Breast Lift (Mastopexy with Implant):
Women are candidates for breast lifts if their breast gland is too low on the chest, if the gland folds over and rests
on the chest, or if the nipples are too low. The addition of an implant is
indicated when more upper breast fullness, or a larger cup size is desired. This
is a valuable procedure in breast augmentation revisions.
Child bearing
with or without breast feeding is the most common cause for these changes in
breast shape, however weight loss, genetic "soft collagen" and advancing age can
all cause or contribute to breast sagging. It is not unusual for women in their
20's to need lifts or implants. Depending on the type of implant (saline or
silicone) and thickness of breast tissue, the implant may be on top or
underneath the chest muscle, but usually underneath.
Dr. Gordon will
discuss the variety of surgical procedures, depending upon what changes are
desired. Prior to surgery, pre-medication to relax the patient is administered
and breasts are carefully marked to indicate where the incisions are to be made
and the correct placement of the implant. Regardless of the type of lift
selected, our patients have the option of choosing saline implants or silicone
gel.
When a woman has breasts which are shaped like sweet potatoes
(tubers) this condition is termed tuberous breasts and is sometimes treated by a
type of lift, which circles the areola and is termed a circumareola lift. A
circumareola lift is also good for the treatment of large areolas, mild forms of
nipple asymmetry. Added implants enhance lift results.
In cases in which there is good nipple position
on the breast mound but poor gland position, then a lift of the gland without
disturbing the nipple position can be done using a vertical incision, which
passes between the bottom edge of the areola and the inframammary fold. We call
this lift an abbreviated vertical scar mastopexy (AVSM). Cup size is increased
with implants.
In the typical advanced cases of nipple and gland
malposition we need to lift both the nipple and the gland. The incision circles
the areola, (often reducing the areola to a more appropriate size) and continues
down to the inframammary fold. We call this lift a vertical scar mastopexy or
VSM lift. This is the most common lift we do and in our hands provides the best
results for the common varieties of breast and nipple sagging. Most of the time
we simultaneously add implants.
Dr. Gordon has a special interest in
cosmetic breast surgery and has made significant progress in bringing the
combined augmentation/lift procedure to its current level. We are now working to
improve the results with patients who have drastic differences in breast size
and shape with some very encouraging results. In most cases of breast lift with
augmentation Dr. Gordon prefers to do both procedures
simultaneous.
BEFORE SURGERY
Prior to surgery, a complete
medical history is taken in order to evaluate the general health of the patient.
Dr. Gordon will do a thorough examination of the entire patient as well as the
breast to determine the most effective surgical approach. He will describe the
type of anesthesia to be used, the procedure, what results might realistically
be expected, and the possible risks and complications. Mammograms or
x-rays may be taken as well as digital photography.
FOLLOWING
SURGERY
After surgery, the patient may temporarily have a drain and will
need to wear an absorbent pad over the stitches for a day or two. A bra should
be worn to aid in breast shaping.
Pain connected with the procedure is
significant but is controlled with oral medication. Daily showers and
antibiotics will be continued to prevent infection. Instructions for the day of
surgery include bed rest and limited activities. Dr. Gordon will determine when
normal activities can be resumed; however, weight training and aerobic exercise
must be avoided for two weeks.
Sutures, if necessary (most cases use
dissolvable sutures), are removed in about two to three weeks at which time Dr.
Gordon may recommend massage to keep the breast supple. Numbness around the
treated area may occur, but this condition is usually temporary. Swelling and
discoloration disappear in a few days, and scars from incisions, although
permanent, fade significantly with time.
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