Breast lift surgery is performed with the patient’s own tissues. Only the loose excess skin is removed by keeping intact the breast tissue. However, this removal process can be carried out based on a certain mold, in such a way as to form a cone-shaped, lifted breast. If there is excess breast tissue, the breast can be reduced as much as needed (breast reduction). If the volume of the breast tissue is not adequate, the breast lift procedure can be carried out in conjunction with breast augmentation using breast implants. However, surgical scars are likely to be more noticeable in such procedures, due to tension. As an alternative, breast augmentation with breast implants can be performed 6-12 months after breast lift.
The sagging of breasts is classified in various ways. The term sagging is usually refers to the condition in which the nipple is at the level of the inframammary fold line or below it. If it is at the inframammary fold line or close to it, the condition is classified as 1st (mild) degree sagging. In such a case, a half-moon shaped part can be removed from the skin on the areola, and then the areola can be positioned a little bit higher. If the nipple position lies 1-3 cm below the inframammary fold line, the case includes a 2nd grade (moderate) sagging. In such a case, a larger part is removed from area around the areola during breast lift operation, and then the circle is puckered and sewn to the areola that is smaller than it. In such cases, a scar will remain only around the areola; however, the skin around the areola will look puckered for a few months. This appearance disappears gradually within 1-to 2 years. The method called ‘vertical scar’ can be used if this is wanted to be avoided. In this method, the skin gap that has occurred above is closed by sliding the skin under the areola, and by causing a vertical scar (vertical short scar technique) that extends downward, instead of puckering and sewing the circle.
If the nipple position lies more than 3 cm below the inframammary fold line, there is a 3rd grade sagging. In such a case, verticle (keyhole) mastopexy technique is used, which remains a vertical inverted-T-shaped scar. In addition, a horizontal scar will remain under the breast. However, the superiority of this method is that it allows for forming a conic and round-shaped breast. In the vertical short scar technique, a slight pucker may remain under the breast. That pucker gradually disappears within 1-to 2 years. If the pucker does not fully disappear, it can be eliminated by removing a small horizontal ellipse-shaped skin part under local anesthesia. In another condition called pseudoptosis, the breast looks sagging although it is not actually sagging, due to the distance between the areola and the inframammary fold that is shorter than normal. The breast implant procedure can be carried out with small silicone breast implants, in order to solve the problem. Alternatively, the areola is positioned at a required higher level, with the vertical short scar technique. Silicone implant placement is more preferable because it leaves a very little scar.