Procedures::Breast
Breast Lift – Breast Reconstruction
The shape of the breast is determined by the consistency of the breast tissue and the skin tension. This can change with time, breastfeeding or weight loss. In some people, the breast tends to sag without any reason. Many times after pregnancy, the breast loses volume and becomes hollow on the upper pole, however, the nipple is still above the infra-mammary fold. This condition is called pseudo ptosis and can be corrected with a breast implant, which reestablishes the volume.
Breast lift (ptosis correction or mastopexy) is done by reducing the excess skin of the breast. In mild cases, this can be done by removing skin around the areola. This is called the periareolar or doughnut mastopexy. This was first described by a French plastic surgeon by the name of Benelli, therefore it is also referred to as the Benelli lift. I like this operation because it produces the least amount of scars, but it’s only OK for mild cases of ptosis; otherwise the results are not stable over time and stretching of the areola can be a problem. This operation, like other mastopexy procedures, can be combined with an augmentation.
The next and one of the most common mastopexy procedures is the vertical or lollipop mastopexy. This is done for moderate cases of ptosis. The scar is around the areola and extends from the areola to the infra-mammary fold, giving the scar the shape of a lollipop. For more severe cases of ptosis, the standard inverted T shape pattern is the best, because it allows for the most control of the breast shape. I vary the procedure depending on the patient’s needs. One procedure can never be applied to all patients.
Mastopexy and augmentation is often combined to give the breast better volume and provide better upper pole fullness. Under the heading of breast photos, I am showing examples of all these procedures.
The recovery for mastopexy is a lot easier than augmentation, because the procedure is less painful. The most significant problem with breast lift is the associated scars, which, depending on the patient’s healing characteristics, can be significant. Recurrence of ptosis is another problem.
Breast Reduction
This is a variation of mastopexy, when breast tissue is removed. The same patterns can be used as in mastopexy. Most often, we use the vertical or the inverted T pattern. In large breasted individuals, several pounds could be removed from each breast.
Patient with large breasts usually have problems with their back and shoulders. In these cases, the insurance may cover the cost of the operation. During a breast reduction, one has to move the nipple to a new position, which can lessen the nipple sensation. All of these breast operations can be done as an outpatient procedure.
Postoperative bleeding is the most common immediate complication. A suction drain is usually used and removed the day after surgery.
