One of the questions that people ask when they are considering a breast lift is, “Will they start to sag again?”. That question is hard to answer because every individual is different, but it really comes down to the patient’s skin quality and the weight of the remaining tissue. Unfortunately, we can’t stop the aging process, and as we age, our skin loses laxity and stretches. This will result in sagging. Also, lifestyle habits can play a role in your skin quality. Weight fluctuations, pregnancy and breast feeding, and even smoking can cause skin to become thin and weak.

There is always the possibility of “bottoming out”, which is when the skin and muscles that have already been stretched out once resulting in the need for surgery, stretch out again after the surgery. However, the chance of this occurring is very low, and doctors experienced in breast lift surgery report even lower numbers.

Illustration showing the female breast anatomy

If you’re considering a breast lift, there are some techniques we can use in the breast lift to ensure longer “perkiness”. A small implant can give the illusion of perkiness, because it creates more volume in the top portion of the breast. The implant is placed under the chest muscle to provide long term support, however just like a natural breast, the larger the implant the more it will drop in later years. A smaller implant, weighing less, will have less “pull” on the skin and muscle and sag at a slower rate.

Some patients don’t want an implant and opt for an internal support system. The use of a flexible, mesh-like support called GalaFlex is a newer technology, and is being used to extend the post op breast lift results. Galaflex is a synthetic material that’s placed over the breast tissue and eventually absorbed into the body. The material is four to five times stronger than breast tissue and helps to keep the shape of the breast longer. Essentially, it acts as an internal bra.

Another internal support system is called Refine. This technique is for women that have minimal sagging. Refine uses two barbed sutures that are placed vertically in each breast so they create an arch. They’re anchored in a small incision above the breast, on the chest. The bottom portion of the suture raise the tissue until the nipple is in the desired height. Refine raises the nipple and the breast tissue, allowing for more volume in the top portion of the breast, and acts as added support for the breast after the procedure. This technique involves no scarring, so it’s a desirable choice, but similar methods have been used for face lifts with problematic results. Pain and uneven results were seen using this technique, so many surgeons today haven’t adopted it.

Fat transfers have recently been reintroduced into the breast lift process. It was banned in the late 1980’s due to negative side effects, but as technology has improved in this process, the ban was lifted in 2009. Fat is transferred from one part of the body and injected into the breast, and while this transfer alone isn’t enough to lift the breast, used in conjunction with the traditional surgical lift, it produces impressive results. The fat is placed in the upper portion of the lifted breast for more fullness and better cleavage.

With all of the advancements in breast lift surgery, the traditional breast lift is still the one most commonly performed. Hundreds of thousands of women every year get the surgery and enjoy perkier, more youthful breasts for many years. Eventually nature will take its toll on every body and gravity will set in, but a breast lift can help prolong the inevitable.