A breast reduction typically includes a lift. However, a lift does not necessarily require a reduction. Both operations have similar incision patterns and resultant scars, but they have different indications. One of the first questions I ask a patient who desires an improved appearance of her breasts is if she would like to be the same size, smaller, or larger. The patient who wants to be the same size and is happy with her breasts when wearing a bra but unhappy with the amount of sagging without a bra is a candidate for a breast lift alone. The patient who desires to be smaller or has one breast noticeably larger than the other, is a candidate for a breast reduction-lift combination. Sometimes patients feel their breasts look smaller after removal of the excess skin with the lift even though no breast tissue was removed; the reason for this is that some of what fills your bra cup is excess skin. The patient with sagging who desires to have larger breasts is a candidate for a breast lift with implants.
The study Safety and Effectiveness of Mentor’s MemoryGel Implants at 6 Years (2009), which was a branch study of the U.S. FDA's core clinical trials for primary breast augmentation surgery patients, reported low device-rupture rates of 1.1 per cent at 6-years post-implantation. The first series of MRI evaluations of the silicone breast implants with thick filler-gel reported a device-rupture rate of 1 percent, or less, at the median 6-year device-age. Statistically, the manual examination (palpation) of the woman is inadequate for accurately evaluating if a breast implant has ruptured. The study, The Diagnosis of Silicone Breast implant Rupture: Clinical Findings Compared with Findings at Magnetic Resonance Imaging (2005), reported that, in asymptomatic patients, only 30 per cent of the ruptured breast implants are accurately palpated and detected by an experienced plastic surgeon, whereas MRI examinations accurately detected 86 per cent of breast implant ruptures. Therefore, the U.S. FDA recommended scheduled MRI examinations, as silent-rupture screenings, beginning at the 3-year-mark post-implantation, and then every two years, thereafter. Nonetheless, beyond the U.S., the medical establishments of other nations have not endorsed routine MRI screening, and, in its stead, proposed that such a radiologic examination be reserved for two purposes: (i) for the woman with a suspected breast implant rupture; and (ii) for the confirmation of mammographic and ultrasonic studies that indicate the presence of a ruptured breast implant.
Cosmetic surgeons may use the “crescent lift” technique for women who have a very small amount of sagging to correct. This involves a small incision running halfway around the top half of the edge of the areola. Usually, a crescent lift is only done when a patient is also having breast augmentation, and even in these cases the crescent incision type is less frequently used.
For breast augmentation or breast enlargement procedure, our surgical specialists are able to custom design the look that each client desires in terms of the shape and size of the breast implants as well as the resulting, enhanced look. They also take into account the body structure of the client in order to further ensure that the client will be most pleased with the outcome of breast augmentation surgery. Dr. Ortega and our team of plastic surgeons provides a comprehensive, inclusive, procedural experience that begins with a personal, confidential consultation and continues through the client’s post-surgical period of convalescence.
Meeting with multiple prospective surgeons is also a great way to make your choice. Make sure you are comfortable speaking to the surgeon, and make sure he or she asks you plenty of questions, and does not rush you through any part of the consultation. After you have fully described your goals, the surgeon should provide you with informative, thoroughly explained options.
Implants come in various sizes, and your surgeon will guide you on choosing the right size to help you achieve the look you desire. In addition, your surgeon will help you decide whether you want a more natural, teardrop shape or a more rounded look. Implants also come with either smooth our textured shell surfaces, and your surgeon will help you decide which is best for you.
Many different types of breast lifts are now available in conjunction with a breast reduction, including lifts just around the areola (periareolar), vertical/lollipop mastopexies (incision around the areola and down to the breast fold, and full breast lifts with an anchor incision. For patients who have very loose skin in the armpit or back, axillary or bra lifts are also often combined with breast reductions.
You won’t be feeling 100 percent after that week, but you’ll be in good-enough shape to head back to the office if your job doesn’t require manual labor. However, if the implant is placed behind the muscle instead of on top (many women choose to do this for a more realistic look and less chance of a scar shell forming around the implant), recovery will be a little harder and you might be sore longer.
The ARTOURA™ Breast Tissue Expander or CONTOUR PROFILE® Breast Tissue Expander can be utilized for breast reconstruction after mastectomy, correction of an underdeveloped breast, scar revision, and tissue defect procedures. The expander is intended for temporary subcutaneous or submuscular implantation and is not intended for use beyond six months. Do not use the ARTOURA Tissue Expander nor CONTOUR PROFILE® Tissue Expander in patients where an MRI may be needed. The device could be moved by the MRI causing pain or displacement, potentially resulting in a revision surgery. The incidence of extrusion of the expander has been shown to increase when the expander has been placed in injured areas.
According to Melissa Doft, MD, FACS, surgery will sometimes be covered when correcting severe asymmetry due to developmental deformity or reconstruction after mastectomy or lumpectomy. For breast reductions, Rady Rahban, MD, FACS, adds that insurance will sometimes pay if the breasts are so large they create symptoms of back pain, neck pain, or rashes under the breast or if surgery is otherwise medically necessary.
Structured implants were approved by the FDA and Health Canada in 2014 as a third form of breast implant. Structured implants incorporate both saline and silicone gel implant technology. The filler is only saline solution in case of rupture and has a natural feel like silicone gel implants. The implant uses an internal structure which consists of a series of nested shells that support the upper pole with the two lumen being filled with only saline. The implant is inserted empty and then filled once in place which requires less of an incision than pre-filled implants. If one of the lumen of the structured implant ruptures, it leaks and empties. The other lumen remain intact and the implant only partially deflates, allowing for ease of explant and replacement.
Subpectoral (dual plane): the breast implant is emplaced beneath the pectoralis major muscle, after the surgeon releases the inferior muscular attachments, with or without partial dissection of the subglandular plane. Resultantly, the upper pole of the implant is partially beneath the pectoralis major muscle, while the lower pole of the implant is in the subglandular plane. This implantation technique achieves maximal coverage of the upper pole of the implant, whilst allowing the expansion of the implant's lower pole; however, “animation deformity”, the movement of the implants in the subpectoral plane can be excessive for some patients.
A lot of patients are concerned over whether or not breast implants are safe. The answer to this is yes. To date there has never been a single study performed anywhere in the world that says that breast implants are dangerous or increase your risk of either breast cancer or any other systemic diseases. Furthermore, the new implants whether saline or silicone are manufactured much better than they used to be 10 or 15 years ago which not only makes them safer but has extended their lifetime use. Even the silicone envelope that encompasses the material inside, whether saline or silicone, is much more durable than in the past. If you do chose to go with silicone implants, even in the case of a rupture, the silicone does not leak to a distant site or go into your bloodstream.
Many patients have concerns that after getting breast implants it may result in less accurate testing for breast cancer, but this is not something they need to worry about. This is a very valid concern but having implants will not make your mammograms less effective. As the rate of women with breast implants has increased, so has the knowledge of the radiologists and technicians, and they have become very adept at performing mammograms on women with implants. During the test and the test films produced, the implants will not obscure or hide any suspicious lesions or growths, but rather appear as a fain shadow. Any experienced radiologist will not have difficulty in viewing and/or diagnosing any suspicious lesions or detecting any breast cancer in a patient that has implants.
Body type is a major factor you need to consider before going for breast augmentation. The wrong size of breasts for a particular body type can create many complications like neck and back pain. If your body is small in size and your bone structure is thin, don’t go for huge sized implants. Opt for the size that will make your body look proportional. Similarly if you have a heavy body, you might have to go for larger breast implants.
Saline filled breast implants consist of a silicone elastomer (rubber) shell that is filled with a sterile saline solution at the time of surgery. Saline breast implants come in a wide range of sizes and are available with both moderate and high profiles (the amount of projection of the breast silhouette). Most women choose round implants, but contoured, or shaped, styles are also available and may be recommended for women with smaller breasts. Contoured implants are made with a textured surface designed to keep them from turning and losing their shape. A new style of round implant is Mentor's post-operatively adjustable implants, which can be adjusted in size up to 6 months after surgery.
Do not consume any alcoholic drinks (including beer and wine) for 48 hours after surgery. In addition, do not have any alcoholic drinks while you are taking the prescription pain pills. The alcohol can interact with these medicines and lead to serious health problems and death. Finally, drink alcohol in moderation for three weeks. Excessive consumption can lead to a fall that could ruin the results of the surgery.
The FDA has identified that breast implants may be associated with a rare form of cancer called anaplastic large-cell lymphoma, believed to be associated with chronic bacterial inflammation. Similar ALCL phenomena have been seen with other types of medical implants including vascular access ports, orthopedic hip implants, and jaw (TMJ) implants. As of February 1, 2017, the FDA has received a total of 359 medical device reports of breast-implant-associated ALCL (BIALCL), including 9 deaths. Most cases of breast implant-associated ALCL had implants in for many years prior to the condition, and are usually treated successfully by simple removal of the implant and the capsule surrounding the implant without the need for chemotherapy if no evidence of systemic disease exists. If women with implants present with delayed swelling or fluid collection, cytologic studies and test for a marker "CD30" are suggested. The American Society of Plastic Surgery (ASPS) states, "CD30 is the main diagnostic test that must be performed on the seroma fluid as routine pathology or H&E staining can frequently miss the diagnosis."  Diagnosis and treatment of breast implant associated ALCL now follows standardized guidelines established by the National Comprehensive Cancer Network.