Want breast implants? You may need a breast lift as well

by Courtney Caplin, MD, DMD
Cosmetic Surgery Columnist

We perform many breast surgeries on both cis and trans women, where I practice. Patients will commonly ask about augmenting their breasts with implants, widely known as a “boob job.” 

Many patients feel deflated after children or with age and want to regain volume, especially in their upper chest. However, if a female’s breasts have sagged too much, an implant alone may not achieve her goals.

During our complimentary consultation, we discuss what the patient’s goals are and then come up with a plan to achieve those results. As part of the consultation process, a brief exam is performed.

What is most important to evaluate is the nipple and areolar position compared to the bottom of the breast, along with the elasticity of the skin and gland present. If the nipple is even with or above the bottom of the breast, an implant alone is usually the answer.

Adding volume can give the illusion of a lift. However, if the nipple-areolar complex has drifted down past the bottom of the breast, a lift is usually necessary.

The implant should be centered behind the nipple, so if the nipple position is low, and only an implant is placed, one of three poor outcomes could happen.

One, the implant could be placed in the proper place for upper chest fullness, but the breast will appreciate like it is hanging off the implant like a snoopy dog nose.

Next, if the implant is placed behind the nipple, but the skin is not elastic enough and does not stretch, then you can see both the implant and then the breast on top of it. This outcome is commonly referred to as a double bubble.

Lastly, if the skin is elastic and the implant placed behind the nipple, the breast may look okay when viewed directly. However, when looking at the patient, the balance does not look right as they appear to have low, large breasts, and still no upper chest fullness.

When the decision made that a breast lift is needed, we educate the patient about how the nipple and areola are rotated up into the proper position. The nipple stays attached, but the hanging skin and gland are removed, and a new perky breast is created. An implant can then be placed centered behind the nipple and is the ideal position on the chest.

Every patient and every person's body is unique, so it is always our recommendation to schedule a consultation where your needs can be discussed. Both my partner and I are triple board-certified cosmetic surgeons and have performed hundreds of these procedures each year.

Our team at Cosmetic Surgery Affiliates in Oklahoma City is compassionate, educated, sincere, and excited to help you achieve your goals!

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Copyright The Gayly. 5/1/2020 @ 11:29 a.m. CST.