While patients will enthusiastically want an augmentation, patients can be more reluctant towards considering a breast lift because a lift involves more scarring than a breast augmentation. Nevertheless, patients who want their breasts to be less droopy will choose to have a breast lift.
Dr. Teitelbaum's overarching philosophy is to be safe and to give a phenomenal result that will last for many years. This is his approach to all operations, but the importance of the approach cannot be overemphasized when discussing the combination of breast augmentation with lift.
This is because an augmentation complicates a lift and because a lift complicates an augmentation. Since by definition someone needing a lift doesn't have perfect skin and an implant adds weight on that skin, there is always a greater tendency for combined lift and augmentation patients to loosen in the future than for lift patients alone, no matter how the surgery is done nor who performs it. The proper medical term for a breast lift is a mastopexy, and those terms are used interchangeably.
Most of the time Dr. Teitelbaum does a breast lift/augmentation during the same procedure. However, there are some patients who will get a safer, more accurate, more complete, and longer lasting result if it is done in two stages. Dr. Teitelbaum fully appreciates how much easier it is for patients to get it all done at once, so when he suggests that you consider it in two stages he is doing so for your benefit.
Every patient wants their augmentation with lift done in a single operation and every plastic surgeon would prefer to do it that way. And that is what Dr. Teitelbaum does most of the time.
But there are situations in which a result can be obtained that is safer, longer-lasting, more precise, and with better scars. This can include very droopy breasts, situations of significant asymmetry of size, differences in the amount of droop between the two sides, or extremely thin breast tissue. These issues have been written about in major plastic surgery journals and are well documented.
Dr. Teitelbaum was at a roundtable discussion with a group of distinguished Beverly Hills plastic surgeons. The topic was one-stage versus two-stage breast lift/augmentation. The moderator asked for the advantages of two-stage, and hands went up with a multitude of reasons. When he asked about the advantages of one-stage, no one raised their hand. Finally, someone spoke up and said, "Well, if I don't do it, then the patients will just go somewhere else to do it." And the balance of the audience agreed. No other advantage of one-stage was expressed, and that kind of thinking is anathema to Dr. Teitelbaum.
Dr. Teitelbaum has performed hundreds of breast augmentations with breast lift procedures, and he does so with great regularity. He has experience with a wide variety of breast shapes, different patient goals and expectations, virtually every type of implant available in the United States, and every method of breast lift. This means that he can customize a result to suit the specific anatomy and desires of each patient.
He has lectured on this topic to other surgeons. He has also served as an expert witness in legal cases regarding lifts with augmentations. While this operation can be performed safely, there are certain pitfalls that must be avoided and Dr. Teitelbaum is very aware of them. Having you heal safely is Dr. Teitelbaum's priority.
As an overview, there are three types of breast lifts performed by Dr. Teitelbaum. The approach will be chosen based on your unique anatomy, the type of implant chosen and your lifestyle and wishes. The doctor will discuss these techniques in more detail during your consultation.
Circumareolar lift: Also called a donut lift, here the doctor makes his incision hidden in the dark pigmentation of the areola, encircling it. This approach is only appropriate for those with minimal breast ptosis (sagging).
Lollipop lift: This technique requires an incision around the areola and then down the breast vertically. It is the most regularly performed surgical approach when it comes to elevating and recontouring the breast shape.
Anchor lift: For the client with pendulous, sinking breasts, the anchor lift represents the most comprehensive surgical approach. Here, an incision is made first around the areola, then down vertically to the breast crease, and then horizontally along the inframammary fold. This gives the doctor the greatest access to the breast tissue for excision and reshaping.