Breast Lift

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• QWhat is the average cost for a 'lift'?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  In general, breast lift procedure will vary depending upon patient's needs. Depending upon the laxity of skin on the breasts which depends upon the position of the nipple-areolar complex to the inframammary fold, a specific type of lift may be required.
  
  In general, there are three types of lifts. One includes removing a small amount of skin above the areola called the periareolar crescent lift; the second is a vertical mastopexy where skin is removed around the areola and down the middle of the breast, also called a lollipop lift; and finally a formal mastopexy, aka, anchor scar where skin is removed circumferentially around the areola, along the middle of the breast, and along the inframammary fold is for more severe cases where the nipple-areolar complex is greater than 3 cm below the fold. Obviously, the more skin and the longer duration of time required for the operation, the more expensive the surgery will be. 
  
  In general, vertical lifts and formal mastopexies require general anesthesia in the operating room and, thereby, costs will be increased as well. A formal breast lift without an implant can range variably anywhere between $7000 and $15,000 for surgeon's costs depending upon the amount of time in the operating room and anesthesia costs. If implants are placed concurrently, this obviously can increase the cost significantly.

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• QHow do a breast lift and breast reduction differ?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  A breast lift and a breast reduction differ by the amount of tissue removed. Both have similar incisions such as an anchor scar (wise patten technique). With a breast lift or mastopexy, only skin is removed or de-epithelialized. Breast reduction surgery is a functional operation to remove breast tissue (glandular and fatty), to alleviate symptoms including back pain, neck strain, grooving of the bra along the shoulders, and rashes underneath the breasts.

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• QCan a breast lift be performed with an implant?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  A breast implant may certainly be performed concurrently with a breast lift. In fact, each week I place implants behind the muscle and lift women's breasts that are lax or have grade 3 ptosis (nipple is greater than 3 cm below the inframammary fold). The silicone or saline implant will provide volume, while the mastopexy or lift will remove skin in both vertical and transverse dimensions and tighten up the breast.
• QWhat is a crescent lift?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  A crescent lift is a breast lift that removes skin only from above the areola. Skin in a crescent shape is excised from the 10 o'clock position to the 2 o'clock position and the areola is superiorly advanced. This lift only affords a small lifting advancement. It is not useful for moderate to severe skin laxity. Complications include widespread scarring and dehiscence due to increased tension. 
• QWhat is a mastopexy?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  A mastopexy is simply a "breast-lift." The three main types of mastopexies are: 1) periareolar lift or crescent lift 2) Vertical mastopexy or lolli-pop lift 3) Formal mastopexy also known as an "anchor scar." The function of the mastopexy is to elevate the nipple-areolar complex and tighten the breast. The type of lift depends on the extent of breast ptosis. Grade1- nipple at the inframammary fold (periareolar lift) Grade2- nipple 1-2cm below the inframammary fold (vertical lift) Grade3- nipple is greater than 3cm below the fold (formal lift-anchor scar).
• QWhen a "lift" is done, is it necessary to have implants?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  When performing a mastopexy, it is not necessary to concurrently place a saline or silicone implant. This depends upon the amount of breast volume and tissue that the patient has naturally, it also depends upon the patient's desire for increased upper pole fullness especially with breasts that have lost their fullness from breast feeding and/or weight fluctuation. Patients who have significant skin laxity with minimal upper pole fullness, often referred to as involutional atrophy, do well with small silicone implant placed behind the muscle and a formal breast lift in an anchor-like scar pattern performed at the same time.

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• QWho is a candidate for a breast lift?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  Candidates for breast lifts usually include women who have a severe amount of sagginess to their breasts. This usually will include those individuals whose nipples are located below the inframammary fold. The inframammary fold is the crease under the breast and is the demarcation line when the doctor determines the degree of sagginess, (referred to as ptosis in Latin). Where the nipple lies in relation to the inframammary fold gives us the degree of ptosis. Very severe ptosis, with the position of the nipple well below the fold, indicates a need for a breast lift in which skin is removed both underneath the areola and along the fold.
• QWhat is a periareolar breast lift?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  A type of breast lift that is available is the periareolar or crescent lift, where a small amount of skin is removed from above the areola and the nipple complex is moved up. This is useful only in very, very mild cases of breast ptosis or sagginess. Often, this is combined with a breast implant placed under the muscle.
  
  Unfortunately, the results from this procedure are not very good. It does not address a truly severe amount of skin laxity. Some patients try this procedure in order to avoid a full breast lift, but they end up returning and having a total breast lift performed.
• QWhat is a vertical breast lift?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  A vertical breast lift involves removing skin in a donut fashion around the areola and lifting it below the areola in a vertical plane up and down. This will often allow for a nice tightening of a breast with moderate skin laxity. Often an implant is placed behind the muscle if the patient doesn’t have enough breast tissue and/or volume.
• QWhat is a full breast lift?

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  A Dr. Stuart A. Linder, MD , Plastic Surgery, answered

  A full breast lift or formal mastopexy usually addresses the most severe form of ptosis, grade III, where there is a great deal of skin laxity involved. To correct this problem, we use the Wise-pattern or anchor-scar lift. This is usually going to produce the most beautifully shaped breast because it is really addressing all the problems of a sagging breast. These include too much skin below the areola in a vertical plane (up and down), as well as excess skin along the fold. I perform this procedure most of the time for severe skin laxity/looseness. When combined with implants in patients with loss of breast volume, especially after breast-feeding, this technique leads to beautifully shaped breasts.