Many patients will require concomitant augmentation mammoplasty procedure with breast lifting in order to reduce the skin laxity. Las Vegas Patients may undergo breast lifts according to the amount of skin laxity they have, including periareolar mastopexy, vertical mastopexy, or formal mastopexy using the inferior pedicle Wise-pattern technique. Patients who have a very small amount of skin laxity as in Grade 1 ptosis, nipple areolar complexes at the inframammary fold level. They may undergo a periareolar mastopexy or crescent lift in order to simply elevate the nipple areolar complex 1.0 to 1.5 cm. This has been shown to be useful especially in very mild amounts of ptosis. Patients who have severe Grade 2 ptosis when the nipple areolar complex is below the inframammary fold 1.0 to 2.0 cm, will do well with a vertical mastopexy, removing skin along the nipple areolar complex in the vertical plane which is referred to as a vertical lift or a lollipop mastopexy.
The round block technique in which skin is removed circumferentially around the nipple areolar complex or the Benelli lift, Dr. Linder has not found to be very useful in that widespread scarring and radiated scarring can occur and he does not favor this approach or the donut mastopexy, Benelli or the round block technique.
Severe laxity or Grade 3 ptosis can be taken care of with a formal mastopexy using the inferior pedicle Wise-pattern technique, removing skin around the nipple areolar complex vertically along the midline of the breast and along the inframammary fold. Patients with Grade 3 ptosis, severe laxity and nipple areolar complex greater than 3 cm below the inframammary fold.
Concomitant augmentation mastopexy is safe when done with Board Certified Plastic Surgeons who understand the anatomy and do not devascularize the nipple areolar complex. On revision surgeries where implants are removed and replaced with open capsulectomies, care must be taken to maintain blood supply to the nipple areolar complex by not undercutting the inferior pedicle. This requires experience and judgment which can be found with Board Certified Plastic and Reconstructive Surgeons.
Las Vegas breast specialist Dr. Linder performs concomitant augmentation mammoplasty procedures with breast lifts. This is a surgery that leads to excellent results. Patients who undergo augmentation mammoplasty with severe Grade 3 ptosis but do not have the skin removed often end up with unfavorable results. A significant proportion of Dr. Linder's patients are both national and international for revision surgery to correct the skin laxity that was not corrected during the original surgery. Please see the examples of periareolar mastopexy with augmentation mammoplasty, vertical mastopexy with augmentation mammoplasty and inferior pedicle formal mastopexy with the Grade 3 ptotic breast lift.