Have you ever undergone breast implant surgery? If yes, you may be a good
candidate for breast implant revision surgery. This surgery aims to change the shape
of the original implants or to replace them with new ones. Breast implants lose their
firmness and shape over time, and you would not want to walk around with sagging
breasts. That’s why you may need corrective surgery to improve your breasts’
appearance by replacing the implant material.
The revision surgery may involve breast reduction/breast lift or changing the
position of the implant material on your chest. It can also involve decreasing or
increasing the size of the implant material or changing its style.

Where a Breast Implant Revision Surgery Is Applicable

Despite the best execution and technique used during your original breast implant
surgery, some changes are bound to occur along the way. These changes may cause
your breasts to lose the appearance they had immediately after the surgery.
Some of these changes may make you feel uncomfortable. The best solution would
be to visit your plastic surgeon for a breast implant revision surgery to restore your
breasts to their original position and state.
Some changes to your breast implant may result from weight gain, weight loss, or
pregnancy. Some issues that a breast implant revision surgery can address include:

Change in your breast size

The most common reason many women go for breast implant revision surgery is to
either decrease or increase the sizes of their breasts. Most women, after undergoing
breast implant surgery, may feel that they could have looked prettier with smaller or
larger breasts. This makes them go for revision surgery to change the sizes of their
breasts.

When you go for this kind of change, your plastic surgeon will simply replace the
small implant material will a bigger one, if you want a bigger breast, or replace the
big implant material with a small one, if you need smaller breasts. If you know the
size of the original material used, you’ll make the work of the surgeon to be easier.

Deflation of Your Breast implant

Saline implants can leak or rupture, making your breasts deflate and sag. Leakage
isn’t a health concern, but it has esthetic consequences that can leave you with less
attractive or lopsided breasts.
Your plastic surgeon can remove the leaking implant and then fix a new one for you.
You may ask your surgeon to fix a new design or a new type of implant material. The
good news is that most of these implants have lifetime guarantees, meaning you
won’t be charged for the replacement.

Implant malposition

When the pocket holding the implant material is larger than necessary, implant
malposition will occur. In this case, the implant material will shift its position, making
the shape of your breasts to be distorted. This way, your breasts will lose their
attractiveness, and you’ll need a breast implant revision surgery to return the
implant material to its original position.
The surgery will also be necessary to reduce the size of the pocket so the problem
can not occur again. If you delay until the implant material gets damaged, then you
must have a new implant material installed. In most cases, the discomfort caused by
implant malposition may force you to seek help before the implant material gets
damaged.

Changing the Implant Type

There are many types of implant materials that you can choose from. If you feel that
the one you are having no longer suits your taste, you can go for a breast implant
revision surgery. This decision has nothing to do with any medical need or a feeling

of discomfort but is a matter of preference. However, to make such changes, let your
surgeon advise you on the best replacement.

Capsular contracture

When the scar around your implant tightens, the implant may change its position.
This is the condition referred to as capsular contracture. If it happens to you, revision
surgery will be necessary to return things to normal. Capsular contracture can be
caused by an infection in your breasts, bleeding in the breast, especially around
where the implant is, or trauma. It may also result from other factors unknown to
the surgeons.
Depending on the problem you are facing, your surgeon will decide on the best way
to deal with it. If it results from an infection, you may need to get treatment before a
new implant material is inserted for you. The surgeon will have to diagnose your
situation then put you on the treatment.

Improving the Feeling of Your Breasts

When you’ve had an implant for a long time, the feeling of your breast may change
because of the growth of breast tissues. Sometimes you may not notice this, but in
some cases, your breast may feel unpleasant and uncomfortable. If that is the case,
you may need an implant correction surgery.
The surgeon will change the size or shape of the implant material, then put it at an
optimal position to accommodate your breast tissues.

Reshaping and Repositioning in your Chest

Naturally, as you age, your breast will lose its firmness. As this happens, any implant
material that you had may also change in shape. This will change the overall look of
your breasts.
You’ll need revision surgery to reshape both the pocket and the implant material so
your breast can have a new look. This process may necessitate the replacement of
the old implant material with a new one.

Final Words

When you have chosen to have breast implant revision surgery, you need to pick a
qualified surgeon to carry out the procedure. This is because this surgery is not like
other routine or standard procedures. It needs to be designed to meet your specific
desires and goals.
For example, if you need a specific breast size, your surgeon will have to assess your
current breast size and the size of the original implant material before deciding on
the size of the implant material to be used as a replacement. The surgeon must
develop a specific surgical plan to take care of all the issues you have raised.

The post Breast Implant Revision appeared first on Plastic Surgery Houston | Cosmetic Surgeon & Dermatologist.

What is Breast Reconstruction?

Just like I mentioned earlier, breast reconstruction helps individuals regain their confidence back after having a mastectomy. The main aim of breast reconstruction is reshaping or reforming one or both breasts after lumpectomy or mastectomy. Mastectomy is a form of surgical procedure where a surgeon removes the breast including the areola and nipple, to prevent or treat breast cancer. Lumpectomy, on the other hand, is the removal of a section of a breast that contains a small tumor. 

Although there are many factors and considerations that can help you determine the best type of breast reconstruction, there are two most reliable ones: 

• Prosthetics or implants: This type of breast reconstruction surgery uses saline implants or silicone. 
• Skip flap surgery or Autologous: This type of breast reconstruction surgery uses tissue from another body part. 

In some rare situations, a surgeon might apply or use a combination of these two types. This helps create a natural reconstruction of either one or both breasts. 

There are other techniques that can help the surgeon in charge reconstruct the nipple that surrounds the area if the treatment has affected it. As much as many patients prefer breast reconstruction done after treatment, it can also take place during lumpectomy or mastectomy. This process is known as immediate reconstruction.

Delayed reconstruction, which a good number of patients opt for, happens after reconstruction. In this case, an individual might opt for a reconstruction after the wound has healed and also other forms of cancer have ended. 

Types of Breast Reconstructions 

This sections discuses the different types of breast reconstruction surgery.

Implants

When using implants to reconstruct a breast, a surgeon will insert saline or silicone implants underneath the muscle or skin, this replaces the previous breast tissue. In most people, this process involves two stages. In the first stage, the surgeon will place a tissue expander underneath the pectoralis muscles or breast skin. This expander functions as a temporary implant that will gradually stretch the tissues remaining. After this process is done and the individual heals, the surgeon will then inject salt water or sterile saline through the skin into the expander once a week. It will make the balloon gradually grow, stretching out the overlaying muscle and skin until the affected breast reaches the size an individual is comfortable with. Once these chest issues heal and the surgeon adds sufficient saline to the expander in preparation for implant insertion, they then move to the second stage which involves inserting the implants. 

In the second stage, the surgeon will remove the tissue expanders and replace them with saline implant or silicone. This will reopen the initial original scar. During this procedure, no new scars are left on the chest. In some rare situations, a surgeon places a permanent silicone or saline implant during mastectomy without using the tissue expander. 

Skin Flap Surgery

During this surgery, the surgeon will take a tissue from a different body part and move it to the chest in a bid to rebuild the breast. In most cases, the surgeon usually removes tissues from the abdomen. The tissues might also Coke from other areas other than the abdomen like back, buttock or thigh. This type of surgery is highly sophisticated since it involves the transfer of tissue from one area to another. There are two methods that can be used for this surgery.

Free flap surgery – In this surgery, the surgeon will completely remove the blood vessels and the tissue that supply circulation of blood for breast placement. They will then stitch the blood vessels into others in the intended area of placement. Oftentimes, these vessels are usually very small, so surgeons use a microscope to sew them up in process called microsurgery. 

Pedicle flap surgery; in this type of surgery, a surgeon doesn’t remove the transplanted tissue from the vessels. Instead, the tissue will remain attached to the body, and the surgeon rotates it into the chest to form a firm breast. Just like the other type, a surgeon takes tissues from the back or abdomen for pedicle flap surgery. 

Deciding to Have A Surgery

When deciding to have a breast reconstruction surgery, they are various key factors that an individual should discuss with their doctor. Choosing a breast reconstruction surgery is a personal choice. Normally, many women grief over losing their breasts or experience self image problems and severe anxiety after mastectomy. For these reasons, many go for breast reconstruction. These are the important decisions to make:

• The type of surgery you’ll undergo.
• Whether to have both breasts operated on to match the reconstructed other beast. 

Some other factors that aid an individual decide the best type of reconstruction include: 

• The individual’s body type, slimmer people might not have enough tissue on other body areas to do a skin flap surgery.
• Overall health: Whether the individual smokes or not, severity, the location and cancer types.
• Other forms of treatment: Such as chemotherapy or radiation that the individual might have been given.
• Whether the reconstruction is to be done on one or both breasts.
• The number of breast reconstruction surgeries an individual is willing to undergo. 

Conclusion

As much as breast reconstruction is an effective way of regaining the shape of breasts, some individuals might need more than this procedure to fully reconstruct their breasts and regain their shape.

The post Breast Reconstruction appeared first on Plastic Surgery Houston | Cosmetic Surgeon & Dermatologist.

Often times after experiencing a dramatic weight loss, patients will see noticeable
sagging of the excess skin. This is primarily due to skin tissues lacking the elasticity to
conform to the body’s reduced size and structure. Dramatic weight loss typically occurs
after weight loss surgeries or significant lifestyle changes. Either way, surgical body
contouring is an effective way to remove excess sagging skin and fat. Body contouring
improves the shape of underlying support tissue and results in a better-proportioned
appearance with smoother contours. There are several procedures defined as body
contouring including:

● Arm lift: corrects sagging of upper arms
● Breast lift: corrects sagging or flattened breasts
● Facelift: corrects sagging of the mid-face, jowls, and neck
● Lower body lifts: corrects sagging of the abdomen, buttocks and/or inner and
outer thighs
● Medial thigh lift: corrects sagging of the inner thigh
● Tummy tuck: corrects excess skin hanging over the abdomen
Who is a qualified candidate for body contouring procedures?
Of course, anyone who has experienced significant weight loss should consider body
contouring. However good candidates for the procedures are:
● Adults whose weight loss has been stabilized
● Healthy adults without medical conditions that would impair the healing process
or otherwise increase their risk of surgery
● Nonsmokers
● Adults with a positive outlook and realistic goals
● Adults committed to maintaining a healthy lifestyle with proper nutrition and
fitness

What costs are associated with body contouring procedures?

Body contouring costs can vary widely. Typically surgeons specializing in body
contouring base their prices on his or her experience level, type of procedure(s) used,
and geographic location. While most health insurance will not cover body contouring
surgeries or its complications, many surgeons offer patient financing plans. Always
speak with a certified surgeon in your area to get a more detailed quote. When choosing
a surgeon in your area for body contouring surgery, always keep in mind that the
surgeon’s experience and your comfort level with him or her are just as important as the
final cost of surgery.

Costs associated with body contouring surgery can include:
● Anesthesia fees
● Hospital or surgical facility costs
● Pre/Post-op medical tests
● Post-op garments
● Prescriptions
● Surgeon’s Fee
Scheduling a consultation and what to expect next
During your body contouring consultation your doctor will discuss with you these topics:
● Surgical goals
● Medical conditions including drug allergies and previous medical treatments
● Current medications including vitamins and herbal supplements
● Social history of alcohol, tobacco and drug usage
● Previous surgeries and outcomes
Your plastic surgeon will most likely:
● Evaluate your health and preexisting conditions or risk factors
● Examine your body and take detailed measurements where necessary
● Take photographs to log in your medical record
● Discuss procedure options and recommend a course of treatment
● Discuss likely outcomes and any risks or potential complications of body
contouring

For your physician to successfully and safely perform the procedure, it is important to be
completely transparent during your consultation. Be sure to ask questions and share
any concerns with your physician. It is always natural to feel some anxiety or
preoperative stress before a procedure. Talk with your physician thoroughly and ask
questions to fully understand all aspects of your body contouring procedure. Below
we’ve prepared a cheat sheet of questions commonly asked when going in for a
consultation for body contouring procedures. Feel free to take with you on the day of
your appointment.

What should I ask my plastic surgeon about body contouring?

● Are you certified by the American Board of Plastic Surgery?
● Were you trained specifically in the field of plastic surgery?
● How many years of plastic surgery training have you had?
● Do you have hospital privileges to perform this procedure? If so, at which
hospitals?

● Is the office-based surgical facility accredited by a nationally or state-recognized
accrediting agency, or is it state-licensed or Medicare-certified?
● Am I a good candidate for this procedure?
● What will be expected of me to get the best results?
● Where and how will you perform my procedure?
● What surgical technique is recommended for me?
● How long of a recovery period can I expect, and what kind of help will I need
during my recovery?
● What are the risks and complications associated with my procedure?
● How are complications handled?
● How can I expect to look over time? After pregnancy?
● What are my options if I am dissatisfied with the cosmetic outcome of my
procedure?
● Do you have before-and-after photos I can look at for this procedure and what
results are reasonable for me?

What are the risks of body contouring?

When deciding to undergo plastic surgery it is necessary to weigh the risks and
potential complications to your personal goals. Your physician will go over these risks in
detail and have you sign the proper consent. However, it is a great idea to have the best
understanding before speaking with a plastic surgeon. Body contouring risks can
include:
● Bleeding
● Infection
● Fluid accumulation
● Poor wound healing
● Skin loss
● Blood clots, deep vein thrombosis (DVT) and pulmonary embolism
● Excessive or widened scars
● Numbness or other changes in skin sensation
● Anesthesia risks
● Unfavorable scarring
● Residual skin laxity or contour irregularity

How to properly prepare for your body contouring procedure

Your plastic surgeon may ask you to prepare for your body contouring procedure days
before the actual procedure. It is essential to the success of your procedure that you
follow each step precisely. Your doctor may ask you to:
● Get cleared for surgery by your bariatric surgeon and/or primary care doctor

● Get specified pre-operative lab tests
● Take certain medications or adjust your current medications
● Stop smoking well in advance of surgery
● Avoid taking aspirin, anti-inflammatory drugs and herbal supplements or other
medications that may increase bleeding

Typically body contouring surgeries are performed in an accredited office-based
surgical facility6, licensed ambulatory surgical center or a hospital. If your body
contouring is performed on an outpatient basis, be sure to arrange for someone to drive
you to and from surgery and to stay with you for at least the first night following surgery.

What to expect after body contouring surgery and recovery

Following the procedure, your incisions will have dressings or bandages applied to aid
in infection control. Often, small tubes will be placed under the skin temporarily to drain
excess blood or fluid that may collect. Your surgeon will provide specific instructions on
how to care for the surgical sites. Your surgeon may prescribe topical and or oral
medications to aid in healing. Your surgeon will also go over any concerns to look for
regarding the incision sites or your overall health. You will also be expected to follow up
with your surgeon over the next few months to monitor your healing progression. Your
surgeon will expect the following of you while recovering at home:
● Avoid bending, straining or lifting for the specified time period
● If tightening of abdomen or thighs is involved your physician may instruct you to
avoid standing fully erect or stressing internal sutures as they heal.
● Surgical incisions should not be subjected to excessive force, motion, swelling or
abrasion while healing.
● It is important to be up and walking as soon as possible and drinking plenty of
water to minimize the risk of DVT (blood clots in legs)

How soon should I expect to see the results of body contouring?

Results can be seen almost immediately following your procedure in most cases.
However, other cases may need up to 2 years to see the final results. Be aware that
even with optimal results you will still have visible scarring. Body contouring is a long-
lasting procedure, provided you maintain a stable weight and a healthy lifestyle. It is
also natural to see a loss of firmness with age. While good results are expected from
your procedure, there is never any guarantee. Some people need multiple surgeries to
achieve their desired results. Always follow your physician’s instructions for after your
procedure to ensure the best possible results.

The post Body Contouring appeared first on Plastic Surgery Houston | Cosmetic Surgeon & Dermatologist.

Breast augmentation medically called “augmentation mammoplasty,” is a surgical operation performed to enlarge and improve the shape of a woman’s breasts. This plastic surgery is done for a number of reasons:

– To enhance the body contour of a woman when she feels that her breast size is too small, which can improve her self-image and self-confidence.

– To correct changes or loss in breast volume after pregnancy or nursing.

– To balance breast size (cup size) when one breast is smaller than the other and the woman wants to achieve breast symmetry.

– To restore breast texture and shape in cases of partial or total loss of breasts for various conditions like treated breast cancer, congenital defects of the chest wall, and others.

-To replace previous breast implants.

Who is the ideal candidate for breast augmentation?

Ideal candidates for breast augmentation are women with fully developed breasts (at least 18 years of age, according to the FDA) who are physically healthy and psycho-emotionally stable, and who have realistic expectations (and at least one of the conditions listed above). It’s important that the patient, after an explanation from her plastic surgeon, understands the limits and advantages provided by this plastic surgery.

When is breast augmentation contraindicated?

Breast augmentation is contraindicated in women with a diagnosis of breast cancer, or who are receiving treatment (like chemotherapy); however, this surgery may be performed after cancer has been cured. Patients with a diagnosis of pre-malignant breast diseases or mental illness, or who are currently pregnant or nursing, should also wait to undergo the surgery.

Patients who have conditions that interfere with blood clotting or wound healing, or who have a low blood supply to the breast as a consequence of previous surgeries or radiation, may be at greater risk of complications and poor surgical outcome.

No procedure in the filed of plastic surgery has been the subject of greater scrutiny or controversy than breast augmentation. It is estimated that more than 2 million American women (1% of the female adult population) have breast implants. Augmentation mammoplasty is among the most common cosmetic surgeries in the United States, ranking second. The annual amount of breast augmentations has grown quickly in the last years; it is believed that there has been a 676% increase from 1992 to 2004.

Breast augmentation costs can vary because of many factors, but its average cost is $3,708 (obtained from 2014 statistics from the American Society of Plastic Surgeons). The patient should consider that this average cost does not include extra fees, such as anesthesia, room facilities, and others. Also, most health insurance policies don’t cover plastic surgeries.

What is the general procedure?

During the first visit to the plastic surgeon, a complete medical record should be provided (including current and previous diseases and allergies), and the patient should discuss with the surgeon why she wants breast augmentation surgery, informing the surgeon of her expectations and the desired outcome.

In this particular case, the plastic surgeon should be made aware of the patient’s family history of breast cancer, and the results of any mammograms or previous biopsies. The surgeon will evaluate general health status and will examine and measure the breasts, including breast size and shape, conditions of the breast skin (like elasticity), and the shape, size, and placement of the nipples and areolas. The plastic surgeon will take photographs to compare with post-operation results. Surgery can last between 1 and 3 hours.

The patient should take blood tests, adjust current medications, stop smoking, and avoid taking aspirin and other anti-inflammatory drugs (to avoid bleeding) for two weeks or more before the surgery.

The doctor will recommend the best type of anesthesia for each patient. The method of implant selection and size and the surgical technique will depend on the patient’s preferences and anatomy, and the recommendations of the plastic surgeon. Patients with sagging skin or stretch marks in the breast may require additional procedures, like a breast lift; this procedure will improve the shape and position of the nipple-areola complex and remove all loose skin.

Incisions are made to keep scars as inconspicuous as possible. There are several types of incisions, but usually the plastic surgeon does them in the breast crest, around the areola, or even in the armpit. Each location has its advantages and disadvantages; it is selected according to the plastic surgeon’s experience and where the implant will be placed (sub-glandular, sub-pectoral, or “dual-plane” position).

– Inframammary (IFM): This type of incision is made under the breast, which allows full access to the breast tissue to place the breast implant devices. This incision is preferred for patients with a crease that may cover the scar, particularly when it is placed slightly above the crease on the breast surface; however, this approach may be suboptimal when the integrity of the inframammary crease ligament has been compromised. This is the incision recommended for inserting implants made of silicone gel because larger incisions are required for these implants.

– Periareolar: In this case an incision is made along the areolar periphery (around the medial-half or inferior-half of the areola’s circumference), and in general, provides excellent access to all portions of the breast, which facilitates review procedures. This incision is recommended when the plastic surgeon will perform a mastopexy (breast lift) and a mammoplasty procedure at the same time; aesthetically, it is preferred because it usually tends to heal with minimal scarring (approximately 5cm) and scars are less visible. Silicone-gel implants can be difficult to place with this incision because it is very short.

Furthermore, the periareolar incision produces a greater incidence of capsular contracture and severs the milk ducts and the nerves to the nipple, which causes functional problems postoperatively that impede breastfeeding.

– Transaxillary: This is a type of incision made in the axilla; after that, the plastic surgeon goes medially to get to the breast tissue, thus allowing the placement of implants without leaving visible scars upon the breast; however, asymmetry in the lower part of the breast is more frequent with this incision. The disadvantage of this type of incision is that during a surgical revision, an inframmamary or periareolar incision should be made, subsequently leaving two scars.

– Transumbilical: This type of incision is less common and consists of inserting the implant through an incision made in the navel (“transumbilical breast augmentation,” or TUBA), so the plastic surgeon should enlarge the incision superiorly to attain the breast tissue. This surgical approach enables placing the ammary implants without leaving visible scars in the breast, but it also makes the technique more difficult. This procedure is done without the visual assistance of the endoscope and is not appropriate for placing silicone gel implants due to potential damage in the elastomeric silicone shell.

– Transabdominal: This type of incision is very similar to the TUBA procedure mentioned above, but in this case, the patient undergoes a breast implant surgery and an abdominoplasty at the same time, so the plastic surgeon uses the same abdominal incisions.

Breast implants are manufactured in different shapes, sizes, and textured surfaces. The history of augmentation mammoplasty reflects the search for the ideal implantable material, commencing with 19th-century attempts to transplant lipomas into breast defects and followed by the modern era of polymer-based devices. The modern mammary prosthesis is actually a mixture of polymers comprised mainly of polydimethylsiloxane that can exist in the form of a solid, liquid, or gel.

Only 2 types of implants are approved by the FDA to be used for breast augmentation in the United States: saline-filled implants and silicone gel-filled implants.

– Saline-filled implants: This kind of implant has an outer shell of silicone but contains a saline solution. In some cases the implant is pre-filled, but sometimes the plastic surgeon must fill it during the operation. This implant provides a uniform shape, firmness, and feeling. The FDA approved them for use in women older than 18 years of age, and at any age if they are to be used for breast reconstruction surgery. If the implant leaks, it will collapse, and the saline solution will be absorbed and naturally expelled by the body.

– Silicone gel-filled implants: In this case the implant has a silicone outer shell and it too is filled with silicone gel, but the gel feels more similar to natural breast tissue. These are approved for use in women older than 22 years of age for breast augmentation, but in the case of breast reconstruction surgery, they may be used at any age. If the implant leaks, the gel may remain within the implant shell. A broken implant filled with silicone gel will not collapse. They are also recommended for subsequent surgeries; in other words, this kind of implant is used during revision surgeries to improve or correct any defect in the results of a previous surgery.

There are other types of breast implants, but they are not approved by the FDA in the United States. Breast implants are not lifetime devices, so it is likely that the patient will have to undergo surgery to remove or replace them.

If a patient does not want to use breast implants, there are more natural procedures available, such as fat transfer breast augmentation, which uses liposuction to take fat from other parts of the patient’s body and inject it into her breasts. This technique is the perfect option for women who desire a small increase in breast size and prefer more natural results.

Where is the breast implant inserted and placed?

After the incision, the plastic surgeon makes a pocket so that he can place the implant; it can be:

– Sub-glandular: In this technique, the implant is placed in the retro-mammary space (the space located between the pectoralis muscle and breast tissue), similar to the usual location of normal breast tissue, which helps to achieve a more natural result. In patients with a thin pectoral muscle, if the implant gets a ripple or wrinkle while it is inserted, it can be seen on the surface. Likewise, using this method has a higher rate of capsular contracture.

– Sub-fascial: In this case, the implant is placed under the pectoralis muscle; it is a modification of the sub-glandular position. Some surgeons report that the muscle provides more protection, according to the type of implant; this position makes it easier to maintain the implant where it was placed.

– Sub-pectoral (“dual-plane”): In this method, the implant is placed under the pectoralis muscle, and may be performed with a partial dissection of the sub-glandular tissue. When this method is performed, the upper part of the implant will be under the pectoralis muscle and the lower part of it under the glandular tissue.

– Sub-muscular: In this case, the implant is placed under the pectoralis muscle, but the plastic surgeon is careful to preserve the inferior insertion of it.

What should the patient do for postoperative care?

Immediately after surgery, the patient will be placed into a recovery area to be closely monitored. The breasts will be wrapped in gauze dressings and an elastic bandage or support bra which will minimize swelling, minimize movement of the breasts, and support the breasts as they heal. Generally, patients can go home after a few hours. Oral medications for pain (analgesics or painkillers) and antibiotics will be used immediately after surgery. Once the bandages are removed, a specialized surgical bra will need to be worn for several weeks. The patient will receive specific instructions about post-operative care and when to follow up with her plastic surgeon. The patient must be sure to follow all of the instructions carefully.

The patient should rest and should not drive for weeks. After a post-surgical period of 24 to 48 hours, the patient can experience soreness and swelling for weeks. Depending on the level of the woman’s daily physical activity, she may resume her normal activities one week after the procedure. Patients who underwent submuscular implantation usually have a longer postoperative convalescence period, and they also tend to experience more pain, due to the healing process of the muscles.

The patient should avoid strenuous physical activity for at least 6 weeks; during this time, surgical scars have usually completely healed.

If the plastic surgeon uses silicone gel-filled implants, it is recommended by the FDA to give an MRI screening, looking for silent rupture; this should be done 3 years after the surgery and at least every 2 years after that. Changes in the woman’s body—including pregnancy, weight loss, and menopause—can change the results of the surgery.

What are the risks of breast augmentation?

The most frequent complications and adverse outcomes experienced by breast implant patients include capsular contracture, a need of new surgeries, and, in other cases, implant removal (with or without replacement). The less frequent complications are implants breaking, leaking, or wrinkling, in addition to asymmetry, scarring, pain, bleeding, and infection. Patients can also present changes in nipple or breast sensation. In addition, women with breast implants may have a very low but still increased likelihood of being diagnosed with anaplastic large cell lymphoma (ALCL).

Dr. Amjadi MD, DDS, FACS

Certified by the American Board of Plastic Surgeons

915 Gessner Rd #870

Houston, TX 77024

713-465-6198

The post Breast Augmentation appeared first on Plastic Surgery Houston | Cosmetic Surgeon & Dermatologist.

As we get older, the skin suffers many changes, but one of the most common is the loss of its elasticity. One consequence of this is the change in the breast’s appearance; this, added to pregnancy, breastfeeding, weight fluctuations, gravity, and heritage, produces a drop of the breasts. Small breasts tend to maintain their shape; however, women with large breasts usually note important changes in their firmness and shape.

A breast lift, also called “mastopexy,” is a plastic surgery that allows the breasts to rise because the plastic surgeon eliminates excessive skin and reinforces the rest of the tissues in the chest, resulting in a more defined, firmer, and younger-looking breast. Additionally, with this surgery, the plastic surgeon may also repair enlarged areolas. Experts consider this surgery to be the best treatment for women who desire to correct droopy breasts, especially when the changes are just beginning. Likewise, this surgery is very common for women who want to recover their “pre-mom” bodies, which is why, in many cases, this procedure forms part of a “mommy makeover.” The patient can get a breast lift at any age, after her breasts have finished developing. She can also get the surgery before or after being pregnant; patients who undergo this procedure are able to breastfeed even after the surgery.

Breast lift surgery does not significantly change the size of the breast or round out the upper part. If a woman is considering a surgical breast lift, one way to determine whether or not it might help her is by putting a pencil under the breast and seeing if the position is held; if it is, a breast lift might be an option. Otherwise, if the patient wants her breasts to look fuller, she should consider a breast lift in combination with a breast augmentation; if, on the contrary, she desires smaller breasts, the patient should consider undergoing a breast lift and a breast reduction.

A breast lift is different from a breast reduction. During a breast reduction, the plastic surgeon can reduce large, heavy breasts and make them smaller; meanwhile, a breast lift surgery just returns the breasts to a youthful position on the chest. In fact, these procedures are often combined. A breast lift may also be combined with a breast augmentation; this elevates and enlarges the breast in the same procedure.

Statistics of the American Society of Plastic Surgeons report that breast lift procedures are increasing in frequency, surpassing breast implant surgeries. In 2013, more than 90,000 breast lift procedures were performed by ASPS surgeons.

What are the benefits of a breast lift?

– After the procedure, the patient will have firm and contoured breasts, with more projection and symmetry.

– The patient’s breasts will look more youthful.

– The patient will look better in and out of clothes.

– The patient will feel more self-confident.

What are the disadvantages of a breast lift?

– The effects of a breast lift might change over time from the effects of gravity and aging.

– This surgery leaves visible scars, but they will be hidden in a bra or swimsuit.

– If the patient gets pregnant again, the results of the surgery may change.

Who is an ideal breast lift candidate?

Patients who are physically healthy; usually maintain their weight; have a positive attitude and realistic expectations; feel their breasts are sagging and have less volume; feel their breasts have changed their shape or are becoming flat and more pendulous, but are adequate in size; think the nipples and areolas are at the breast crease (pointing downward); think the skin has stretched and the areolas have enlarged; and patients who think that the breasts are asymmetric (one breast may appear firm and well positioned while the other does not).

How much does a breast lift cost?

The average cost of a breast lift is $4,377, according to the American Society of Plastic Surgeons. However, breast lift surgery costs always vary. This cost mentioned above does not include extra fees like anesthesia, room facilities, and other expenses.

This surgery is usually considered a cosmetic surgery, so most health insurance plans will not cover the expenses unless they are done as part of a mastectomy reconstruction.
Likewise, if the patient desires other results and has decided to combine the mastopexy with another procedure, the cost is higher. For example, if the patient wants to add implants during the procedure, this may add approximately $1,000 to the final cost of the treatment. Again, however, prices will vary. (For example, silicone implants cost more than saline implants.)

What should a patient do before a breast lift surgery?

The first step is to select a qualified plastic surgeon. During the consultation, the patient should discuss all of her desires and worries with the physician. The physician will examine the patient’s body, and in most cases will ask for some lab tests to determine her general health condition. Likewise, it is important for the patient to be completely honest about her medical record (including current medication and allergies), especially any family history of breast cancer.

During the examination, the plastic surgeon should determine the patient’s skin elasticity on the breasts, and the location of her breasts on her chest. Likewise, the physician will assess the degree of sagging of the breasts, and the complex nipple-areola position. All this helps to decide the amount of skin and fat that should be removed.

During the consultation, the best surgical technique for the patient should also be decided according to her physical characteristics and desires (in this case, the plastic surgeon’s opinion is very important). The patient should communicate all her expectations and desires to the plastic surgeon, as good communication allows the patient to obtain the best results possible. At this point, the patient should decide if she wants to get breast implants as a complement to the surgery.

The patient should follow all of the plastic surgeon’s recommendations, especially if they ask them to get lab tests, take certain medications, or adjust her current medications. It is important for the patient to undergo a mammogram before and after the procedure, and to keep those scans as a baseline to help detect any future changes in her breast tissue. Also, she should stop smoking and avoid any medication that may cause bleeding.

What is the general procedure of a breast lift?

In most cases, the patient will be under general anesthesia; however, the plastic surgeon may choose local anesthesia with intravenous sedation as the best option for some patients. Once the operation has begun, the surgeon may decide to combine various techniques or change a technique to ensure the best result. The procedure takes about three hours.

The breast lift procedure can be performed through different incisions and techniques. The technique to be used in each case will be decided by the surgeon according to the breast size and shape, the size and position of the areolas, the degree of breast sagging, the skin characteristics and elasticity, and the amount of extra skin.

The most common incision in a breast lift surgery is one called an “anchor-shaped incision.” In this case, the plastic surgeon makes the incision around the areola, at its border, and then goes down vertically until reaching the breast’s crease; after that, a third incision is made along this natural curve. These three incisions leave permanent scars. However, this standard incision has been the most commonly used, and experts affirm that it reduces sagging, especially in the breast’s inferior half. Most women obtain excellent results with this method, but it is mostly recommended for women with smaller breasts.

Another type of incision is “donut mastopexy”—using this method, the plastic surgeon eliminates less skin than in the traditional one. With this technique, the patient has a shorter recovery time and will also have less scarring. When using this method, the plastic surgeon creates the incision in the border of the nipple-areola complex circumferentially. This incision removes less tissue. This technique is better for changing the shape and size of the areolas. In patients with big breasts, this technique is not recommended.

The third type of incision is the “lollipop breast lift” (or vertical mastopexy); it represents a middle ground between the two methods above. In this case, the plastic surgeon makes 2 incisions, one around the areola, and other vertically down to the breast crease. It is recommended for patients who desire a more discreet lift. The scar from this technique is less visible than the one produced with a traditional (anchor pattern) incision; however, in the case of a donut incision, the plastic surgeon has less opportunity to manipulate the tissues.

On the other hand, a laser bra breast lift represents a new technique used as an alternative to the traditional procedure. It is a good option with excellent and durable results to treat sagging breasts. When the plastic surgeon performs a traditional mastopexy, they can only eliminate the excessive skin, but with this technique, they may also add support to the inferior half of the treated breasts. This technique may be used in all women because it can treat the different sizes of breasts without a problem, so all women are good candidates.

If the patient wants to recover volume in her breasts using breast implants during mastopexy, the plastic surgeon can combine these procedures to restore firmness and volume during the same surgery. When these procedures are combined, the patient obtains impressive results.

Once the plastic surgeon has removed the excessive skin, they reposition the nipple-areola complex, putting it in a higher position. After that, the plastic surgeon pulls down the skin over the nipple, reshaping the breast.

Once the breasts have been reshaped and all the excessive skin is cut, the incisions are closed with sutures, skin adhesives, or surgical tapes, which tighten the remaining skin. The plastic surgeon will try to make the incisions in areas where they may be hidden by the natural breast contours, but in some cases, they cannot be hidden. Although scars are usually less visible with time, they are permanent.

What is the postoperative care for a breast lift patient?

Usually this procedure is an outpatient one, meaning that there’s no overnight stay. The patient will be taken into a recovery area where she will continue to be closely monitored.
Bandages and compression garments are used to help during the healing process. In most cases, a special bra is also indicated; these garments should be used for at least 1 week, as they help to reduce chest movements and maintain the shape of the operated breast.

Likewise, they help to reduce pain and discomfort and avoid letting the incisions open. In some cases, the surgeon leaves drains in the operated area to eliminate the remaining fluid and to speed the healing process.

The patient’s movements should be limited during the first postoperative day, so someone should take care of her. Likewise, the patient should take a rest from work (1 week minimum) without bending or lifting the arms; several days after surgery, the patient can restore movement until it is comfortable enough. The patient will have to avoid heavy lifting for at least 4 to 6 weeks after the surgery, so if she has young children, she may need to look for help.

Incisions will be red at first and normally stay this way for several months following surgery. After a breast lift surgery, the patient can usually go back to work within a month or less (depending on the nature of the work).

The recovery process for a breast lift may vary from patient to patient; however, there is not a specific period of time, as the recovery time will depend on the surgical method that was used, the healing ability of each patient, and the postoperative care. It is important to follow the plastic surgeon’s indications until the healing process is complete; this will prolong results and reduce the possibility of complications.

Dr. Amjadi MD, DDS, FACS

Certified by the American Board of Plastic Surgeons

915 Gessner Rd #870

Houston, TX 77024

713-465-6198

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