Breast Lift San Francisco

The question of needing a breast lift comes up often during consultation for breast augmentation. Though the two procedures influence each other, in most cases breast augmentation alone cannot eliminate the need for a breast lift.

The determination is made at the time of consultation. After evaluating where we are starting from and determining where we would like to be, a brief exam is all that's needed. Experience helps make the determination, but at the risk of over simplifying, here is a quick trick that may provide some clarity.

Place your hand in the fold under the breast. The palm should face forwards. The tips of your fingers should be pointing to the middle of the collarbone and they should be at the junction of the breast and the chest wall. This is called the inframammary fold (literally the under the breast fold). Hint: It may be easier to check the left breast using the right hand.

Once the hand is in position, point your thumb at your fingertips. If the nipple is above the level of thumb tip then a lift is probably not needed. If the nipple is below the tip of the thumb then a lift is probably needed. If they are at the same level you are on the borderline.

Like every good rule there are exceptions. Sometimes a lift is used to change the shape of the breast even when the nipple is not low. Conversely, sometimes an implant is placed lower on the chest and a lift is not needed even when the nipple is low.

There are several ways to do a lift. My goal is always to do the smallest amount of surgery that can give us the best result. If there is a small amount of sagging, then a lesser lift with a smaller scar will usually suffice. If the nipple is pointing south, then a more involved lift is necessary, otherwise the nipple will be low, even with a breast implant.

Contrary to what some patients believe, when I do a breast lift I do not remove the nipple and the areola (the colored part around the nipple) and then replace it on the breast where it looks good. Except in the unusual circumstances, the nipples remain attached to the underlying breast tissue. The goal is to leave the nipple attached to its blood supply and nervous supply to try to maintain circulation and sensation. Too much information?

Do you need a breast lift? Clearly, it's elective surgery, but when considering breast enhancement a lift is always considered. It may be quickly discarded, but will it help? Only your plastic surgeon knows for sure.

By: Joseph Mele MD, FACS