Breast Lift Surgery with Breast Augmentation Surgery
Breast Lift | Breast Augmentation in Scottsdale
A mastopexy is a procedure used to lift sagging breasts, while an augmentation mammoplasty is a procedure performed to increase the size of a woman’s breasts using an implantable prosthesis. These two procedures can be combined to lift and enhance the breast with more volume. The mastopexy augmentation procedure allows the implant to be placed at the time of the mastopexy to make the breasts appear larger and firmer, while rearranging the breast skin and decreasing the areola size to give the breasts a more youthful appearance. This technique is often used after women have lost weight or after breast-feeding when the volume of breast tissue has decreased and the size of the pigmented area around the nipple (the areola) enlarges.
It is important to note that while an implant traditionally makes the breast larger, it can also be used to restore volume in deflated breasts. It is not necessary to make a woman’s breasts larger than they already are. Infact, in some circumstances, Dr. Parson can keep your cup size the same by removing some of your own breast tissue during the lift and replacing it with an implant. Breasts that are large and heavy can be lifted, but the results may not be as long-lasting as when the procedure is done on smaller breasts.
Breast Lift | Breast Augmentation Incision
There are a few standard ways of lifting a woman’s breast: Peri-areolar Mastopexy, Vertical Mastopexy, and Standard Mastopexy. The factors that determine which way that is most suited to your specific anatomy include: the size and shape of your breasts, size of your areolas, and extent of breast ptosis (breast droop). All of these factors will be taken into consideration and will help Dr. Parson determine the best technique for you and your body.
Peri-areolar Mastopexy | Breast Lift
Peri-areolar Mastopexy involves a circular incision made around the areola and is reserved for women who have a small amount of sagging. If there is a moderate amount of sagging, a second incision which runs vertically from the bottom edge of the areola to the crease underneath the breast, similar to a lollipop, may be needed.
Breast Lift with Augmentation Patient Photos
Click the thumbnails below to see the before and after photos in sequence. Please note that all photos are actual patients of Dr. Parson.
Standard Breast Lift | Mastopexy
After Dr. Parson removes excess breast skin, the nipple and areola are shifted to a higher position. The areola, which in a sagging breast may have been stretched, can be reduced in size. Skin that was formerly located above the areola is brought down and sutured together beneath it to reshape the breast. The nipples and areolas remain attached to underlying mounds of tissue, and this usually allows for the preservation of sensation and the ability to breast-feed.
The First Office Breast Lift Visit
The first office visit is a time when both you and Dr. Parson can become acquainted with one another. Dr. Parson will listen to your specific concerns and goals in regards to your breasts. You will also have a chance to meet with other members of Dr. Parson’s team. During the visit a thorough medical history and physical examination will be obtained. Dr. Parson will also use the state-of-the art TouchMD system. TouchMD is designed to help you, as a patient, be better informed and aware of your medical experiences. You will be given access to the mytouchmd.com web portal, which will allow you to relive the experience you had in the doctor’s exam room.
Dr. Parson will then develop a surgical plan that is specific to each patient. He will explain, in easy to understand terms, why certain procedures are better “fits” for each patient’s various situations. Dr. Parson will also discuss whether a breast implant would be of benefit in your particular situation.
Dr. Parson asks cosmetic surgery patients to bring to the pre-operative visit a photograph of a woman’s breasts that they find desirable. This will help Dr. Parson understand your expectations and determine whether they realistically can be achieved. Dr. Parson also uses the Mentor sizing system. Dr. Parson and his staff will be able to let you “try-on” the size implants that we will be using with your own clothing. This helps to create realistic expectations of what to expect following your surgery.
The Pre-Operative Breast Lift Visit
It is important that plastic surgery patients take certain measures in the pre-operative period to decrease chances for potential complications. All of your medications will be reviewed prior to this period. Any medications that may cause surgical complications will be discontinued at least 2 weeks prior to operation. Any infections that arise prior to operation, however seemingly trivial, should be reported to our office. Even an otherwise innocent infection can result in a surgical wound infection, and must be treated prior to breast lift surgery. A baseline mammogram should also be obtained prior to the operation.
Appropriate prescription medications will be written well prior to your procedure. This allows you you to have your medication when you return home from the operation.
Pre-operative photographs are taken at this appointment. These photos will be recorded in the TouchMD system so that you will also have access to them from home. These photos will serve as a marker for you to see the improvement from your breast lift surgery afterwards. You will be asked to sign a surgical consent. The consent explains the potential risks of the procedure in detail. Some of these risks have been explained here, but more discussion will occur at the consultation.
You will need to arrange for someone to drive you to and from the surgery center. It is mandatory to have someone stay with you for at least 24 hours after surgery for your comfort and safety. If you don’t have help available Dr. Parson’s office will be able to assist you.
The Day of Breast Lift Surgery
All patients are required to register and check-in two hours before the scheduled surgery time. Patients are not allowed to have anything to eat or drink from midnight on the night before surgery Breast lift with augmentation surgery is performed with a general anesthetic. Our board-certified anesthesiologist feels that this method of anesthesia provides the greatest degree of patient satisfaction for this procedure. This procedure usually takes 3 hours to perform. Dr. Parson meets with the patient one last time to review details and make surgical markings if needed. After being taken to the pre-operative area, a nurse will take a history, check vital signs and start an IV for fluids. After surgery, the patient remains in the recovery unit for about an hour and is discharged home.
The Breast Augmentation Implant
The implant will be placed through one of the incisions made to perform the lift and is usually positioned below the muscle. Determination of whether a silicone (gel) or saline implant is used, as well as the size of the implant will be discussed during your first consultation. Often times, Dr. Parson will ask patients to bring in pictures of their desired size and shape. This helps foster communication between you and Dr. Parson so that we can help you achieve your desired results with reasonable expectations.
Several varieties of implants have been developed for breast augmentation over the last several decades. The implants used today in the United States all have a silicone shell. One type is filled with saline, the other with silicone. Saline implants have the advantage of being able to be adjusted intra-operatively because they are implanted as a flat balloon, and then filled up with saline during surgery. These implants may be better suited for patients who have a significant size difference between breasts. The silicone-filled implants have the advantage of a more natural feel and may be better suited for women are thin and do not have a lot of breast tissue.
In addition, both implants come in various forms. The silicone shell may be smooth or textured. Implants also come in two shapes, round or anatomical. The “anatomical” implant has a tear drop shape that theoretically creates a more natural looking breast. In practice, however, the round and anatomical implant has the same appearance when implanted and the anatomic implant carries the risk of an unnatural feel. Dr. Parson typically uses the round-style implant. Lastly, there are several profiles of implants. Your chest shape, breast size and desired result will help us determine which implant is right for you.
Level of Breast Augmentation Placement
In addition to several types of incisions and implants, there are also two possible locations for placement of the implant. The implant can be placed beneath the breast tissue, but on top of the pectoralis muscle. The second, more common method is to place the implant beneath the pectoralis muscle, between the pectoralis and the ribs. The advantages of placing the implant above the muscle are that it is less painful for the first few days and the appearance of the implanted breast matures faster. In addition, contraction of the pectoralis muscle, more noticeable in body-builders, has no effect on the appearance of the breast. The advantages of placing the implant under the muscle are several. First, it provides a more natural appearing breast with a better transition from the upper chest to the breast mound. Second, the rates of scarring around the implant are significantly lower when the implant is placed beneath the muscle. Third, the risk of visible ripples or folds in the implant envelope (a more common problem with saline than with silicone implants) is diminished because of the greater amount of the patient’s own tissue overlying the prosthesis. Fourth, the ability to obtain an adequate mammogram is enhanced with placement under the muscle, as the mammogram technician is better able to separate the breast from the implant when the muscle is interposed. With the exception of patients who are body builders, Dr. Parson usually recommends the sub-pectoral technique to his patients.
Every plastic surgeon has their preference for incision and each approach has its benefits and disadvantages. No one way is correct all of the time. Dr. Parson varies his choice of incision depending on the specific characteristics of the individual.
The Post-Operative Breast Lift Period
When Dr. Parson is finished with your surgery he will place you in a bra with gauze dressings. Your breasts may initially be swollen, and bruised. This should quickly resolve over the following 7-10 days. Pain should not be severe, and is usually well controlled by a combination of: narcotics, anti-inflammatories, and local pain medications. Local pain medication it delivered to the patient via an On-Q Pain Buster Post-Op Pain Relief System (which is an optional benefit provided by Dr. Parson). Dr. Parson recommends this system to his patients and finds that they require fewer narcotics than normal.
After 2 to 3 days, Dr. Parson or his nurse will remove your dressings, and the incisions are checked to ensure that there are no problems or complications. Once the dressings are removed you will then be able to shower. Dr. Parson will provide you with a sports bra and instruct you to stay in the bra 24/7 over the next 4 to 6 weeks. This helps with pain and swelling and provides support to the breast. Sensation will gradually return over the next 6 to 8 weeks. It normally takes approximately 12 weeks for all of the initial swelling to subside, and it takes 1 to 2 years for the scars to mature and fade. Dr. Parson will ask that post-operative photos be taken at some point in time when adequate healing has occurred so that results can be compared to pre-operative photos.
Antibiotics are continued for 7 days after the procedure to lower the risk of infection. Activity should be restricted to no lifting of greater than 20lbs for the first 4 weeks. The breasts should not initially be manipulated in any way. One should be up and walking on the morning following surgery, and a regular diet may be begun to the point of tolerance.
Risks of Breast Mastopexy and Augmentation
- Bleeding (hematoma) – Unexpected bleeding around the implant is unusual but it can occur. More significant bleeding is very uncommon and might require additional surgery to correct.
- Loss of nipple sensation – loss of nipple sensation is uncommon but it can occur. Sensation changes are usually only temporary, however, it may take up to two years for full sensation to return.
- Malposition of implants – Differences that were present in breast size prior to surgery may not be able to be completely correctable following surgery. A second procedure is occasionally necessary to obtain further symmetry.
- Infection – The risk for post-operative wound infection following this procedure is usually less than 1%. Patients are given both pre-operative and post-operative antibiotics to decrease the possibility of infection.
- Capsular contracture (hardening of the breasts secondary to scar formation) – Data typically quotes a 10% incidence of this problem. Treatment may be necessary for more significant contractures, which would include further surgery to remove the scar tissue.
- Deflation/Rupture – The incidence of implant leakage is approximately 2% per year. Saline implants slowly deflate in size with a rupture while silicone implants are less easy to detect. Implants typically last 10-15 years prior to any further surgery being required.
- Visible Rippling – Patients with small breasts that have had a large augmentation can be at risk for visible rippling of the overlying skin. This problem is much more common with textured implants and those placed above the pectoralis muscle. Silicone implants have been found to decrease this complication as well.
Permanent scarring will be present following the procedure. Dr. Parson will attempt to minimize these scars as much as possible, however, part of the final scar appearance will be dependent on how each patient individually heals. When poor healing is present there may be areas of scars that remain more prominent when compared to other areas. These types of scars may require further treatment. Dr. Parson will discuss your particular scarring potential in more detail at the time of your consultation.
Schedule a Breast Lift and Breast Augmentation Consultation Today
Breast lift surgery is a comprehensive procedure that can help women regain the youthful contours they desire. If you are unhappy with the appearance of your breasts and would like to learn more about mastopexy, call Dr. Shaun Parson today at 480-282-8386. During your consultation he can review your procedure options, including breast lift and breast augmentation.