An augmentation/mastopexy is a breast lift with a breast implant or fat to add volume and contour. It is an outpatient procedure designed to improve the shape and position of the breasts, without reducing their size. It is particularly used for breasts which sag or droop (ptosis).
Some patients will have a better shape to their breast such as increased superior fullness if an implant is used at the time of mastopexy. This is called an Augmentation Mastopexy, or a Breast Lift with Implants. The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height.
There are a variety of techniques for a Breast Lift. Such techniques include the Lollipop lift (vertical lift), donut (periareola) lift, Benelli lift, crescent lift, anchor lift (inverted T ).
Most commonly, we prefer the lollipop or donut lift because of the shape, small scars and easier healing. Although the "anchor-shape" or inverted "T" incision is still more popular in the United States, it represents an older technique with extensive scarring and a less optimal result in many cases. These newer techniques are utilized in the vast majority of cases, the rare exception being extremely large breasts. The nipple-areola complex is repositioned higher, the excess skin is removed, and the breast is reshaped in a pleasing contour and in a more normal position.
For the addition of a Breast Implant with a Breast Lift, we have been using
an approach for more than 20 years known as the Transaxillary Breast Augmentation.
Axillary - with this incision, there are no scars on the breasts. Special
training, experience, and equipment may be required for this procedure.
It is our most common and recommended site for silicone implant placement.
There are many mesh products surgically used to support breasts; Seri®, Belladerm , Flexiderm™, GalaFLEX, Alloderm®, TIGR™,TiLOOP™, Strattice™, and ADM (acellular dermal matrix) to mention a few.
These all have different properties and are manufactured by different companies. For example: Alloderm® is derived from cadaver skin which is processed to provide a matrix that will be replaced by your own collagen. Seri® is a silk derivative. GalaFLEX is a dissolving mesh created from glucose, or sugar and dissolves much like absorbable sutures.
All meshes have their own unique properties but can be used to help support a sagging breast during a lift.
It is usually preferred to do both in one stage or surgery. A number of Plastic Surgeons prefer two operations. For example, the Breast Lift followed by a separate surgery for the implants, usually staged apart at a minimum of 2-3 months to allow swelling to subside and healing to reach a reasonable point.
Our revision rate for both to be combined into one surgery is less than 15%. Two separate surgeries is not necessary for at least 85% of the patients when performed by an experienced Plastic Surgeon.
Saline and Silicone implants
Both Saline and Silicone breast prostheses (implants) are the best means now available to enlarge the breast through surgery. The saline implants (silastic bags filled with physiologic salt water) are placed either behind the pectoralis major muscle and breast tissue or in front of the muscle. Your plastic surgeon will determine which placement is best for you, although common guidelines suggest that women with minimal breast tissue should have the implant placed beneath the pectoralis muscle for more soft tissue padding and above the muscle in women with larger drooping (ptosis) breasts that do not want a breast lift.
A saline implant can be placed through an incision 1 ½" to 2" long placed in one of four locations: under the breast by the crease, half way around the areola, the armpit, or through the belly button (umbilicus).
Silicone implants are usually placed through 2 common incisions: under the breast by the crease or half way around the areola. In some occasions the armpit (axilla) can be used. The scar is slightly longer because the implant is pre-filled when received, whereas a saline implant is filled once inside.
Silicone Gel Implants are not recommended for Augmentation Mastopexy and Breast Augmentation candidates under the age of 22 years old. This is an FDA approval issue but it is always the doctor's decision along with the patient as to what treatment is needed and preferred. Saline implants are always possible.
It's important to know what size bra you currently wear. Is it a 32, 34, 36 bra, and, of course, the cup size? The strap size is important to know because that affects the diameter of the cup and subsequently the diameter of the breast implant that we choose. We also need to know your height, your weight, and it's helpful to know your dress size as well.
In addition, it would be very helpful if you include photos of yourself. A front view, a side view, and a three-quarter view are most helpful. This will let us see if there are any breast asymmetries, if the breasts are narrow, if the breasts are wide, what your chest wall looks.
Breast Implant Sizing (generalization for most patients)
General risks of surgery include infection, pain, delayed would healing, hematoma (a collection of blood at the surgical site), bleeding, hardness of the implant or reactions to anesthetic. The general risks are higher in smokers.
Cosmetic Complications: You may not be fully satisfied with the appearance of your implants; implant size issues, prominent scarring, asymmetric or undesired appearance or placement of implants or hardening may interfere with patient satisfaction. Asymmetry (unequal breast size or shape) may occur. The implanted breast may sag or droop (ptosis) over time, much like a natural breast. Very rarely the implant may change position or break through the skin, particularly if you have very thin breast tissue covering the implant. (This is more common with saline implants).
The Newport Beach plastic surgeons at Pacific Center for Plastic Surgery guarantee our best effort to avoid complications and give you the results you desire. However, complications can occur; even for the best of surgeons and cannot be completely prevented. Make sure you are comfortable with the risks and complications of this procedure and that all your questions are answered by our staff.
Contact our office at (949) 565-2121 to schedule your first consultation.