Which Breast Surgery Is Right for You?

ASK THE EXPERT Which Breast Surgery Is Right for You?

BY CHARLES A. MESSA, III, M.D., F.A.C.S.

According to the American Society for Aesthetic Plastic Surgery, breast augmentation is one of the most commonly performed cosmetic surgery operations in our country. Patients will often come to our office wanting their breasts to be fuller and are not certain which type of surgery is best for them. Is an implant necessary, or lift, or both?

The technique used to enhance a woman’s breast should be individualized based on each woman’s personal appearance goals and unique anatomy. A common misconception is that breast implants make a woman’s breast stay up longer and not sag. This is not true. A breast implant adds volume or size to the breast. An implant can increase breast width, projection, and firmness, but doesn’t prevent the breast from sagging with time, especially if a woman doesn’t wear a bra.

When a woman loses breast tissue volume or size as a result of weight loss, pregnancy, or through natural deficiency in breast development, then placing a breast implant beneath the glandular tissue or under the muscle (pectoralis) will enhance the appearance. When there is excess breast skin, such that the nipple and areolar position is now below the fold of the breast, then a breast lift or mastopexy is most likely necessary. This procedure involves removing the excess skin and tightening the remaining breast tissue to elevate or lift the nipple and areola and the breast itself. The type of mastopexy procedure utilized depends on the shape and the degree of sagging (or ptosis).

There are three main types of breast lifts depending on where the incisions are placed on the breast. Periareolar (Benelli, around the nipple only), circumvertical (lollipop, around the nipple and from the nipple to the fold), an inverted “T”, or anchor incision same as above with an additional incision along the inframammary crease or fold. All are safe and effective techniques for lifting the breast depending on the degree of sagging.

A breast augmentation and mastopexy can be safely performed at the same time, depending on the patient’s anatomy and individual history. An implant can improve the aesthetic appearance of the breasts when volume or size enhancement is necessary, in addition to skin tightening or lifting.

In general terms, if a patient is an A or small B cup bra with sagging breast tissue, a breast lift and implant would be beneficial if the patient desires an increase in breast size or projection. When a patient’s breasts are a full C or D cut, then the breast lift alone may be sufficient depending on her individual breast appearance goals.

As with facial rejuvenation and body contouring, there is no single breast enhancement procedure that is applicable to every patient. A thorough preoperative consultation and discussion of each woman’s individual appearance goals is essential to ensuring the proper surgery technique is performed.

Dr. Messa is board certified by both the American Board of Plastic Surgery and the American Board of Surgery, an active member of the American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and a Fellow of the American College of Surgeons. He is a recognized expert in cosmetic plastic surgery and has achieved Allergan’s Black Diamond Award as one of the top 1% of plastic surgery practices in the country by volume. Dr. Messa has also achieved Chairman status with Medicis and Mentor Corporation. This award honors distinguished leaders in cosmetic surgery for demonstrating expertise and excellence through a high volume of aesthetic product procedures. The certification is awarded to leaders in the field of medical aesthetics and demonstrates their commitment to innovation, excellence, and the highest level of patient care. To schedule your consultation with Dr. Messa, please call our office at (954) 659-7760.