Question: After nursing three children, my breasts are sagging and significantly smaller. I’ve been thinking about having a breast lift, but I’m concerned about ending up with really small breasts and also about the scars that result from the surgery. Do the scars fade eventually or will they always be visible?
Answer: It is very common for the breast size to diminish and the skin to sag after having children or losing significant weight. Each pregnancy can result in less breast tissue and more sagging (ptosis). A breast lift tightens the skin of the breast and raises the nipple to its appropriate position. When the skin is tightened around the breast, the breast tissue is compressed, thus resulting in a smaller cup size after surgery. In order to return to the original breast size and give more fullness, most patients elect to have breast implants inserted at the time of the lift. Any time that skin is tightened on the body, i.e.) breast lift (mastopexy), facelift, tummy tuck; scars will result. As a plastic surgeon, I try to place the scars in areas that are more easily concealed. The skin is sewn together utilizing specific techniques and a specialized suture material to facilitate optimal healing. Your body’s healing properties then take over, and the scar will vary in appearance from a very fine line to a more thickened scar; this will differ from one person to the next. Fortunately, there are medications and treatments (laser) that can greatly improve the appearance of thickened scars. There are a number of techniques used to perform a breast lift: the standard keyhole technique, the vertical technique (lollipop), and the periareolar technique (around the nipple). Your surgeon should be able to discuss the option most suitable for your needs. As always, it is important to find a board-certified surgeon with significant experience and training in these procedures.