Background: Sagging of the breasts is a common result from pregnancies and weight loss. The loss of breast volume withdraws the support of the overlying breast skin leading to collapse of the breast mound. The breast mound then falls over the fixed inframammary fold creating a sagging breast appearance.
The classification of breast sagging is well known and is based on the location of the nipple relative to the inframammary fold. The relevance of this classification is in how it directs how the sagging breast is best treated and what type of breast lift is used to get the nipple back up above the inframammary fold.
In Grade II breast ptosis where the nipple sits just below the fold, the best correction is that of a vertical breast lift. Known as the lollipop lift because of its scar pattern, It moves the nipple vertically upward leaving a vertical scar between the nipple’s new position and its former location. In some cases, surgeons may try and make the periareolar or donut lift work to avoid the vertical scar but the lifting effect will not be the same.
Case Study: This 35 year-old female had two children and lost much of her original breast volume. She wanted her breasts lifted and large breast implants placed at the same time.
Under general anesthesia, a vertical breast lift was performed raising the nipples 7 cms in the process. Silicone breast implants of 650cc high profile were after the lift was completed. The push of the large breast implants had its own lifting effect as well.
Her one year result shows a major change in breast shape and size. Her vertical breast lit scars were remarkably imperceptible. The areolas were wider and the nipples ‘flatter’ as often happens after breast lift with a large implant push behind it.
The vertical breast lift is a very effective tool in the management of the sagging breast. While many women fear the resultant scars, in the right patient even large implants placed at the same time do not cause excessive widening or prolonged redness of the scars.
Highlights:
1) Vertical breast lifts and implants is a common combination breast enhancement procedure when ptosis occurs after pregnancy.
2) Vertical breast lifts are useful when the degree of breast sagging is modest with the nipple at or just below the inframammary fold.
3) The size of the breast implant placed partially controls how much breast lifting effect can be achieved.
Dr. Barry Eppley
Indianapolis, Indiana