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Christopher K. Patronella, Md, Facs, Fics

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Christopher K. Patronella - MD, FACS, FICS

Solutions for Saggy Breasts: Breast Lift, Breast Augmentation or Both?

Posted June 11, 2015 in Breast Augmentation, Breast Lift

By Sherri Roberts

Pregnancy, breastfeeding, gravity, and weight loss are all factors that take their toll on a woman’s

Combined breast lift with breast augmentation

This 32-year-old patient of Dr. Patronella had a combined breast lift procedure and breast augmentation with saline implants to give her breasts a firmer, fuller look. Dr. Patronella filled the right implant to 400 cc and the left to 380 cc.

breasts, causing them to lose firmness and fullness over time. Breast lift and breast augmentation surgery can be wonderful solutions for these concerns, providing the breasts with a shapelier, uplifted contour. To ensure you receive the best results possible, it is important that you receive your evaluation from a board certified plastic surgeon who has the expertise to determine, recommend, and provide the procedure that will most effectively help you achieve the look you desire based upon your goals and the unique characteristics of your breasts, including the degree of sagging they exhibit. An improper recommendation in this area can lead to less than ideal results that eventually make sagging look even worse. As a breast revision specialist, Houston plastic surgeon Dr. Chris Patronella says this is a common issue he sees among the women who consult with him for breast revision surgery.

“I see a lot of women who had significant sagging of the breasts, and they received recommendations to have breast augmentation surgery with large implants to fill out the loose breast skin,” said Dr. Patronella. Unfortunately, this approach only compounds the problem. “A year or two later they come in for a breast revision consultation because they are bigger than they wanted to be, and they sag even more,” commented Dr. Patronella, whose breast enhancement expertise led to an invitation to serve as a board member for the prestigious NOVO–Council of Leaders in Breast Aesthetics, sponsored by breast implant leader Allergan Medical.

Because breast augmentation surgery can provide a small amount of lift to breasts, in cases where sagging is mild to moderate, this procedure alone may be adequate to prevent the need for a breast lift.  But if sagging is more severe, breast augmentation without a breast lift ultimately will only make the condition worse.

Dr. Patronella noted, “If you put something large and heavy in, it’s going to pull excessively on previously damaged skin (skin that has been stretched). The better choice is to help women understand the limitations of what can be done when sagging is present. A lift needs to be done with a smaller implant that isn’t too heavy for the tissue to support.”

Combining Breast Lift Surgery With Breast Augmentation

Breast lift surgery with breast augmentation is a popular procedure combination Dr. Patronella performs at his private surgery center, allowing women to simultaneously improve two of the most common aesthetic concerns they experience: a loss of breast volume and elasticity, characteristics that together can cause breasts to develop a deflated appearance The surgeon developed an innovative method to combine the procedures which greatly increased the success rate of this historically challenging surgery: the Delay Fill Implant Technique. Dr. Patronella has been honored to present the method to plastic surgeons at annual meetings of the American Society for Aesthetic Plastic Surgery and the Texas Society of Plastic Surgeons. And he was invited to write a chapter about it for the award-winning plastic surgery journal Seminars in Plastic Surgery called “The Delay Fill Technique: A Safer Approach to Combination Augmentation Mastopexy.”

With this method, the breasts are lifted, and saline implants are placed in pockets that the surgeon forms under the chest muscle. However, rather than fully inflating the implants to the desired size as they typically are at the time of surgery, the implants are filled only partially with sterile saline water. The full inflation of the implants takes place two weeks later in a 10- minute office visit that requires the use of local anesthesia only.

Describing the science behind the method’s success, Dr. Patronella explained,  “Partially deflating the implants allows for improved blood flow by reducing compression upon the soft tissues. The two-week delay between surgery and their full inflation allows the breast tissues to adjust to the surgical manipulation that is required to both lift and add volume to the breasts and also enhances blood circulation within the tissues. These factors ultimately translate to better wound healing.”

Having performed hundreds of cases using the approach, Patronella commented, “The Delay Fill technique is the perfect marriage of accommodating the patient’s desire to have breasts that are perky, round, and full, while also addressing my concerns as a surgeon to achieve complication-free wound healing and a good long-term result.”

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