Concomitant Augmentation Mammoplasty Plus Mastopexy
Patients often present with loss of upper fullness of their breasts, referred to as involutional upper pole atrophy as well as severe skin laxity or referred to as grade 3 ptosis. These patients do well with implants placed as well as a mastopexy or skin removal and raising of the nipple areolar complex at the same time. Some doctors will stage these operations, placing the implant and then performing a lift several months later. However, that has a pitfall requiring two surgeries, is more expensive and requires two general anesthetics. The majority of the patients that I see in consultation, I have found it completely safe to do a combined augmentation mammoplasty procedure with a silicone or saline implant placed behind the muscle with a breast lift, either a vertical or a complete inferior pedicle Wise-pattern anchor scar technique lift performed concomitantly.
The example here shows a patient with complete loss of upper pole fullness, severe ptosis, grade 3, the nipple is well greater than 3 cm below the fold and an implant has been placed under the muscle with a formal lift, removing skin both vertically and along the inframammary fold. Her postoperative photographs show a nice elevation of the nipple areolar complex.
This is a four-week photo. Notice there is still some pink around the areolas and the vertical scars. This, however, will soften with time. The position of the areolas shows nice lifting and the nipples are at a direct straight out position. It is safe to perform both implants and lifts at the same time as long as you find a qualified Board Certified Plastic and Reconstructive Surgeon who specializes in augmentation mammoplasty and mastopexy, understanding the anatomy and blood supply to the nipple to prevent any type of avascular episodes.