BREAST AUGMENTATION WITH BREAST LIFT IN BEVERLY HILLS
As women proceed in their aging process, breast lifts become a more prevalent surgery in our practice. The skin becomes more lax as time goes on and aging occurs both by gravitation as well as with weight fluctuation changes. Breast augmentations are often performed with breast lifting procedures in women in their 40s, 50s, and 60s. The influence of gravity over time will lead to laxity of skin which may lead to severe ptosis. When women develop grade 3 ptosis and the nipple areolar complex is well below the inframammary fold, this may require a mastopexy procedure.
Augmentation alone with severe ptosis usually does not lead to an acceptable or adequate result, as the nipple areolar complex is still below the inframammary fold and not at a position that leads patients to a happy final result. As a result, a formal mastopexy can be performed concurrently with placement of a saline or silicone implant behind the muscle, using the dual plane technique. A formal mastopexy usually requires a Wise-pattern or an anchor scar where an incision is made around the nipple areolar complex, vertically around the midline of the breast and along the entire inframammary fold. With grade 2 ptosis, where there is less of a drag of laxity and the nipple areolar complex is at the level of the inframammary fold, these patients may do well with simply a vertical mastopexy in which a lollipop skin is removed around the nipple areolar complex and along the vertical plane thereby preventing any scarring along the inframammary fold. With minimal ptosis, a periareolar crescent lift can be applied in which a crescent of skin is removed above the nipple areolar complex; however, this may lead to widespread scarring and often a very inadequate result.