Breast augmentation and breast lift surgery each address different concerns, and for many patients, one of the two delivers the results they’re looking for. However, there are times when a single procedure doesn’t completely address every concern. At our Chicago practice, Dr. Karol A. Gutowski may recommend combining breast augmentation with a breast lift for those who are experiencing sagging and loss of volume.
Breast augmentation is a surgical procedure that increases breast size using implants or, in some cases, fat transfer. During the procedure, Dr. Gutowski places an implant behind the breast tissue or chest muscle to create more volume and projection. Patients who are good candidates for augmentation by itself have good quality breast tissue but want more fullness.
A breast lift, also called mastopexy, reshapes and raises breast tissue that has begun to droop. This can happen after pregnancy, weight loss, aging or simply due to genetics. During the procedure, excess skin is removed, and the remaining tissue is tightened and repositioned higher on the chest wall. The nipple and areola are also elevated as part of the procedure. A lift doesn’t change breast size, so patients who are satisfied with their volume but want to correct sagging are usually the best fit for this procedure on its own.
This is one of the most frequent misunderstandings we see during consultations. While an implant can fill out the upper portion of the breast and make it look fuller, it doesn’t actually change where the breast tissue sits on your chest. If your tissue has stretched or dropped, placing an implant behind it can actually make the sagging more noticeable by adding weight to tissue that has already lost its ability to hold its shape. For patients with significant sagging, an implant alone is not the answer.
Some patients expect a lift to give them a fuller look. A lift removes excess skin and reshapes what’s already there, but it works with the volume you have. Some patients may even feel that their breast tissue is slightly smaller after a lift because the breast has been tightened and skin has been removed. If you’re hoping for a higher position and more fullness, a breast augmentation mastopexy may be a better fit than a lift by itself.
Age is only one factor that affects how breast tissue behaves. Genetics can also influence skin elasticity and breast shape, and some younger patients naturally have tissue that sits lower on the chest. Pregnancy and breastfeeding can also change breast position regardless of age. We work with many younger patients who benefit from a lift.
Having these procedures done at the same time means you only go through anesthesia and recovery once, which can be easier on your body and your schedule. It also allows Dr. Gutowski to plan the two procedures together so that the implant placement and the lift work with each other rather than being done in isolation.
A mastopexy implant procedure is performed under general anesthesia and takes two to four hours. Dr. Gutowski makes the incisions needed for the lift, removing excess skin and reshaping the breast tissue into a higher position. Once the tissue has been repositioned, the implant is placed either behind the breast tissue or beneath the chest muscle. The order and technique can vary from patient to patient based on factors like the degree of sagging and the amount of volume being added.
The type of incision used depends on how much lifting is needed. For mild sagging, a donut incision around the areola may be enough. Moderate sagging often calls for a lollipop incision, which goes around the areola and straight down to the breast crease. More significant sagging may require an anchor incision that adds a horizontal line along the crease. Incisions for implants are usually placed in the breast fold or under the areola.
The type of implant you choose matters even more when a lift is involved because the two procedures need to complement each other. A very large implant can put more weight on freshly tightened tissue, which may compromise the results of the lift. During your consultation, Dr. Gutowski will help you find a plan for breast augmentation with lift that considers size and tissue quality. You’ll discuss implant type, profile and volume so that the final result looks proportional and holds its shape well after healing.
The first week after surgery is the most uncomfortable, with swelling and soreness that can be managed with prescribed medication and rest. You’ll wear a supportive surgical bra during the initial healing phase to help your tissue settle into its new position. Most patients return to desk work within one to two weeks and resume exercise and heavy lifting after at least six weeks. Because you’re healing from a breast augmentation and breast lift at the same time, swelling may take a bit longer to fully resolve.
A breast lift and augmentation can address multiple concerns in a single surgery, saving you time in recovery while giving Dr. Gutowski the control to improve volume and position. Dr. Karol A. Gutowski is a board-certified plastic surgeon serving patients throughout the greater Chicagoland area. If you’re considering this procedure and want to find out whether it’s right for you, fill out our online form or call us at 847-906-1527 to schedule a consultation.
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