Combined Breast Lift & Breast Enlargement (Breast Augmentation-Mastopexy)

Combined breast lift and breast enlargement (augmentation-mastopexy) is a surgical procedure designed to uplift, reshape, and tighten sagging or droopy breasts while at the same time enlarging them with implants. The excess and/or loose skin is removed with or without rearrangement of the breast tissue. The breast implants inserted at the same time as the breast lift procedure serve to restore both firmness & size and increase fullness of the upper poles of the breasts.

There are many ways of undertaking a combined breast lift and breast enlargment including peri-areolar (round block), v-shaped, vertical scar and T-scar. Professor Malata favours the vertical scar technique because of its' minimal scars, better coverage of the implant, more powerful elevation of the breast tissue and nipple. Sometimes a traditional anchor-shaped (T) scar technic is needed especially in patients who have lost a lot of weight. Rarely the scar is entirely limited to around the nipple-areola (round block mastopexy).

Augmentation-mastopexy is unpredictable as it attempts to control 2 variables at the same time. Sometimes it is better to stage the 2 surgeries (at least 3 – 6 months apart). Combination surgery involves compromises as the breast lift limits how big the breasts can be made to while the breast enlargement limits how high the lift and how well reshaped the breasts can be. The poor quality of soft tissues in patients seeking augmentation mastopexy also limits the breast implant size as the larger the implant the greater the postoperative stretch.

As in any cosmetic surgery, there are risks as well as benefits and the final results are not guaranteed. The chance of complications following augmentation-mastopexy depends on the exact type of operation needed and other factors such as your general health. Professor Malata will explain how the risks apply to you. Detailed postoperative instructions will be discussed during consultation and a procedure-specific handout given to you by Professor Malata.

Some risks of combined breast enlargement and breast lift:

 Frequent:

• Bruising & swelling

• Numbness of nipples & breast skin: common

• Delayed healing and T-junction wound breakdown: common but insignificant

• Altered nipple & skin sensation: usually temporary

• Long scars – largely unavoidable

• Interference with breast feeding – minimal

Infrequent:

• Bleeding and haematoma: uncommon

• Infection: rare but disastrous

• Residual asymmetry between the breasts

• “Bottoming out” (malposition of the nipples)

• Poor scars: lumpy - hypertrophic/ keloidal scars

• Nipple loss: extremely rare

• Fat necrosis

• Interference with breast feeding – mild

• Recurrence of the droopiness with weight changes, ageing, pregnancy, lactation.

Alternatives to combined breast augmentation and breast lift:

• Staged surgery: maximises the effect of each but requires 2 operations

• Breast augmentation alone: leads to large but saggy breasts

• Breast lift alone: leads to well shaped & uplifted but small breasts.

• no surgery: padded bras, push-up bras, loose clothes