Breast Lift with Implants or without Implants? The Pros and Cons

Breast Lift with Implants or without Implants? The Pros and Cons

We have some absolute certainties in life, and one of them is the passage of time. Wasting time is a real shame, as it should always be optimized as much as possible. This is especially true because, as time passes, we change, and our bodies change, and not necessarily for the better. One part of the female body that undergoes multiple changes throughout life is undoubtedly the breasts. Their tendency is to sag and appear less attractive. As we will see shortly, there is a way to remedy this with a procedure called Mastopexy (breast lift), which can be performed with or without silicone implants.

What Drives towards Mastopexy?

The breasts are a crucial and meaningful part of the female body because:

  • They identify the woman as such.

  • They significantly influence her self-esteem, either elevating or diminishing it depending on the situation.

  • They play a key role in defining the degree of beauty, attractiveness, and femininity.

A sagging breast that loses its shape inevitably undermines the aspects just mentioned, leading to a common desire to remedy this through mastopexy. In reality, there are small daily habits that can help postpone or improve breast sagging.

Changes Leading to Mastopexy, with or without Implants

There are essentially two main mechanisms that alter breast shape over time:

  1. Loss of elasticity in various components of the breast over time, particularly the skin and the fascial-ligamentous system that supports it.

    • Abnormal stretching and mechanical stress on the aforementioned components.

    • At the heart of the first point is the inevitable aging process, which can only be slowed down with a healthy lifestyle and behaviors practiced consistently from a young age.

    • The second aspect relates to physiological changes in the breast that occur with pregnancy and breastfeeding, as well as with age.

    • Also, stress from significant weight fluctuations.

    • Or a naturally large or augmented breast with a prosthesis, which also contributes to increasing its weight.

When Mastopexy without Implants

Mastopexy without implants can be considered when the breast has the following characteristics:

  • Has a reasonable volume initially, around a C or D cup.

  • Exhibits skin relaxation and excess skin, making the breast appear empty and lowered compared to the inframammary fold.

When Mastopexy with Implants

Mastopexy with implants is advisable when:

  • The goal is to compact the breast without tone by removing excess skin.

  • The initial volume is so scant that the breast appears almost like an "empty bag," as some patients describe it.

  • In these cases, mastopexy without implants would yield an unpleasing result due to the lack of volume.

What Mastopexy Involves:

  • Mastopexy is indicated when there is an excess of skin in the breast.

  • The goal is to surgically remove the excess skin to achieve a more compact and lifted breast.

  • There is also a redistribution of breast glandular tissue, which is fixed to the pectoral muscle in a more suitable position.

  • Since the skin is surgically removed, there will be resulting scars around the areola and the lower part of the breast.

  • It is usually performed on an outpatient basis, either under general anesthesia or deep sedation with local-regional anesthesia.

Postoperative Care after Mastopexy, with or without Implants:

A small premise is necessary. The skin of a breast that needs mastopexy is, by definition, of poor quality (for the reasons listed above). Otherwise, the breast would not have sagged. Therefore, even if the excess is removed, the remaining skin retains the same characteristic of being poorly supportive. With this in mind:

  • The main rule is to regularly wear well-supportive bras, especially during the day and even more so during physical activity.

  • It is advisable to always wear a bra, perhaps a more comfortable one, even at night.

  • Continuous gravity stress on the breasts occurs even when lying down, pulling them laterally.

  • These recommendations are even more critical if you have undergone mastopexy with implants due to the additional burden of supporting the weight of the implants.

Mastopexy without Implants: Pros

  • The breast is lightened compared to its initial weight, albeit slightly. This benefits the duration of the result over the years.

  • Scars undergo less stress and are therefore better positioned.

  • Since there are no implants, there is no need to worry about their "maintenance".

Mastopexy without Implants: Con

  • The overall volume is slightly reduced.

  • The breast's consistency, once settled, is similar to its original consistency.

Mastopexy with Implants: Pros

  • Allows achieving a good aesthetic result even for those with a small breast initially.

  • The breast's consistency is improved due to the underlying implant, and it thus remains over time.

Mastopexy with Implants: Cons

  • The implant, by increasing the breast's weight, represents additional stress on skin that is no longer supportive (for the reasons explained). Potentially, this acts against the result's duration over the years.

  • It is necessary to monitor the implants over time.

  • The additional weight of the implants could generate more stress on the scar in the first months when the scar is still weak and more "stretchable."

Final Considerations:

  • If the request is to have a high, compact, and large-volume breast, I would find myself unable to meet the patient's expectations.

  • Having a clear understanding of the dynamics regulating breast position (see above) is essential.

  • In other words, the breast's position constantly battles its own weight. Wanting a large breast that also "stays up" is an unrealistic expectation.

If you find yourself feeling the need to improve your breasts and want more information, do not hesitate to contact me. We will find the best solution together.

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