These 2 forces are counteracting each other. Breast lifting involves removal of skin ( and tightening of the breast skin envelope) while breast augmentation involves expansion of the breast skin envelope. The use of the tailor tacking technique is very helpful. This technique involves use of a temporary sizer and temporary “closure” of the overlying breast skin over the sizer. I use a “tailor tacking” technique that allows a determination of what breast implant should be used to SAFELY produce the results the patient is looking for. Generally speaking, making sure that the breast implant has some sub muscular and some sub glandular component ( dual plane) and tailoring the overlying skin/subcutaneous tissue/breast tissue as precisely as possible over the underlying breast implant is key.ĭespite these efforts, breast implants are after all a foreign body that don't necessarily stay where we wish they would therefore, breast implant related problems such as positioning ( too high, too low, lateral displacement etc.) can occur and may be a reason for returning to the operating room for revisionary breast surgery. Essentially, we are trying to create a breast implant/breast tissue interface that feels and behaves as naturally ( as a single unit) as possible. To achieve a surgical result where the breast implant and breast tissue “come together” and behave like a single breast is one of my goals but can be difficult to achieve. The analogy I use in my practice is that of a thinned out balloon, being expanded with additional air I hope that this analogy helps patients understand some of the issues at hand when performing the combination breast augmentation/lifing operation. Remember also that patients presenting for breast lifting surgery and general have lost some skin elasticity/thickness making potential incision line healing problems and/or recurrent drooping/sagging important concerns to communicate. Removing too much skin/ breast tissue is problematic removing too little breast skin/tissue can also be problematic. These two “forces” must be balanced as perfectly as possible in order to achieve the desired results. On the one hand, when performing breast augmentation/lifting surgery we are increasing the breast size with breast implants on the other hand, we are reducing the breast “envelope” in order to achieve the breast lift. Personally, I find that the breast augmentation/lifting procedure to be one of the most challenging of the breast operations I perform, even compared to somewhat complex revisionary breast surgery. I would say that, in most communities, anesthesia and surgery facility fees (minimally) are patient responsibility, when returning to the operating room for revisionary breast surgery. Patients should be aware of this higher revisionary rate obviously, the need for additional surgery, time off work/life considerations, and additional expenses our “factors” that should be considered before undergoing the initial operation. This revisionary rate may be as high (or higher) than 20%. Furthermore, the potential need for revisionary surgery is increased with breast augmentation / mastopexy surgery done at the same time. In other words, the combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. Some general thoughts regarding this combination procedure may be helpful to you: Based on your description, depending on exactly how much “sagging” is present, you may benefit from breast lifting and/or breast augmentation surgery. Unfortunately, your photographs are not present you may wish to repost them for more specific advice.
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