BREAST LIFTING WITHOUT A BREAST LIFT
Some patients present with significant involutional upper pole atrophy, even slight bottoming out versus grade 1 to 2 ptosis. These can sometimes be correctable without the use of a mastopexy or an inframammary tightening procedure if the pocket dissection is perfectly made. In the example below, the left breast showed significant increased skin laxity over the right side. I did not guarantee the patient that her breasts could be lifted without a mastopexy; however, I did instruct her that I would make as precise a pocket as possible, specifically not opening the lateral pocket beyond the lateral areolar border and not dissecting below the inframammary fold, which may allow some tightening of the external skin and overlying breast tissue.
Notice, her postoperative six-week results show nice tightening of bilateral breast with the nipple slightly higher on the left than It’s preoperative position. Precision pocket dissection requires excellent visualization. I go through the periareolar approach because it is easy to dissect the parasternal attachments of the pectoralis major muscle and release it precisely. Also, it is easy to not open too much tissue along the lateral breast pocket, staying media to the pectoralis minor and serratus anterior muscle and thereby not allowing for lateral displacement and inadequate cleavage. This is an excellent example of a breast lifting procedure with only an augmentation mammoplasty without a mastopexy. These results are not always obtainable and not always predictable. In any case, should the patient form skin laxity over time due to the weight of the implant, then a breast lift would certainly be warranted. At this time we were able to augment her, tighten up the skin externally without the use of any further scarring that would be required for a breast lift.