

Saline implants are not superior to silicone version, and vice versa.  Patients should realize that the most ideal option largely depends on their anatomical features (e.g., amount of breast tissue) and goals and expectations.

Meanwhile, these are the advantages of saline breast implants:

*  Shorter scar.  In the US, only saline implants filled at the time of surgery are available (currently there is no pre-filled saline implant).  Once the shell is inside the breast pocket, plastic surgeons inject this with a sterile saltwater before closing the incisions.

Because an empty shell can fit in a small incision, patients who will use saline implants should not be concerned with visible scars.

* Lower cost.  Saline implants cost less than the silicone version (around $900 to $1300 cheaper).  The difference in price is due to the reason that the cost of production for these implants is lower.

* No risk of silent leak.  In case of rupture, patients will immediately know it right away.  By contrast, women with silicone implants have to undergo regular MRI screening to detect silent leak.

* Slightly lower risk of capsular contracture.  This complication happens when the scar tissue surrounding the breast implants becomes too thick that it squeezes the devices.  Some studies suggest that women with saline implants are at lower risk of having this problem than patients with silicone version.  While the difference is just 1 percent per year, it can be as high as 10 percent after a decade of having the silicone implants.

On the other hand, saline implants have their own disadvantages such as:

* Less favorable cosmetic result.  Because saline implants are filled with only saltwater, women with little amount of breast tissue cannot achieve a natural result.  However, this is usually not a concern of patients with a moderate to significant amount of tissue and fat.

For patients with little breast tissue, silicone implants are the best option.

* Prone to sloshing

Unlike the silicone implants which are notable for simulating the natural “feel” of tissue, the saline version is prone to sloshing because it is only filled with water.  For this reason, some plastic surgeons intentionally overfill the shell to make the implants firmer.

* Natural deflation

One study has suggested that saline implants have a natural deflation rate of 1 percent per year due to evaporation and other factors.  By contrast, silicone implants maintain their for volume for years except in the event of rupture