Breasts Reshaped

Want your breasts a bit more perky or to tweak their appearance some?

Breasts can be lifted non-invasively as well as with surgical mastopexy. Do you just want some lift, or are you looking for more cleavage with a full mastopexy or augmentation mastopexy? Unusual shapes as well as nipple positions can all be addressed. See below to learn more.

Treat yourself to the best by exploring your options at Pulsar Health in West Palm Beach, FL - just book a consultation.

Over time breasts can "fall", especially fuller ones. Some people simply develop breasts that aren't aesthetically pleasing to them, such as droopy breasts (called "ptotic breasts") or a defined breast abnormality like "tubular breasts". The breasts can also have shape issues following breast surgeries such as lumpectomy, segmentectomy or prior breast augmentation. Breast tissue descending while the implants stay fixed causes an unusual looking "snoop dog deformity", also known as a "waterfall deformity", which will need a breast lifting procedure (mastopexy) with or without replacement of the implants (augmentation mastopexy) to correct.

For breasts that are simply "sagging", a breast lift, called a mastopexy, can correct their position on the chest wall. Please see the website section called "Breast Resizing: Going Bigger" to understand more about the anatomy if you are interested. We have some questions and answers below to help you learn more, but feel free to book a consultation if you have further questions.

Q: Does a breast lift always have to involve surgery?

A: A breast can be lifted non-surgically, but usually to a lesser extent than a surgical mastopexy. There are non-invasive breast lift options which are useful for early fall of the breasts to avoid surgery (and the necessary scars in surgery) if done early and often enough:

• Radiofrequency Microneedling with the Virtue DEEP device to treat the upper breast area. This is designed to tighten skin, like elsewhere in the body, so for relatively early / minor breast sagging, this is a great consideration with minimal downtime. It improves the quality of skin tissue including strength and elasticity.
• Platelet-rich plasma "bio-filler" breast lifting is also non-invasive and best where only a small lift with some added volume is wanted, as well as improvement in the quality of the breast skin. It is typically repeated and can be done within an hour with virtually no down time or scars, but it doesn't have the higher lift of the more invasive procedures or correct excessive skin.
• Threads can be used to lift the breasts but be careful with these as they can cause distortion of the breast tissue, so at Pulsar Health we recommend not going through the breast tissue itself, but staying on the surface under the skin. There is more swelling with these, and the Thread lifting effects are much better on relatively small breasts. 
• Renuvion J-plasma has a tightening effect that can be done at the same time as an awake breast augmentation or liposuction. It is usually done "awake" but of course can be used with general anesthesia. It can help contracture of tissues just under the skin to gently lift, using only 3 incisions of a few millimeters each. It is not as effective at lifting as a mastopexy but there are a lot less scars.

Q: Are there different types of surgical breast lifts?

A: They come in two main flavors: skin-only mastopexy and full mastopexy. We can just adjust the shape or position of the nipple-areolar complex (NAC) in a mini version of the skin-only mastopexy. Mastopexies can be combined with size adjustments. There may be combination procedures with breast implants involved where the implants need to be replaced, moved, or removed, which is called an augmentation mastopexy or explantation with mastopexy. For more information on augmentations, please see the section on Breast Resizing: Going Bigger, and for more information on explantations, please review the section on Breast Resizing: Going Smaller. When removing breast implants, often a mastopexy is very helpful in making the breasts look pretty again as the skin and breast tissue have been stretched out over time. 

Q: What is a full mastopexy versus a skin-only mastopexy?

A: A skin-only mastopexy removes excess skin, or moves the nipple-areolar complex. This is easily done awake if that is all we are doing. A full mastopexy involves moving breast tissue around as well as skin reduction. It has the same incisions as the skin only mastopexy, but moving the breast tissue can give you a longer lasting result as all the weight isn't on the skin, and implant-type looks can be achieved if you have enough breast tissue. Nipple sensation can be affected in a full mastopexy. There will be some drop in cleavage over time as the mastopexy "settles" in the first few months. We account for the settling by making the lower portion of the mastopexy a little too tight at the beginning, so that it settles to the right length after a few months. Tightening the skin can give you a more voluptuous result, but it can also have more difficulty healing, so we aim to find a happy balance between shape and scars.

Q: What are the scars in a breast lift (mastopexy)?

A: A mastopexy needs a vertical scar down the front of the breast OR a scar around the nipple areolar complex (NAC). A scar around the NAC can flatten the breast profile, whilst a vertical scar can create a more conical breast shape. Typically, there is significant ptosis (fall) of the breast, so three scars are needed like in a breast reduction: the vertical scar from the NAC to the where the breast meets the chest wall (infra-mammary fold or IMF), the scar around the NAC and a scar in the IMF. The length of the scar in the IMF depends on how much lifting is needed to get a great result. Scars tend to be red as they heal for a few months and then fade to a skin-colored line. At Pulsar Health, we watch over your healing phase to help you get the best possible results.

Q: Can you redo a mastopexy, such as if my nipples aren't in the right place?

A: At Pulsar Health, we do perform revision surgeries when things haven't "gone right" elsewhere. It is helpful to have the prior procedure operative records as that can help us protect the blood flow to the nipple areolar complex (NAC) in a revision surgery. We can adjust the position of the NAC without making other scars except the ones around the NAC for up to a couple of centimeters (less than an inch), but bigger movements will require a more complicated mastopexy.

Q: What if breasts have a tight area, or are an ususual shape?

A: Sometimes, there are areas of the breast that are "constricted" or too tight, as occurs in tuberous breasts. This requires more complex surgery where the constricted bands are released. Depending on the degree of tightness, sometimes even expanders may need to be used to stretch out the skin for a more natural breast teardrop aesthetic. Check out the Breast Reconstruction and Breast Resizing: Going Bigger website sections for more information. More than one surgery may be needed to give you the beautiful breasts you want.

Q: Can I vape before breast surgery?

A: All nicotine exposure including smoking and vaping must be stopped for three months before and two months after surgery because there is too much risk to having issues with healing of the scars and the blood flow to the nipple areolar complex. Before surgery, we do ask that you obtain a screening mammogram or breast ultrasound so that we can be sure your breasts are okay to work on. Labs may be requested. 

Q: What surgeries can I do "awake" without having to go under general anesthesia?

A: Skin-only mastopexy or moving the NAC that can be done "awake", and depending on the individual, sometimes a full mastopexy. An augmentation mastopexy is better under general anesthesia as there may be "tightening of the capsule" or other work needed, and a mastopexy with breast explantation that removes all the capsule should be done under general anesthesia for subpectoral implants.