Here at Brisbane Plastic & Cosmetic Surgery we see hundreds of patients every month, from all walks of life including borderline breast mastopexy patients. In recent years we’ve seen more patients coming through our clinic that are older, or that have had children. This changing demographic has also impacted the number of combined procedures we perform each year. When we talk about “combined procedures” we’re referring to surgery such as breast lift mastopexy and augmentation mammoplasty. These procedures are often suggested to patients that are wanting breast implants but have excess breast skin.

In some cases, women are considered “borderline” mastopexy patients. This term basically refers to a patient that has slight laxity in their breasts. In this scenario, the patient could get a positive result with breast lift (mastopexy), but may also get a great result with just implants. The decision is ultimately up to the patient, and as you can imagine this is a difficult decision to make! This blog post aims to explain the basics of breast mastopexy surgery, help you figure out whether you would require a mastopexy.

What is a breast lift? 

A good place to start is to properly understand exactly what mastopexy surgery does. When a patient has breast ptosis, the mastopexy procedure serves the purpose of excising excess skin, and moving the nipple to a higher position. The below photo provides an indication of the incisions and process of lifting.

The most common patients that have breast mastopexy surgery are those that are genetically pre-disposed to breast laxity, have lost weight, had children, or are older. If you’re wondering whether you need a breast mastopexy, here’s what you can do.

Nipple positioning

Nipple positioning is a key factor you can look at to determine whether you need a mastopexy. Stand up in front of a mirror to examine your breasts. Can you see that your nipple sits below the fold of your breast? This might indication that you could possibly benefit from a breast mastopexy.

The Pencil Test : Do I need a breast lift?

In some cases, a patient’s nipple may not sit below the fold of the breast, but they may still have considerable breast droop in the lower pole. A common test that patients can do at home to assess whether they need a breast lift is the pencil test.  If you stand and place a pencil underneath the breast fold, and the drooping breast tissue holds this pencil in place, this is a strong indication that you will require a breast lift. 

Photo Assessment : Borderline Breast Lift Mastopexy

Here at Brisbane Plastic & Cosmetic Surgery we perform photo assessments for patients that are wanting to know which procedure is right for them prior to booking a consultation. The process is simple. Patients simply need to send an initial enquiry via this link to request a photo assessment. We will then provide detailed information about what photos we require, and will show your images to Dr. Richardson. Dr. Richardson reviews these images to provide your recommended treatment plan. We will send through the full quote for this procedure, as well as available dates. This is a great way to start your journey and find out whether a breast lift mastopexy and augmentation mammoplasty is right for you.

Borderline Breast Lift Mastopexy

In some cases, the need for a breast lift mastopexy is not so black and white, and Dr. Richardson may say that you are a “borderline mastopexy patient”. This means you could achieve your desired outcomes with mastopexy or with augmentation mammoplasty, and the decision is up to you. To better understand which decision is right for you, we need to consider the main factors that will play into your results:

The limitations of implants

As with any surgery, standalone breast augmentation mammoplasty has its limitations. A breast implant can help to fill out loose skin, but it cannot lift the breasts. If you have a low-sitting nipple, a breast implant is unable to correct its positioning. Likewise, if your breast tissue hangs below the inframammary fold, a breast implant can help to fill out the upper-pole. This can create a fuller breast, but cannot pull the breast tissue upwards. In fact, when we consider the long-term outlook for breast implants, the additional weight breast implants place on the lower pole can actually exacerbate laxity and worsen the positioning of the breasts over time. Understanding that an implant will not lift your breasts is the first step to making your decision. Ask yourself why you want the surgery. If it is to create a fuller-looking breast, a standalone breast augmentation mammoplasty might be good for you. If your goal is to elevate your breasts, you might want to consider a breast lift.

Two-Stage Procedure

One solution to the dilemma of being a “borderline breast mastopexy” patient is to prepare for a two-stage procedure. This refers to when a patient has a combined procedure in two separate surgeries. These surgeries are spaced a few months apart for optimal healing. The beauty of the two-stage procedure is that there’s no obligation to go ahead with the second stage! It also allows you the time to adjust to your results and assess whether a second procedure is needed for you to be happy with the aesthetic outcome. The two stage procedure for “borderline breast mastopexy” patients would involve a standard breast augmentation mammoplasty as the first stage, and a breast lift later down the track if required.

The financial decision

Of course, finances play a role in your decision. A breast lift mastopexy with augmentation mammoplasty is considerably more expensive than a standalone procedure. What you need to consider is whether you may need a revision mastopexy down the track. If this is the case, the price of two surgeries will set you back significantly more than one combined procedure. There are pros and cons to one stage vs. two stage surgeries, which you can read about via the blog post here. The best advice would be to acknowledge the significant financial outlay of any option, and think long-term.

Seek advice of past patients

It’s all well and good to know your options and understand the risks involved. However, the best thing you can do is talk to people who have been through the same thing! Learning from the advice of past patients is one of the most valuable tools you will be given here at Brisbane Plastic & Cosmetic Surgery. We created The Dr. Phil Society so that our patients could interact with each other in a transparent way at any time. It’s become an integral aspect of our patient experience. The society has helped countless women feel more secure in their decision and their results. Anyone is welcome to join the Dr. Phil Society, just click the link here. 

Final Thoughts

This blog post has given an overview of some of the things you should consider when planning your breast surgery. If your surgeon has thrown the ball in your court, it can be daunting. The first step is assessing your breasts, and understanding your main concerns and goals. Key points to consider are the limitations of breast implants, the opportunity for a two stage procedure, and the financial considerations attached to this. Seeking the advice of patients who have gone before you is an incredibly valuable tool that we provide through The Dr. Phil Society and we strongly encourage you to utilise it. 

If you have any questions regarding breast surgery or decision-making with regard to plastic surgery in Brisbane, contact Brisbane plastic surgeon Dr. Phil Richardson’s rooms today to find out more.