June 17, 2024


The Healthy Technicians

New Staple-First Technique Maximizes the Breast Lift and Minimizes the Scarring

Last year in the United States, approximately 60,000 women chose to have a Breast Lift (or Mastopexy), a surgery that raises and reshapes breasts that have sagged from pregnancy, significant weight change, or the natural process of aging. A number of these women, wanting more breast volume, had augmentation with saline or silicone gel implants at the same time.

Augmentation Mastopexy is a complex surgery that challenges even the most skilled and experienced plastic surgeon, who must deal with the opposing forces required to make breasts fuller (by stretching the skin with implants) yet firmer (by tightening the skin with a breast lift).

To do this surgery, plastic surgeons commonly draw a complex pattern on the breast, remove some of the excess skin, and then tailor tack these tissues together. They do the same on the other breast, and then trim excess skin multiple times to provide maximum tightening and make sure that the breasts were still symmetrical.

About six years ago, when I was performing an Augmentation Mastopexy, the proverbial light bulb went off: If a surgeon tightens and tailors the breasts first with surgical skin staples, perhaps he or she could identify the total amount of excess skin to be removed and previsualize the final breast shape and symmetry before making an incision. I found this to be true.

Over a five-year period, I used this technique on 45 patients. The findings were published in the Sept. 2009 issue of the American Journal of Cosmetic Surgery, in an article entitled “Augmentation Mastopexy for Moderately to Severely Ptotic Breasts: Previsualizing Breast Shape and Symmetry With the Innovative and Versatile Staple-First Technique.”

This new approach is especially useful for women with moderately to severely ptotic (droopy) breasts. No matter what women want size-wise, or how droopy or uneven they are, the surgeon can produce consistent and predictable results.

For me, the technique has taken the guesswork out how much excess skin needs to be removed. It allows the surgeon to get the maximum lift and create the best symmetry and shape in one simple step with the least amount of scarring. In addition, it allows the surgeon to adjust for any asymmetry of the breasts, which is common among women.

And because there is no longer the need to do multiple skin trimmings, the operative time is shorter, patients receive less anesthesia, and their recuperation is easier.

With the adage of measure twice, cut once, it is very comforting to preview the end result of an Augmentation Mastopexy before making an incision.