Improving Self Image
Breast augmentation is the second-most common operation performed in plastic surgery. For good reason– breasts have a strong association with femininity, and deflation or lack of development can have a strongly negative impact on how a woman feels about herself.
Most of the time, breast implants fix concerns very efficiently, pleasantly enhancing shape and improving volume . However, sometimes an implant just isn’t enough.
The Problem
Breast implants are excellent devices, the most studied medical devices in the world. Some version of silicone implants has been around for more than 60 years. To put this into perspective, liposuction didn’t come around until 1980. Implants have been proven to be safe and have undergone several iterations of improvement. However, even the best tools have limitations.
With breasts, the limitation comes in the form of ptosis, or droopiness. Ptosis is graded based on where the nipple sits in relation to the fold under the breasts. If the fold is drawn onto the front of the breasts, the nipple is expected to be above this line. If the nipple is at or below the line, there is droopiness present.
Ptotic breasts do not typically look great if breast augmentation alone. Patients will commonly show “waterfall deformity,” where breast skin hangs off of the front of an implant like a waterfall cascading over rocks. Breasts appear elongated as a result. Placing implants on top of the muscle (a discussion for another post) can make this deformity less obvious, but only because subglandular implants often sit lower than optimal, camouflaging the deformity. In other words, trading one problem for another.
The Solution
Rather than trade one problem for another, a better approach is to place implants into the best position and fix tissue shape as well. Therefore, the mastopexy-augmentation, or breast lift with implants. This operation is best viewed as a form of body contouring surgery, trading scars for a better appearance. In my practice, scars are minimized as much as possible.
I prefer to use a circumvertical technique for repairing breast droopiness. This version of the operation has two major benefits. Importantly, this technique uses breast tissue to make the shape of the breast, rather than some other techniques, that use skin to hold shape. Skin has a covering function rather than a supportive function, and using skin to hold tension doesn’t end up looking as good as a better support structure with the body’s own scaffolding.
The second benefit of this approach is a minimization of scars compared with other versions while maximizing effectiveness. Incisions are closed with dissolvable stitches under the surface of the skin to minimize scar appearance.
The Catch
Combining a breast lift and implant placement is convenient as it minimizes the number of anesthetic episodes and recovery time. The tradeoff is that the two operations compete with each other to some degree– implants expand, a lift tightens; implants add to breast mass, a lift attempts to defy gravity.
Although need for revision is uncommon, a combination operation carries a higher risk compared with performing th operations independently. This usually involves recurrence of droopiness (normally this takes about 10-15 years to happen) or implants not staying in the correct position. Scars may widen, but this is relatively uncommon and usually easy to correct.
The Consult
To see if breast augmentation or a breast lift with implants is best for you, please call or contact us today. I am happy to answer any question that you may have!