The effects of age and gravity on the breasts are a concern for many women. Unfortunately, over time these forces inevitably take their toll.
With age, breasts become less elastic, begin to stretch, and eventually descend. This is known as breast ptosis, commonly called breast sagging. Women that want to reverse these effects do have options, namely breast enhancement through breast lift surgery.
What if you aren’t interested in going under the knife? Are there less invasive options?
Technically, yes. But the experts we spoke with agree that, with the exception of a treatment called ThermiBreast, non-surgical breast lift treatments are almost entirely ineffective. Even ThermiBreast has a subtle effect and only works for certain patients.
Non-surgical breast lift treatments: marketing vs. science
So far, non-surgical breast lift treatments have been overwhelmingly ineffective. Unfortunately, this fact can be drowned out by loud advertisements. “There is a ton of hype and very little proof of concept,” says Englewood, CO plastic surgeon Dr. Greg Buford.
Dr. Robert N. Young, a board-certified plastic surgeon in San Antonio, agrees. “While science is making big improvements in terms of methods that utilize radiofrequency, fat transfer, and stem cell therapies, they have not yet reached the same degree of effectiveness in providing significant lift.”
While techniques to improve moderate sagging show some promise, treatments for significant sagging have proven elusive. “Studies show that some methods may lift the breast an inch or so, but for most women who have had children or have significant sag in their breasts, it is not enough to restore breasts to ideal,” says Young.
Why is this? As Buford points out, breasts do not droop because of weak muscle. “They droop because the internal fibers — called Cooper’s Ligaments — stretch over time and weaken,” he says. “When this happens, the surrounding tissue becomes lax and the breasts begin to droop. Ultimately, we will need to identify better strategies aimed at tightening these ligaments before we can effectively lift and shape the breasts without surgery.”
While some non-surgical treatments cause mild swelling that might make the breast look like it sits a few millimeters higher, most breast lift alternatives only treat the skin, says Dr. Suzanne Trott, a board-certified plastic surgeon located in Beverly Hills. “In almost all cases, a lift is needed because a significant amount of skin needs to be removed to tighten the breast envelope,” she explains.
What’s more, Buford says that many of the non-surgical breast lift treatments being marketed to consumers are usually performed by non-plastic surgeons.
“While some plastic surgeons — such as myself — do offer non-surgical breast lifts, the majority of these procedures are being performed by non-plastic surgeons who unfortunately do not understand the anatomy as well as the anatomic changes that occur with the aging breast,” says Buford. “Without understanding these key concepts, it is impossible for these providers to adequately assess optimal ways to actually lift the breasts.”
Ineffective non-surgical breast lift treatments
We asked our expert panel about some of the many so-called “alternatives” to traditional breast lifts – and why they don’t work. Here is what they had to say:
A treatment marketed as the “laser breast lift” involves the use of a Coolbeam laser. Non-surgical breast lift laser treatment removes a tiny layer of skin, ostensibly tightening the skin and thereby providing a natural lift. Whether it’s effective is another story.
“No lasers currently do anything to achieve lift in the breast,” says Buford. Trott agrees, pointing out that lasers all work by injuring the skin and promoting the formation of scar tissue and collagen. “So far, none of these have been shown to produce long lasting results anywhere on the body. They can also be painful and cause burns and hyperpigmentation in darker skin,” she says.
Thermage is a treatment that uses radiofrequency (RF) energy waves to tighten the collagen in the skin. It has been touted by some as an alternative to surgical breast lift.
However, Buford says that he hasn’t seen any significant results with it so far, and Trott points out that it’s an older technology that is painful and no longer thought to be effective.
If those touting the “Botox breast lift” are to be believed, Botox can have the same effect on the breasts that it has on the face, namely a tightening and lifting effect. As Trott points out, Botox is a muscle relaxant, so there is no way that injecting it could lift the breast. “The only effect it would have is to weaken the pectoralis muscle, which is not going to lift the breast,” she says.
Buford goes further. “This is one of the most over-hyped treatments for breast ptosis,” he says. “For the most part, Botox works on muscles and muscles are not the cause of drooping breasts. Simply injecting Botox is not going to do much — if anything — to lift your breasts.”
The experts agree, anyone telling you that “exercising” your breasts will lift them doesn’t know what they’re talking about. “The only thing that you can do is exercise your pectoralis major muscles, which is still not going to lift your breasts,” says Trott. “This goes for anywhere on the body — you can’t tighten skin and soft tissue with exercise.”
Vampire Breast Lift
The much-discussed Vampire Breast Lift is another supposed treatment for breast ptosis. This procedure, which purportedly uses microneedling and platelet-rich plasma (PRP) to tighten and lift the breast skin, will do no such thing, according to our experts. “It will rejuvenate the skin, that’s all,” says Trott.
Buford doesn’t pull any punches. “The Vampire Breast Lift takes the award for the most over-hyped procedure out there,” he says. “If you look at the claims, they are ridiculous. Since it takes up to 90 days for collagen growth and remodeling to occur, it is ludicrous to think that results shown at two weeks show anything but swelling. Stay away from this one.”
There are several topical creams out there that claim to tighten the breast skin and lift the breasts. While these products may provide a temporary tightening effect, they are certainly not a lasting treatment, and they will not lift the breast. “Most creams that I have seen for lifting contain estrogen, which is going to have little if any effect on lifting the breasts,” says Buford.
This treatment is purported to lift the skin on the upper pole of the breast, for an overall lift. “Theoretically it sounds like a good idea, but I have not seen it work well and it can cause significant discomfort,” says Trott.
There is also a permanent threadlift technique for the breast that involves a system called the “Refine” lift. Although it may only have a modest effect, it requires anchoring the suture to the chest wall in two areas. According to Trott, these anchors can cause indentations that would be visible in any low-cut top. It is not a widely accepted treatment and the downsides are too great, in her opinion, to justify the minimal gains.
Are there any effective alternatives to surgery?
There are a couple of non-surgical breast lift treatments that may be minimally effective on some patients. However, they are still no substitute for a surgical breast lift.
“One thing that can work for a few hours is the injection of sterile saline into each breast to fill it out and lift it,” says Trott.” It would probably take a couple of hundred cc on each side and it might last for the evening.”
Also known as the lunchtime boob job, this form of temporary breast enlargement can set you back as much as $3,500.
Both Young and Buford feel that a treatment called ThermiBreast can have a mildly positive effect in some patients.
“For patients with heavy pendulous breasts or poor tissue, this is not a good option,” says Buford. “But for our younger patients, we are seeing results that definitely lift a few centimeters and help to better shape the overall contour.”
Young concurs. “I offer ThermiBreast for women who are good candidates and have minimal lift needed, but this is the main drawback with ThermiBreast. Generally the procedure is best for women with Grade 1 [mild] ptosis. Most women need more lift than this.” Young also points out that the cost of the ThermiBreast procedure is usually only slightly less than surgical breast lift procedures.
Trott is altogether unconvinced that ThermiBreast can be effective. “[It] may cause a little swelling at first, which might make the nipple look a few millimeters higher, but I have not seen a result that any consumer would be happy with,” she says.
The future of non-surgical breast lift alternatives
The fact that breast lifting without surgery is currently so ineffective doesn’t necessarily mean that this will always be the case.
“With improvements in fat transfer procedures and the newer use of stem cell therapies, there is little doubt that there will continue to be new procedures and new technologies introduced to improve outcomes of non-surgical breast lifts,” says Young. “At this time, there is science to back some of the new methods but they are not as reliable as existing surgical methods which have been used successfully for many years.”
Buford agrees. “The technology is definitely improving. As time goes on, I hope that the technology will be able to meet the claims and that we will be able to offer patients a non-surgical option,” he says.
For now, the experts agree, a breast lift without surgery should be avoided. There is simply no substitution for a surgical breast lift.
Breast Lift Procedures: Know Your Options
By Dr. Robert N. Young, MD, FACS, board-certified Plastic Surgeon
My patients would all love to achieve the ideal lift without having to undergo surgery or expensive procedures, and no one wants to be disappointed with something that doesn’t work.
Here is a rundown of your options — both surgical and non-surgical — as well as some outdated methods that have been widely discredited.
How breast lift surgery is performed
Traditional breast lift surgery, also known as mastopexy, typically involves the removal of excess skin. The remaining tissue is then pulled together and sutured. This process tightens the breast, raising and lifting it at the same time.
There are several types of breast lift available, depending upon the amount of sagging, nipple position, and skin laxity.
Crescent lift (crescent wedge) – Incisions are made around the top of the areola only. This technique is used to address minimal breast sagging, and is sometimes combined with breast augmentation when the patient desires a perkier look than can be accomplished through breast lift surgery alone. Scars are well-hidden, and once healed they are often unnoticeable.
Areolar lift (donut lift or circumareolar lift) – Incisions are made all the way around the areola. This is a minimal breast lift which is designed to address mild sagging. It is sometimes combined with breast augmentation, and can be performed when the woman wants to reduce the size of the areolas or correct nipple asymmetry. Scars are well-hidden along the edges of the areola.
Vertical breast lift (lollipop lift) – Incisions are performed around the breast areola, with a vertical incision that runs down to the inframammary fold, creating what looks like a lollipop. This type of lift is designed to tighten and lift the breast. It can be performed to reshape the entire breast, and produces a moderate amount of scarring.
Anchor lift (inverted T-LIFT or full breast lift) – Incisions are made around the areola, vertically down to the crease, and horizontally out along the crease on both sides. This lift is often recommended for women with significant sagging, or for those who also need to reduce the size of the breast. Of all techniques, the Anchor Lift provides the most tightening, reshaping and lifting. While it does cause scarring, this generally fades over time.
The pros and cons of mastopexy
The benefits of breast lift surgery are that the results are instant and can last years. Breast lift surgery can improve many things women are unhappy with, including breast deflation, sagging, size, shape, asymmetry, and irregularities.
With any of the techniques previously described, the nipple and areola can be repositioned to provide a more youthful appearance. Large areolas can also be reduced if the patient desires, and irregularities such as inverted nipples can be successfully addressed.
Once the excess skin has been removed, the breasts appear perkier while still maintaining a natural look and feel. Breast implant can also be added to provide additional volume.
While many women are fearful of scarring, which can be quite noticeable immediately after surgery, scars diminish over the first year, often to a point where they are no longer noticeable. Newer technologies such as the use of silicone gel sheets and scar gels and creams, while somewhat costly, can help scars heal faster.
Non-surgical options: Don’t expect miracles
At this time, non-surgical breast lift procedures do not perform as well as traditional surgery. While science is making big improvements through the use of radiofrequency, fat transfer, and stem cell therapies, we have not yet reached the same degree of effectiveness in providing significant lift.
For decades, breast exercises, suction devices, nutritional supplements, and breast creams were the only non-surgical alternatives offered. These alternatives still exist today and include an overwhelming array of bras, sleepwear, pads, straps, creams, lotions, gels, and exercise programs that promise miraculous results.
Most women who have tried them have been disappointed and eventually turn to surgery. Others try one of the newer non-surgical technologies — laser, radiofrequency, fat transfer, stem cell injections, and even Botox are now being publicized as non-surgical alternatives to breast lift surgery. But do they work?
My own San Antonio AAAASF Certified Surgery Center is used for all breast lift surgeries I perform. While the majority of my patients elect to undergo traditional breast lift surgery, I also offer fat transfer for breast augmentation when implants are not desired, or when a lift and more upper pole fullness is needed.
I also offer ThermiBreast for women who are good candidates and need a minimal amount of lift. This is the main drawback with ThermiBreast: the procedure is best suited for women with Grade 1 (mild) ptosis — most women need more lift than this.
ThermiBreast uses controlled radiofrequency to generate heat, which contracts the tissue and causes tightening. A small thin probe is inserted under the skin while the patient is under local anesthesia. The probe is carefully monitored by the surgeon until it reaches a precise, optimal temperature. The probe is then moved in a pattern to cover the entire breast area.
ThermiBreast is usually done in one session, and requires little downtime. However, some patients may have difficulty tolerating the procedure under local anesthesia alone. Early results have shown that it results in approximately 1 inch of lifting. The cost of ThermiBreast is usually just slightly less than surgical breast lift procedures.
New methods are being introduced all the time, and have been for many years. Over the years surgeons have tried many surgical procedures to improve breast lift, including internal bras (slings made from tissue or mesh), anchoring the breast from above, and other methods which have not been terribly effective.
Most recently, the so-called Laser Breast Lift, Botox Boob Job, and Vampire Breast Lift have been marketed as alternatives, but their effectiveness and longevity remain unproven. Time will tell the effectiveness and safety of these fads. For now, none of these techniques can rival the results of breast lift surgery performed by an experienced plastic surgeon.
Dr. Robert N. Young is a Board Certified Plastic Surgeon with a successful San Antonio practice. Having performed over 10,000 breast enhancement surgeries, he is widely referred to as “The Breast Doctor” of San Antonio. For over 25 years, Young has been a leader in minimally invasive breast augmentation techniques.