There are a lot of reasons why a woman’s breast appearance changes through the years – pregnancy, weight loss or gain, genetics and age can all play a role. Women often seek breast surgery to improve their overall look and create a more youthful appearance
Board certified plastic surgeon Dr. Charles Messa explains how to determine if a breast lift or a breast augmentation is the right choice, and why it’s important to manage your expectations up front.
Deciding What’s Right For You
When a patient is considering cosmetic breast surgery, it’s important to consider all the options, including a breast lift, a breast augmentation, or a combination of both. “Patients come in and they want their breasts enhanced, so it’s my job to find out what they are hoping to achieve,” says Messa.
Dr. Messa says it’s important to realize that every woman is different and unique, and so are her breasts. “I find out what they are hoping to achieve and do complete measurements of their breast tissue. I can look at the skin and the stretch of the breast tissue and the amount of breast tissue they have and where the nipple and areola is positioned in relation to that, then begin to determine if that person needs a breast lift or not.”
Messa says younger women can often get the results they want with breast implants alone because of the elasticity in their skin, but older women whose skin is too stretched may also require a breast lift. “Breast ptosis involves stretching of the breast tissue and that means that the nipple and areola is lower than the inframammary crease,” explains Messa. “Many times if it’s just a minor degree of asymmetry an implant alone will be enough to enhance volume and give a certain degree of breast lift.” Messa says if the nipples point downward, or fall more than two centimeters below the breast crease, a lift is the right choice to improve appearance.
What’s The End Game
Messa says the end result should be a natural looking breast – whether it’s achieved with a breast lift, a breast augmentation or both. He says the outcome will depend on many factors. “It depends upon the amount of extra skin they have and the vertical skin excess. It also depends on the degree of laxity of the tissue and tissue stretch, and also the resulting volume they want to achieve in terms of cleavage or upper pole fullness.”
Messa says subtle changes are best for achieving a youthful look, and that’s possible with good communication before the surgery. “With very good measurements of the base width of the breast and height of the breast and looking at the amount of laxity, I can come up with a goal that achieves their goals and hopefully gives them the most nature, symmetric look possible,” he explains.
Managing Expectations
In some situations, a woman may feel embarrassed or self-conscious about the way her breasts look, especially in tight-fitting clothing or in a swimsuit. That’s where Dr. Messa says a breast lift or breast augmentation can restore self-confidence. “We’ll talk about what’s possible in the consultation, but it is important to manage expectations in any cosmetic enhancement.” He says it is possible to rejuvenate sagging breasts that have lost volume, but it’s impossible to roll back the clock by decades.
“A patient can come in with very lax breast tissue from multiple pregnancies, weight fluctuations and even after surgery they are not going to have the breasts of young woman who has never had a child,” Messa details. “The look will be much more appealing after breast lifting and maybe implants, but the expectations are important.”
Messa says he’s also very aware of creating symmetrical breasts. “We focus on detail and focus on technique to make things as symmetric as they would like to achieve.”