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Breast Lift

Age, pregnancies, lactation, hormonal factors cause the breast tissue to become fatty, i.e., brittle or friable, and loose volume while the skin looses its elasticity. The consequence is stretching and sagging of the breast, which can be corrected by a breast lift.

This pamphlet is written to clarify concepts about the breast lift. Two main questions that all women ask are about size and scars.

"Will the lift make my breast smaller?" No. By definition the lift repositions and reshapes the breast. Thus, the breasts will go back where it should be and regain a nicer shape. The lift is not a reduction. To the contrary, when the breast is repositioned and reshaped, it is no longer hanging down: it gives the impression to look larger.

The first and foremost question pertains to the scars. It covers over 90 years of surgical evolution. In 1910, Girard, a French surgeon published the first technique. Multiple techniques were devised since then. Today the scars remain the patients' major concern.

Removing the excess of skin to reposition and reshape the gland is the oldest technique and can still be used. This technique follows 3 patterns:

* The anchor pattern; the most common one used in the United States. Reliable and not that difficult technically, it is a good procedure. The major drawback is the extensive scar.
* The lollipop pattern, rather new in the United States, has the advantage to leave less of a scar than the anchor pattern. The technique was created in the late 1950's by another French surgeon, Claude Lassus.
* In 1987, Dr Louis Benelli in Paris designed the doughnut pattern leaving the scar only around the areola. This last technique is more difficult but it eliminates any scar on the breast itself.

All of these techniques involving the skin only can obtain a good lift only on breasts that were small with a good elastic skin. However, these 2 conditions are lacking in most saggy breasts, which gave poor breast tissue and skin. Stretching and sagging will usually recur.

The limitations of the skin lift led to another generation of lift, achieving durable results in virtually all saggy breasts.

This new generation of breast lift is based no longer on the skin but on the gland.

They allow a good durable lift in all kinds of saggy breasts, because the breast tissue is tailored and reattached to the chest wall. We don't just rely on the skin anymore. Everything is done on the gland while the skin covers the gland without supporting it.

Thereby, the result is much more durable and predictable though with time if the quality of the breast tissue is poor some sagging will recur but usually much less than the skin technique.

That new concept had started already with Claude Lassus' lollipop pattern, using part of the gland to secure the whole breast on the chest wall.

In 1986, Serge Krupp, (Switzerland) devised another technique more versatile than the Lassus. These authors were not published in the English until Madeleine Lejour (Belgium), in 1994 published a book and video tapes in English, that popularized these procedures in the U.S.

In 1995, Dr. Benelli published 2 glandular techniques through his doughnut pattern. His results speak for themselves but his technique is difficult. After seeing him in meetings, reading his articles and watching his video tapes, I went to Paris to spend a week with him. I then started doing the "Benelli's". He is now well known in the U.S., though less than 15% of the U.S. surgeons use his technique. They don't feel comfortable with it and prefer the anchor pattern. In Europe and South America the "Benelli" procedures became the standard. By now, several surgeons have modified his original techniques.

In 1996, Sampaido Goes (Brazil) innovated an internal brassiere. Through a doughnut pattern he does a complete undermining of the skin and then places a nylon mesh around the breast. The mesh in turn secured to the chest wall. His results are excellent but it is very extensive surgery and the risk of infection with the mesh the major objection. For this reason, it has not gained popularity in the U.S. nor in Europe.

In 2001, Ruth Graf (Brazil) found another good technique which is quite reliable but implies a lollipop pattern versus a doughnut pattern. Some U.S. surgeons use it. All of these glandular lifts give good durable results and usually far superior to the skin lifts.

 

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