Q: Dr. Eppley, Do you do a suture suspension breast lift? If so, can you please tell me how it is done, and what are the associated risks. Thank you.
A: The concept of a suture suspension breast lift can take many forms. In theory, many of the traditional forms of breast lifts use sutures for support whether they are skin-only or whether the breast pillars are sewn together to create an uplifted mound. Even more recently the use of GalaFLEX mesh (a resorbable mesh) can be implanted along the lower breast pole. All of these approaches are still an open method with scars and the objective is to try and prevent long-term bottoming out of the breast mound.
That being said, when you ask about suture suspension breast lift you are likely referring to a true suture suspension that is being used to support the lower breast pole by lifting it toward the collarbone (clavicle)…without removing lower pole breast skin. This is done by making a incision next to the clavicle and attaching a small metal screw into the underside of the collarbone. To this scres is attached a very large permanent polymer suture. The suture is passed by a curved needle under the skin the whole way around the breast and back up to the collarbone. By tightening the suture and typing it down to the collarbone screw, the breast mound is ‘lifted’ and suspended upward. Having done this procedure what I can say about it is that it is a technique in evolution (not perfected) and only applies to a certain type of sagging breast. It is a breast where the nipple is in a reasonably good position and it largely needs a tightening of the lower pole only to get a good shape. This can be done in breasts that also need more volume by a simultaneous implant placement. For those breasts in which the nipple sits at or below the lower breast fold, a more traditional excisional breast lift approach needs to be done.
The risks of a suture suspension breast lift include a small scar over the midportion of the collarbone, palpability of the large knot under the collarbone scar, unknown longevity of this breast lift method, potential palpability of the suture under the skin along the perimeter of the breast, and risk of further breast sagging long-term.
Dr. Barry Eppley