Breast augmentation and breast lifts after child bearing

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Article provided by Patti Flint M.D.

Many women who see me in consultation tell me their breasts looked good until they had children. Breast feeding can also lead to undesirable changes. Certainly child-bearing and breast feeding are wonderful positive experiences, but it doesn't seem like you should be left with life-long undesirable changes in your breast because of them. Not to worry, there is a solution.
Cosmetic breast surgery following child bearing comes in different types. Some women only lose size, some maintain their size but develop drooping, and some suffer from both a loss of size and undesirable shape. Allowing a board certified plastic surgeon to hear about your goals of breast surgery and to perform an exam will insure you obtain the desired result from surgery.
Hormonal changes following completion of child-bearing result in shrinkage of the breast tissue. Most women notice the decrease in size and desire their pre-pregnancy breast size restored. Others who breast-fed enjoyed the extra size they had during breast feeding and desire to retain it long-term. In either case, a breast implant is a good option. The implants are inserted through a small incision underneath the breast in the crease. They are placed under the chest wall muscle so as not to interfere with mammograms, and so that they look and feel natural. The volume of the breast can be restored or increased depending on the patient's desire. The procedure is performed as an out-patient during a less than one hour general anesthesia. Soreness resolves in about a week and resumption of exercise and lifting is allowed at three weeks post-operatively. The breasts regain softness at about three months post-procedure.
In some women, the skin does not snap back after it has been stretched. As the breast tissue shrinks, the skin becomes too large for the decreased breast volume and the nipple and breast drop below the crease underneath the breast. This results in a deflated, droopy appearance. In this instance, an implant alone will not restore the pre-pregnancy shape of the breast, because the implant does not by itself result in the nipple and breast tissue assuming a higher position on the chest wall. The excess skin must be removed with a breast lift or mastopexy for the shape to be restored.
Breast lifts come in different varieties. Some are promoted to provide a shorter scar than a standard "anchor" scar. I have performed many short scar breast lifts, included both the "donut-lift" and the "lollipop lift." The first involves an incision around the areola only, and the second has that scar as well as an extension for the bottom of the areola to the middle of the crease beneath the breast. In very small breasted women who do not need much lift, either of these lifts can perform well, however, most of my patients want larger breasts and need to be lifted a fair distance. In that scenario, the short scar lifts do not hold up over time, and result in undesirable trade-offs, such as stretching of the areolae over time, or flattening of the front of the breast. I strongly prefer the gold standard "anchor" lift which involves the lollipop scar with a horizontal extension across the crease underneath the breast. With this lift, the areolae are permanently down-sized and the breast stays lifted over a long period.
It is common for an implant to be used at the time of a breast lift to improve long-term fullness in the upper area of the breast above the nipple. Without an implant, this area tends to lose its fullness over time. Even in women who want to remain the same size and just be lifted, an implant can be used and any unwanted increase in size can be removed by down-sizing the glandular tissue during the surgery.
These procedures are performed as an out-patient under a two-hour general anesthesia. The post-operative soreness is mild and similar to recovery from breast augmentation alone. A sports bra is recommended for three weeks, and exercise and lifting may be resumed after this period. Shape takes about three months to reach its final form.
There is really no reason to be unhappy about the size or shape of your breasts following child-bearing. In a brief out-patient procedure, you can regain what you lost, or improve it.

Patti Flint M.D. is a sponsor of Sonoran Living Live.