If a breast sags too much, this cannot be corrected by inserting an implant. The only solution is to remove the excess skin.
This restores the breast to a pleasing shape.
The scar is usually around the nipple, vertically below the nipple and in the crease underneath the breast. If there is a limited degree of sagging, a scar in the crease can sometimes be avoided.
Contrary to what many people think, the areola does not need to be released from the breast tissue. The milk ducts and the majority of the blood vessels and nerves will therefore remain intact. Sensation in the nipple is therefore always preserved.
As always, the scars remain red for a few months and then gradually become paler. The small scar around the areola often heals very well and can subsequently be coloured using permanent make-up so that it is not noticeable at all. The vertical scar fades over the years. The horizontal scar is largely hidden below the breast.
It is important to note, however, that some patients (about 10%) have a tendency to form hypertrophic scar tissue (also called "proud flesh") in that area. If this happens, the scar does not remain flat but tends to grow larger, remains red for longer and can sometimes cause an unpleasant prickling sensation. Fortunately there are many different treatment options but these have to be used long term, as long as the scar is red.
Sometimes a breast lift is combined with a breast enlargement. If there is not enough of the patient's own breast tissue to create a pleasing shape, it is better to insert an implant.
The durability of the result will vary from one patient to another. For some women the skin is so elastic that the skin of the lower breast will stretch again over the years. This causes the breast tissue to sag downwards and the upper breast is less well filled. This phenomenon is known as "bottoming out". It is impossible to predict who will be affected by bottoming out and to what extent. It is now possible to fit a mesh under the skin, like an internal bra, to reduce the degree of bottoming out to a minimum. This mesh is marketed under the name Breform. However, it can only be used in non-smokers who no longer can or wish to become pregnant, and who are satisfied with a B-cup or C-cup.