Breast sagging is a common concern of patients at Northwest Face & Body. Over time there will inevitably be a loss of support of tissues and the resultant droopiness of the breast tissue. There are a number of factors that will influence this including breast size, prior pregnancy, breastfeeding, hormonal changes, poor support over years, and hereditary factors. Luckily, breast lift surgery in Bellevue and Kirkland can address these changes.
The degree of breast ptosis (droopiness) is determined by the relationship of the nipple to the breast crease. In general, the “normal” position is about 2 cm above the fold with only a moderate amount of tissue fullness below this. Mild ptosis would be when the nipple is at fold level. Moderate is with the nipple 1-2 cm below the fold and severe would be beyond this with the nipple often pointing down.
The appearance is also significantly impacted by breast tissue that may add heaviness to the lower pole. This may create “pseudo-ptosis” or the appearance of droopiness even when the nipple position is normal. Often this will be associated with a loss of upper pole volume and may benefit from volume replenishment with augmentation.
It is also possible to correct for the size of the areola for those in whom it may be excessive.
Breast Lift Techniques
The choice of procedure is directly related to the degree of ptosis that exists as well as the breast volume and desired outcome.
If there is mild ptosis or pseudo ptosis and a smaller breast volume or in particular a loss of the upper pole fullness, breast augmentation alone may offer an ideal solution by simply re-expanding the skin envelope of the breast.
Mild ptosis where the nipple is less than 2cm from ideal may be corrected with a “crescent” lift technique. This technique involves removing a crescent moon-like portion of skin above the nipple to allow its repositioning. This can often result in a nice repositioning with minimal scarring.
For more moderate ptosis, the correction will require adding a vertical incision under the nipple to allow for movement without distortion of the structure. This also allows for tightening of the skin “brassier” to provide the needed lift and support. This procedure may be accompanied by augmentation to provide added volume resulting in added upper pole fullness. This corrects for the common loss of fullness and flattening that may occur. The incision is generally quite favorable in the majority of individuals and allows for the ideal repositioning of the nipple.
Anchor Incision Mastopexy (Inverted T incision)
For more significant ptosis and when there is a significant amount of excess breast tissue, an inverted T type of approach will be needed. This allows the removal and tightening of the excess lower pole breast tissue and skin as well as the repositioning of the nipple. The incision design places the lower part of the incision in the natural fold of the breast and is well hidden. We are then able to minimize any “bunching” or “dog-ear” problems with the skin. As with the other lift options, this may be combined with augmentation to restore or add volume.
Breast lift is an outpatient procedure almost always performed with general anesthesia at our Kirkland location in the Greater Bellevue area. The surgery time varies considerably depending on the specific problem but may take as much as several hours. You will be awake and quite alert within minutes of finishing the procedure and we will have you stay in the recovery room until we are satisfied you are ready to go home. This is generally 30 min to 1 hour following the surgery. Of course, you will need to have a driver and a responsible adult to be with you afterward.
A good option is for you and a companion to spend the night across from our Kirkland facility at the Woodmark Hotel. We would then see you for a check up the following morning.
There is usually minimal discomfort and many do not require much medication use. Although, there is inevitably some swelling and possible bruising. This tends to be fairly minor and resolves fairly quickly. Some degree of swelling does continue to resolve for a longer period of time. Therefore, there is ongoing refinement and reshaping that occurs for some months.
We ask you to wear the specialized support garment that we provide at essentially all times for the first 2-3 weeks. Subsequent to this we will advise you as to the best choice of a brassiere.
There may be some strips of tape over the incision lines and we will remove this after several days.
We will ask that initially some ointment be applied to the incision areas to assist in healing and in order to improve the long term scar appearance we will generally have you start using a special silicone sheet material to place over the incisions.
Who Is The Right Breast Lift Candidate?
The ideal candidate for a breast lift or reduction is one who is past childbearing options as pregnancy may result in recurrence of ptosis and other tissue changes. Of course, a younger individual with significant concerns may certainly consider the procedure even given future potential pregnancy but should be aware of the risk that recurrence of droopiness or other changes might well arise. Additionally, those who have undergone major weight loss may benefit from a breast lift.
A current smoker is not a candidate for breast surgery due to the very high complication rate particularly to the risk of tissue loss. Dr. Allegra will not consider the procedure for you if you actively smoke.
If you do not want any visible scar it is not possible to achieve significant improvement of the ptosis. However, if the degree of droopiness is modest we can review the option of augmentation alone that may reduce it.
No one has absolute symmetry in all areas of the body; this is particularly true of the breasts. It is best to think of them as fraternal, not identical twins. We make all efforts to achieve the best symmetry possible. We are generally able to restore the nipple position to close to ideal, but minor variations are normal and affected by many factors during healing.
Cleavage is dependent on several factors that are mostly due to basic anatomy. With a breast lift, it may be possible to improve the position of the nipple on a horizontal plane as well which could narrow wide spaced breasts and perhaps allow for better cleavage. Dr. Allegra can review the possibilities depending on your anatomy.
Overly large nipple size can be fairly easily addressed with a breast lift.
If there is an element of volume loss particularly in the upper pole then the addition of a breast implant at the time of the breast lift is often an ideal option.
The major risk of breast lift and reduction is related to the blood and nerve supply to the tissues. This procedure is performed gently with all attempts to avoid compromising the tissues. However, there is a risk of poor healing with possible tissue loss of skin areas that might require further corrective surgery. This is particularly true in smokers and we will not offer this procedure to you if you are smoking or haven’t stopped for at least 3 weeks.
Visible scars are unavoidable with the majority of breast lifts and will be highly dependent on your individual healing tendency. In most cases, the results are truly excellent but some individuals may be highly prone to widening or thickening of a scar that might then warrant further treatment. Pigmentation problems, particularly darkening of the incision are occasionally seen–particularly if you have a darker complexion, or are of Mediterranean or Asian descent. This generally will improve or resolve with minor treatment.
Some asymmetry as noted above is normal and unavoidable. However, more significant asymmetry rarely occurs requiring correction.
Infection is a rare but potentially serious complication that often requires further surgery and drainage. Dr. Allegra would remove the implant and later replace it.
Bleeding (hematoma) is also rare but might require another surgery for drainage.
Loss or decrease in nipple sensation may occur. Usually, this will return over time; however, a permanent loss is a rare possibility.
The Best Breast Lift In Bellevue And Kirkland
Dr. Ludwig Allegra is a plastic surgeon with over two decades of experience. He has served the Bellevue and Kirkland areas since 1983 and performed hundreds of cosmetic and plastic surgeries. An accomplished and double-board certified surgeon, Dr. Allegra is one of the best plastic surgeons in Bellevue.
Located just minutes from downtown Bellevue and Kirkland, Northwest Face & Body easily serves the Eastside and Greater Seattle area. Offering comprehensive plastic surgery and non-surgical procedures, Northwest Face and Body serves all of your cosmetic needs.