The patient is a young woman with good breast size, but volume loss and ptosis (droop) post pregnancy. Breast Augmentation fills the “empty bag” and provides superior fullness to make attractive cleavage in a bra. For this approach to work without a mastopexy (lift) with its accompanying scars, two things are necessary. First, the patient must accept that she will be relatively large as there must be adequate implant weight to get the device to the bottom of the breast (bag). Second, a bi-planar technique is used. This keeps the upper part of the implant covered with muscle while allowing the extra breast tissue to distribute over the implant surface. In patients with good breast volume, saline implants are usually well hidden by this technique as well. Third, the patient should have downward pressure on the implant with a bandeau (an elastic strap) for at least several weeks. The implant usually reaches a good position. Even if the implant position is not all the way at the bottom of the breast, it nonetheless looks very good and need for a mastopexy is usually avoided.
