So, the question is how do you know whether you need just implants, implants and a lift, or just a lift. And the biggest issue is where the breast is relative to the fold underneath and, more importantly, where the nipple is relative to the fold.
If your breast is kind of hanging off your chest and you put an implant in back here where your breast is supposed to be, it just pushes out and now your breast hangs off the implant and it looks awful. So you have to lift the breast tissue so that it’s in front of the implant. Now you’ve got augmentation along with good shape.
If you already have a lot of tissue, a lift may be all you need to do, but, the issue with the lift by itself is that, a lot of times, it does not fill the upper pole, or the upper half of the breast as well as putting a smaller implant behind it to give it some extra volume does.
The anatomy that is involved in this is basically where should the nipple be. And if you look at the fold underneath the breast and you look at where that fold comes out from under, draw a horizontal line over to the mid-axis of your breast, that’s about where your nipple’s supposed to sit. So, if you measure between that, and where your nipple is, if it’s more than about five centimeters then you’re gonna end up with what’s called an “anchor scar” or the “anchor pattern lift” as opposed to the “lollipop” or “short scar lift.” The anchor lift, at least in my practice, I won’t do with implants at the same time. You may find surgeons that do, I think the blood supply is disrupted too much and the anchor lift could take the risk of putting an implant in. If it’s less than five centimeters, than you can do the short scar or the lollipop lift which has a lot less skin disruption, a lot less blood supply issues, and you can put an implant in simultaneously.
So, those are the things that I measure, I look at, in my practice in deciding just implants, implant with a lift, or just a lift.