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Cosmetic Breast Surgery

We have the opportunity to consult with a great number of women who know that they want to improve the appearance of their breasts.  Most, however, are not quite sure what steps need to be taken to accomplish their goal.  The majority of these patients are interested in breast implants, which increase breast size, but do not necessarily improve sagginess.  In fact, this problem can be worsened by implant misuse.

Aesthetic breast surgery, like abdominal surgery, must be tailored to the specific woman, and occasionally, the specific breast, to be completely satisfying. Unstudied cookie-cutter approaches lead to poor results and patient dissatisfaction.

So, how is this avoided?  Be aware that no two breasts are exactly alike.  Arm yourself with some good knowledge before the consultation.  Check out reputable websites like the ASPS site.  Take a critical look at what it is that you find unsatisfactory and communicate this clearly to your consulting plastic surgeon.  Size and asymmetry are most easily corrected by addition of volume using a breast implant.  The best use of an implant alone is in a woman whose nipple has not dropped from its ideal location.  It is centrally located over a breast mound that is still on the chest wall.  It is my firm opinion that saline implants should be placed beneath the pectoralis muscle from a small incision in the breast crease. This approach obscures the aesthetic weakness in saline implants--- the ripple.  Since all currently used saline implants have this problem, the device is best camouflaged beneath the muscle.

That brings us to the problem of the droopy breast.    Asymmetrical post childbirth sag is a frequent issue for cosmetic breast surgeons.  Add to this, young women with tubular breast deformities, and you have the majority of women who require some type of breast lift or---mastopexy.  I would personally never recommend implant placement directly beneath the breast tissue to correct sag.  First of all, this leads to an overtly visible implant.  Secondly, the chosen implant is typically too large and worsens the sag over time.  --Poor judgment-- 

Rather, the answer lies in a variety of reconstructive maneuvers which tighten the breast alone or tighten the breast around an appropriately sized implant.  Application of the appropriate technique requires experience. It is easier to just stick in a large sized implant, but the deformity produced by this cavalier approach is difficult to correct in the future.

Mastopexies can include incisions just around the areola or in the shape of a lollypop or anchor.  These scars are well tolerated and difficult to spot; but, more importantly, recreate a natural youthful appearance to the breast.

Aesthetic breast surgery is performed using a sedative anesthetic as an outpatient.  I always tell my patients that the first three days hurt, but this is well managed by oral pain medications.  The mastopexy adds time to your implant augmentation procedure, but not to the period of recovery. Aesthetic breast surgery is often combined with other body contouring procedures such as liposuction and abdominoplasty.  Facial cosmetic surgery can also be performed at the same anesthetic time.