PROCEDURE GUIDE

Breast Augmentation:
When to add a Breast lift

Breast implants DO NOT lift breasts

While most of our breast augmentation patients need only implants, a significant portion of women we see will also benefit from combining it with a breast lift.

Some do not realize that they need a lift. Some believe implants alone will lift their breasts. Other do not wish to consider a breast lift because they do not want the scars of a lift. However, when a lift is needed, avoiding a it will lead to suboptimal results.

Because of a strong background in Breast Reconstruction after Breast Cancer, and one of the most extensive experiences in cosmetic breast surgery, Dr. Jugenburg is well equipped to determine whether or not you would benefit from adding a breast lift to your breast augmentation, and will make recommendations based on your assessment of you at the time of your consultation.

The above image is an example of a patient who requested a breast augmentation only and declined a breast lift. Her breasts were fuller, but not lifted.

Note that the implant added volume to her breasts but did not lift her nipples. Her nipples remained as low as they were before surgery, thus making her look good when wearing clothes but not when naked.

4 months after the breast augmentation she returned to get a breast lift done, to correct her breast shape.

Breast Sagging is More Common Than You Might Imagine.

A breast lift procedure doesn’t move your breasts up on your chest, it lifts the hanging breast tissue and reshapes it to sit above the breast fold. In the case of a breast augmentation, a breast lift is added when there is a danger that the breast tissue will be left hanging off the implant. In such situations, a breast lift or reshaping is meant to take the natural breast tissue and align it with the breast implant.

Remember, a breast implant does not go INTO a breast, it goes UNDER the breast. If you have breasts that seem to hang off your chest, they will then hang off the breast implants. The implants add volume and push your natural breast tissue forward. But they DO NOT lift the hanging breast tissue.

It is in these situations that Dr. Jugenburg would likely recommend that you consider a breast lift.

Do I need a breast lift?

In order to determine whether or not you will need a breast lift in addition to your breast augmentation, you will need to be seen at our clinic for an in-person assessment.

However, before you come and see us, you can do a small self- assessment to get an idea of what we might recommend.

Does it seem like most of your breast volume is below your nipple?

Does your nipple sit low on your breast?

Is the amount of skin from the breast fold to your nipple short/small?

Do you wish your nipples were sitting higher on your chest?

Do you feel deflated after significant weight loss (>20lb) or after pregnancy?

Do your breasts resemble any of the before pics seen on this page?

If you answered yes to any one of the above six questions, consider that you might benefit from a breast lift at the time of your pregnancy.

Surgical Improvement of Augmentation Mastopexy

Augmentation Mastopexy – breast augmentation combined with a breast lift – is a procedure that not only adds volume to your breasts, but also aligns the breast tissue and the breast implant. When standing upright, your breast tissue should be centered on, or very slightly below the center of the implant.

Typical patients requiring this procedure are women who used to have very large breasts and have lost the volume either following massive weight loss, or after pregnancy. While less common, it is possible for some women to have naturally sagging/deflated looking breasts even though they never lost volume from their breasts.

This procedure requires careful surgical planning before surgery, and flexibility to adjust the plan during surgery because it is never 100% possible to predict how the breast tissue will sit over the implant. Thus all patients are seen before the surgery where I makes the surgical markings for the breast augmentation and a breast lift. A typical procedure involves first placing an implant into a sub-muscular (under muscle) or sub-glandular (over muscle) space. I then sit the patient up during the surgery and adjust my breast lift plan to fit the now augmented breast. This allows for the best possible cosmetic outcome for these select group of patients. Some surgeons chose to do a breast augmentation first and then do a breast lift later. This approach, on the other hand, allows me to get everything done in one session. Quicker results. Lower cost (compared to having to separate surgeries).

During your Breast Augmentation consultation at the Toronto Cosmetic Surgery Institute, we will examine your existing breast anatomy and discuss with you the options that may be available to improve your breast shape. However, the intention will not be to give you a perfectly symmetrical and perky chest, but a beautiful breast enhancement that gives the impression of a more symmetrical lifted breasts.

What if I do not want a lift?

Some would rather have somewhat droopy breasts than get the scars of a breast lift. Although I am biased, if I feel the breast lift scars are a better look than droopy breasts, I will let you know. If you still decline to get a lift, we are able to proceed with your understanding that your breasts will not be lifted. This is not the end of the road, however. If after several months you decide that the sagging bothers you to a point that are willing to have the scars of a lift, you are able to come back to us and get a delayed breast lift performed.

Head on view of a patient who should have had an augmentation mastopexy but chose to do a breast augmentation only. The result is a fuller breast, but the nipple/areola continue to sit low relative to the breast mass and are not idea. She came back 4 months later to get a breast lift in order to reshape her breasts, position the nipple/areola over the implant instead of them hanging off the implant.

Side view of a patient who opted not to get a breast lift. You see the nipple continues to stay on the lower end of the breast and the volume fills up the upper area. A breast lift would have repositioned the nipple more centrally on the breast implant.