Breast Surgeries are on the rise as number one cosmetic surgical procedure for women

Breast Surgery Palo Alto CAIn 2016, breast augmentation was the number one cosmetic surgical procedure sought out by American women, according to the American Society of Plastic Surgeons (ASPS), at approximately 290,000 surgeries. Quickly gaining ground are breast lifts with the number of women opting for them rising almost 600% since 2000 to 101,264 in 2016.

Whether its implants or a lift, at a combined number of almost 400,000 in 2016 alone, there’s no question about it — women are upfront about their décolletage and chest area looking firm and fabulous. But that should surprise no one. It certainly doesn’t surprise plastic surgeon Dr. Orna Fisher. 


Since 2000, breast lifts have been outpacing implants 2 to 1, according to ASPS. For good reason notes Dr. Fisher, elaborating, “many women who want breast implants are also really in need of a lift, they just don’t realize it. In fact, over 50% of women who come in to see me for a breast augmentation find out they actually need a lift. Most often they opt for breast implants in addition to the lift, since breast implants alone will not do the job. The point is when a someone comes in and says “I want my breast done”, they don’t really know what it is they need in order to look the way they want.”

There are a number of differences between a breast lift (Mastopexy) and breast augmentation. To have the benefits of both procedures, they are done simultaneously and this is called an augmentation mastopexy, or simply, a breast lift with implants.

“The goal of a breast augmentation is to have the appearance of larger breasts, oftentimes with a bit of added volume at the top. This is done using breast implants, most often placed under the pectoralis muscle of the chest. On the other hand, the goal of a breast lift is to create a breast with a more youthful shape regardless of size. With a lift, the nipple areolar complex is raised to the correct position on the breast. The breast itself is made more compact and perky.

Breast lift surgery by itself does not increase the size of your breasts and in fact can make breasts smaller just by removing skin”, explains Dr. Fisher.

 “Most women who want a breast lift have lost volume in their breasts from pregnancy, breastfeeding, or weight fluctuations. After having children, they miss the volume that they used to have as their breasts changed and hangs differently,” Dr. Fisher states. “Weight loss and the natural process of aging can also contribute to breasts losing their shape and taking on a deflated or saggy appearance over time.” To address these changes , Dr. Fisher performs breast lift surgery.

A lift will also reduce some of the tissue to make it tighter so that it sits higher,” says Dr. Fisher,who cautions of the approximately four-hour surgery, “you can expect a slight reduction in cup size and the procedure can also improve breast asymmetry.” 

There are three types of breast lifts that can be performed. The periareolar breast lift, or concentric lift, is a lift made only with incisions around the areola. Ideally, this type of breast lift corrects mild drooping or sagging. The second is the vertical breast lift, or lollipop lift, which is performed with incisions that go around the areola and vertically down to breast crease from the areola. The third type is an inverted T breast lift, or anchor lift, when an incision is made similar to the lollipop, but also travels along the breast crease, forming an anchor shape. This is the most common breast lift procedure, and very effective in cases where the other two types come up short.

While a mastopexy will aid in achieving improvement in breast shape and position, scarring is a consideration. Dr. Fisher uses meticulous surgical skills to ensure the least visible scarring after breast lift surgery. “The size of the resulting scar will largely depend on how much correction is needed. Typically the greater the correction needed, the larger the incisions need to be,” says Dr. Fisher, who deftly uses advanced suturing techniques to minimize scarring.

Breast lift surgery is designed to achieve improvement in breast shape and position, however, a breast lift alone will not improve flatness at the top of the breasts. If a patient would also like to increase fullness at the top of the breast, or possibly increase breast size, Dr. Fisher performs a breast lift in combination with implants.


Almost 4% of women in America, or 1 in every 26, has breast implants, according to the American Society for Aesthetic Plastic Surgery (ASAPS).

“Breast augmentation is typically for women who think their breasts are too small – generally women who are a B-cup or smaller and they would like more enhancement,” explains Dr. Fisher. “There are also those women that are more pear-shaped, and feel that larger breasts would provide more balance and proportion to their bodies”, explains Dr. Fisher of breast augmentation surgery which generally takes between one to one-and-a-half hours to perform.

Using FDA-approved implants, which are silicone shells filled with either saline or silicone, Dr. Fisher will place the implant behind the pectoralis muscle. “This technique decreases the risk of certain complications and provides greater aesthetic longevity, when compared with implants placed in front of the muscle,” offers Dr. Fisher. “Most modern plastic surgeons will put implants under the muscle, with rare exceptions.”

Dr. Fisher uses a variety of techniques to minimize the appearance of scars after breast augmentation surgery. “By carefully selecting the incision site and using meticulous suturing technique, minimal scarring is possible,” she explains.


Today’s silicone implants are made of a cohesive gel. Because it’s made of a “gummy” consistency as opposed to a liquid, they are a much safer product than they were in the past. If the shell should rupture with a traumatic injury, the inner gel stays intact.

A silicone implant comes pre-filled and intact, whereas a saline implant is an empty shell that is filled with salt water during surgery and has a plug similar to a pool floatation raft. This makes saline implants less reliable than silicone gel implants in general. Saline implants are not ideal for everyone. Those who choose to go with the saline implant like the idea that their body will absorb the salt water, but if your chest goes flat due to a leak, than you may suddenly feel yourself in a dilemma to see how urgently you can have your implants exchanged”, states Dr. Fisher.


As carefully as you research various breast procedures, it’s also important to not only find a qualified plastic surgeon who is board certified, but also one who is a good fit for you. “Go with someone who understands both your desired aesthetic as well as your needs,” cautions Dr. Fisher, who emphasizes that patients need to remember the relationship works both ways. “You are choosing the surgeon who is a good fit for you, and the surgeon is choosing you as a patient. In some cases, there must be
 room for compromise in terms of what you you want and what is possible for you and we make that decision together. 

 “I will make sure that you get the look you want, and I will also make sure you know as much as possible about about the choice you are making” offers Dr. Fisher.  



Posted in: Breast Augmentation

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