Lifting Without a Lift
Some patients may present with grade 1 or 2 ptosis, which may be lifted internally by maintaining a pocket of perfect dissection. When pockets are made overly enlarged such as lateral dissection, implants will often go lateral to the side and may have poor cleavage final results as well as increasing skin laxity and sagging.
The example shows a patient who has had significant skin laxity, left greater than the right, by making a very conservative pocket bilaterally, especially on the left and not dissection lateral to the lateral nipple areolar complex. High profile silicone implants under the muscle are able to lead to a nice tightening of the breast without a breast lift. On looking a her preop photo, I was not convinced with the patient that I would be able to achieve as much tightening as we did; however, by maintaining a conservative pocket dissection, not opening the lateral breast as seen by the hatch marks, the implant was able to take up nicely the entire space leading to a nice tightening result as well as the left nipple areolar complex was then elevated slightly with greater symmetry to the right than preoperatively. In other words, specific precision pocket dissection on patients with skin laxity, may help to tighten the breast from the inside out. The final results are not always guaranteed though.