Cosmetic Surgery Excellence

Breast Lift + Augmentation #2 – Realself

Q: I had a mastopexy with breast implants 6 months ago and now the skin has loosened. Do I Need Another Breast Lift?

I had a mastopexy with breast implants 6 months ago. Since they have settled it seems like a little more skin needs to be removed. The upper pole skin is loosened and some stretch marks that I had have now reappeared although not quite as before. I have a moderate profile implant and wonder should if I do a secondary mastopexy should I use a moderate plus profile to obtain more projection and ensure greater upper pole satisfaction as well as stave off another future mastopexy.

A: Mastopexy re-do? When it may help.

Mastopexy is done to excise excessive skin.  In most individuals their skin excess worsens after pregnancy due to the enlargement & deflation following the hormone related engorgement which affects the elasticity of the skin.  Some younger people have mastopexy to improve the appearance of the breast due to elongated breast or enlarged areolas.  In these individuals the elasticity of the breast iskin s not necessarily impaired.  The only way to determine if another mastopexy is necessary is to have an evaluation so that the skin elasticity and excess can be quantified.

In general, implants do not lift the breast and very rarely will a periarolar lift tighten the breast envelope adequately.  The vertical mastopexy also will tighten the envelope but does not reshape the breast in a way to keep the nipple up.  If one has undergone the standard “wise Patterned” breast lift, it is unusual to have much excess skin and the shape of the breast is round and attractive.    With this technique there can be “bottoming out” where the fullness of the  implant and breast tissue falls too low below the areola. This can be treated with excision of an ellipse under the breast rather than full redo mastopexy.

My recommendation is to be seen / provide photos so that proper evaluation can determine the best option to achieve the results you are looking for.  Beware that doctors who do not do the standard wise pattern lift will not have the confidence in the outcome and will believe the scars are too much but the patient’s who undergo this technique are uniformly happy as the breast are up where they want, the skin is taught, the areola is small and the breast is attractive- sunny side up, just like the cute breasts of a young woman.

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