Does the prosthesis correct the sagging breasts?

"Dr., does the breast prosthesis correct my sagging?". I think I lost count of how many times I heard this question in the office. It really is a good question, but with a variable answer.

What may be indicated for one patient may not work for another. Let us then try to discuss the topic and elucidate the case.

THE sagging breasts It occurs when there is a disharmony between its contents and its wrap (skin). As long as the breast has a content that can completely fill its wrap, leaving it stretched, the breast is usually "standing", beautiful and above the breast fold (fold below the breast).

The problem usually occurs after an episode of swelling and swelling, such as pregnancy, weight gain followed by weight loss, etc. Knowing that the breast is made up of gland and fat, the swelling may be due to the enlargement of the gland, the fat or both.

During breastfeeding, the gland enlarges due to milk production. During weight gain, when fattening, the breast increases due to increased fat. In pregnancy, the association of these two factors is common. Both make the skin stretch to accommodate the largest breast volume.

It turns out, however, that the skin is a weak elastic that suffers from being stretched. Stretch marks are the hallmark of the breakdown of the elastic fibers of the skin. Even without stretch marks, it will not return to the pre-stretch size even if the patient returns to the original weight. There will always be a skin lacquer.

This skin lacquering commonly leads to a mismatch between the existing volume in the breast and its envelope, the skin. There is more skin in relation to the breast, added to a poorer elastic and supportive quality of the skin, generated by stretching and breaking the elastic fibers. The result of this? THE breast fall, also known as ptosis.

Knowing this then, let's return to the initial question about whether breast prosthesis corrects sagging. The answer is: it depends.

OK, let's resume the discussion!

From what we have seen before, for the breast to be stretched it is necessary that the content is in harmony with the wrap. We can then make three adjustments to suit them:

First: Increase the content and stretch the skin until it becomes tense again. This can be done with a prosthesis. But there are limits. The size of the prosthesis should be aesthetically acceptable so as not to be huge, artificial. Therefore, the sagging skin should be small so that a properly sized prosthesis will stretch and still look beautiful. This usually occurs in cases of pseudoptosis, ie a slight sagging where the areola is still above the mammary fold. This case is more common in thin women with small breasts. For this case, the answer to the question is:? Yes, the breast prosthesis corrects sagging?.

Second: Reduce the wrap and make it fit the content. This is usually done when the volume of the breast is large or moderate and is not intended to be increased and may even be reduced. The surgery is breast reduction (in cases of volume reduction) or breast lift (mastopexy, when it is intended to lift without changing the size). The surgery consists of removing excess skin and reducing the gland. The scar will be proportional to the sagging, excess skin to be removed: the more skin, the more cuts, the more scar. In this case, the answer is: No, the breast prosthesis does not correct sagging? If placed, the breast would become large and sagging.

Third: It is the association of the two cases above. Reduce wrap while increasing content. It is indicated when the patient wants to enlarge the breasts, but has a sagging that would not be compensated with the appropriate volume prosthesis, and still need to remove skin. In this case, the skin removal is smaller due to the volume increase with the prosthesis, leaving a smaller scar (often only around the areola). In this case, the answer would be: • Does the breast prosthesis only partially correct the sagging breasts?.

To further spice up the discussion, there are still personal variables such as skin type and natural elasticity, breastfeeding history, biotype, and patient genetics. All this influences the decision and can change the outcome of each of these behaviors.

Breast Lift / Mastopexy Surgery (January 2021)

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