I can not tell you how many times patients ask if they can have a lift by just having breast augmentation surgery when they come into my New York City plastic surgery office. I think that there is a huge misconception “out there.” Breast sagging is usually defined by the tissue or nipple areola complex(NAC) resting below the normal breast fold. This hanging is what most women complain about. Commonly it is related to the position of the NAC on the breast mound itself and so when the NAC starts to head “south” women seek out surgery to remedy this and restore the appearance of a youthful breast. But, as mentioned, if the gland drops below the breast fold and the breast feels empty then women often seek a solution to this problem. Most of the time, not only does the breast deflate, but the skin stretches and loses its elasticity( or bounce back). Many women present thinking that if they fill up the envelope with an implant, the breast will rise up. In fact, while this may appear subtely to do so, it does not do it to any significant degree. If a woman needs a lift of the NAC or a lift of the gland, an implant will only add more volume. A formal breast lift operation will be necessary. This can be as limited as a circumareola lift which places an incison around the border of the areola. For more significant laxity and descent, a “lollipop” incision using a vertical breast lift approach can be performed. If the tissues have severe laxity and more significant descent, further incisions are probably necessary using a Wise pattern or an invertd “T” anchor type of incision. All of which can give excellent results!
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