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The
natural shape of the breast
gradually changes with
time. Some women become
dissatisfied with the
shape of their breasts
due to droop and wish
to restore or even improve
upon their youthful shape.
To understand breast lift
surgery, the development
and anatomy of the breast
must be understood. Surgery
has very definite limits
and only turns back the
clock rather than stopping
it.
Anatomy
The breast is a skin gland,
related closely to sweat
glands, but specialized
to the production of milk.
It develops at puberty,
from the small gland button
which exists under the
nipple at birth. As the
gland grows, the surrounding
fat grows, and the overlying
skin expands. Initially,
this gives a cone shaped
breast with the nipple
at the peak, but very
quickly, the skin continues
to expand under the weight
of the gland and a relatively
tear-drop shape develops.
With pregnancy and nursing,
further changes occur.
The gland enlarges rapidly,
putting (sometimes painful)
stretch on the skin and
underlying tissues; often
this is great enough and
rapid enough to cause
damage to the elastic
fibres of the skin (causing
stretch marks). Later,
the gland shrinks to its
original size or may be
significantly smaller,
leaving an expanded skin
covering.
We think of the breast
as a gland which is supported
by the brassiere-like
overlying skin. As the
skin is expanded, or the
gland shrinks, or both
occur, the gland drops
to the bottom of the bra
(skin envelope).
The breast is only loosely
attached to the underlying
chest (pectoral ) muscle,
and exercises to tighten
the breast have little
or no benefit. This is
disappointing to patients,
and often they come in
having tried everything
prior to a surgical consultation.
Droop
vs. Loss of Volume
Generally, the degree
of drooping is described
by how far the breast
and the nipple/ areola
have dropped below the
level of the fold under
the breast.
Some patients feel they
have developed drooping
but the nipple and areola
are still above the level
of the fold. In this type
of case, the cause is
generally loss of breast
volume alone and placement
of an implant is the usual
recommended treatment. |
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| Pre-op
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Post-op |
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| Post
Partum Atrophy (not true
droop) treated by Augmentation
(implants) only. |
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| In
most cases when the patient
complains of drooping,
the nipple and areola
have descended below the
level of the fold, and
the degree of droop is
described by the plastic
surgeon in terms of the
distance from the level
of the fold to the level
of the nipple. Mild droop
is within one centimetre
of the fold, moderate
from one to two centimeters
and more severe drooping
is when the nipple/ areola
is three centimeters or
more below the level of
the fold. For these patients,
it is necessary to re-shape
the breast by lifting
the position of the nipple
and areola, and, if possible,
tightening the lower breast
skin and breast gland. |
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| Post-op |
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| 44
years old, Breast Lift
with Small Reduction |
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| In
addition to true droop,
there may also be loss
of volume, so an augmentation
and a lift may be combined
to give better position
with increased fullness. |
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| Pre-op |
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| Post-op |
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| 42
years old, Droop &
Loss of Volume Treated
by Lift & Augmentation |
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Most
surgeons agree it is near
impossible to give fullness
to the upper breast with
a lift alone, and women
who are looking for high,
tight, teenage-looking
breasts, are certain to
be disappointed regardless
what it done surgically.
Conclusion
Breast lift surgery may
be done with minimal risk
to the integrity of the
breast gland, and with
very satisfying results.
The major drawback is
the incisions needed,
but most of the time,
breast lift scars fade
very well in time. Recent
improvements in technique
have also reduced the
necessary scars, while
producing better appearing
breasts. |
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Deciding whether a Breast Lift is right for you starts with a personal consultation with Dr. Gelfant.
You are invited to contact us at our Vancouver offices to arrange a meeting.
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