Which Breast Surgery is Right for You?
When you have done everything you can to change your body but your breasts just aren’t responding to anything you do or try, and you are unhappy with the way they look – how do you know which breast surgery is right for you? I can’t tell you how many times I have listened to patients tell me how saggy their breasts are, but when we actually get to measure them, they really aren’t saggy at all – clinically speaking that is. But we are our own worst critics and often see ourselves very differently than others do and most certainly how a surgeon will. In the Tebbetts world, you know when you need one vs the other because we MEASURE the breast and plan the operation by the numbers – no guess work here. So today, let’s look at how to determine which breast procedure is right for you.
Differences Between Breast Augmentation, Breast Reduction and Breast Lift
Breast Reduction, Mastopexy and Breast Augmentation are the three most common cosmetic breast procedures we do today. Breast Reduction and Mastopexy are basically the same operation – however, a breast reduction removed skin and tissue whereas a Mastopexy takes away skin only. A breast augmentation seeks to make a breast larger – that’s it – an implant will never lift a breast – it simply makes the breast you start with bigger.
A breast lift is needed on a breast like this:
A breast augmentation is needed on a breast like this:
And a breast that falls in between looks like this:
It is very important not to ask a surgery to do something it was never meant to do – like expecting and implant to lift a breast – let me show you a few things that may help you make sense of all this.
There are two basic things about your breast we can’t change – where the inframammary fold starts and how wide your breast is. Now with time, pregnancy, weight gain and loss, hormones etc – the breast envelope and mammary gland change – relative to those two anatomic structures we cannot change. Sometimes leaving us with something that looks more like this…….. Ideally we would like to see the nipple above the fold – right? That is what you do when you pick up all that extra stuff and settle it into your bra. Wouldn’t it be nice to have that position all the time even without a bra? So the distance from Nipple to fold under stretch is a very important deciding factor in which operation will be best for you. You can see how this distance would be shorter than this one right? An implant always has to go to the bottom of what we give it to go to and begin filling from the bottom up. So if the nipple to fold distance is greater than the limit set by High Five, an implant would simply make you a bigger, saggier version of what you are now.
So if the nipple to fold measurement tells us that you need a lift, how does he know how much to take? Or what will a mastopexy really do for you? The goal of a breast lift is simply to get the nipple above the fold – that’s it – – so that means if you have ever stood in front of the mirror and yanked your breast all the way up here – you are dreaming! No operation or implant will ever change the position of your breast on your torso. Now to get the nipple above the fold, we know skin will have to be removed, but sometimes tissue will need to go too – whatever it takes to get the nipple to it’s new position is what has to happen. Another measurement that is important in determining what you need, is how much stretch you have in the skin envelope. Every once in a while we will see a patient that is borderline or right at the cut-off of the nipple to fold measurement and could possibly have an implant but then when you factor in the amount of stretch and how much implant it would take to fill it – – it would be disastrous to try to fill that stretch skin with implants. When your surgeon uses a proven measurement system – like High Five – to plan your operation, it takes all the guess work out of the planning and execution of your surgery. And you can stop worrying about cup size because now you understand the numbers!
The incision for a Mastopexy or Breast Reduction may vary depending, once again on the measurements. But the most common incision looks like this – an anchor or upside down T. This is what it looks like closed, what it looks like open is something like this . The incision is certainly a trade off to this operation, but if you really need a lift, it is usually an acceptable trade off. Look at what a difference a lift alone made in this breast!
There are shorter incisions that can be used – like this or this but please be sure to discuss these carefully with your surgeon because choosing to use a shorter incision just to do it may backfire on you. Which incision should be used on you, should once again be determined by measurement. The other two tradeoffs or risks are – that you may lose sensation in the breast and nipple and may not be able to nurse another baby.
Breast reductions, sometimes, are still considered medically necessary and covered by insurance. Please discuss this with your surgeon to see if you qualify for help from your insurance company. Mastopexy and breast augmentation are obviously cosmetic and will not be covered by insurance.
So once again, it all comes back to the numbers. If you measure, then you know and can be confident in your decisions to change your body. I hope this information will help make it a little easier for you to understand which procedure is best for you.