Breast Augmentation Mastopexy
Breast augmentation and mastopexy are two separate surgical procedures often performed concurrently to enlarge the size of the breasts, alter their shape, and lift them higher on the chest. A mastopexy, more commonly called a breast lift, is designed to lift the breast and correct sagging while improving overall shape. When combined with a breast augmentation, the result is full and youthful breasts with an attractive shape.
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Who Can Benefit From Breast Augmentation/Mastopexy?
If you are dissatisfied with the size of your breasts and your breasts have sagged, you may be a good candidate for breast augmentation and mastopexy. If your breasts do not match, have lost firmness, or if they have changed and become pendulous as a result of pregnancy or weight loss, breast augmentation and mastopexy may greatly improve their appearance. Breast augmentation involves inserting saline implants inside the breasts and can not only make breasts larger and fuller but can make them more symmetrical and in better proportion with the rest of your body, while mastopexy can remove excess breast skin, raise the level of the nipples, and improve the shape of the breasts.
What is the Procedure Like?
Most of the time, breast augmentation and mastopexy are performed in the doctor's office on an outpatient basis, but sometimes, they are performed in a hospital. The surgery is performed under general anesthesia to ensure your maximum comfort and safety. A local anesthetic is used to numb the breast area to relieve pain after surgery.
Based on your specific anatomy and what you want to accomplish, the doctor will determine the ideal size and shape for your implants. Saline implants are filled after they are inserted into the breasts, while silicone implants are pre-filled. Once the implants are in place, the breast lift is performed. During mastopexy, the doctor moves the nipple to a higher position, but the tissue beneath the nipple is moved with it so that sensitivity will not be lost. Any excess breast skin is removed, and the breast is given a more pleasing shape in a higher position.
The operation may take two to five hours. Since each patient is different, the scarring varies from person to person. Dr. Rubinstein approaches each case with the goal of having the least scarring possible. In many cases, the only scarring left is hidden around the edge of the areola.
In some cases, the doctor may ask you to spend the first night after surgery under observation (either in the office or in the hospital.) In the majority of cases, however, you will be allowed to go home within a few hours. The doctor will apply dressings to the breast area and wrap your chest with ace bandages. You may choose to wear a surgical bra (with no underwire) after this dressing is removed.
What Can I Expect During Recovery?
You will need someone to drive you home, and you will need help around the house for a couple of days. After that, you should feel well enough to take care of your daily household tasks. You will be allowed to shower immediately after surgery, but you may require some assistance. You will probably have to wear a support bra for a period of time for your maximum comfort. Stitches will dissolve on their own in most cases, and in rare cases, a drain may be used for a few days to collect excess fluids.
You can expect some swelling and bruising after surgery, but this should clear up within a month at the longest. This may delay your ability to see how your breasts will ultimately look, however. The doctor will give you a prescription for pain medication for any post-surgical soreness that you may experience. Scarring improves over time.
You will need to refrain from vigorous exercise and avoid bending or lifting for a period of time, and you may need to sleep only on your back for a few weeks. You should be able to return to work within a week or two of surgery. Gentle sexual activity is usually okay after about two weeks, but your breasts may remain somewhat tender for a month after surgery. You may experience some temporary loss or gain of sensation, which should resolve over time.
What Are the Risks of Breast Augmentation/Mastopexy?
Breast augmentation and mastopexy are both very safe, and complications are rare. Both silicone and saline filled implants may be used. Dr. Rubinstein can help guide you in choosing the best type of implant for your goals.
One unusual complication is excess scar tissue which makes the breast feel hard. The scar tissue can be treated but may have to be corrected with subsequent surgery. No patient begins with perfectly symmetrical breasts. The doctor strives for a result that will correct the natural pre-existing differences from one breast to the other. In rare cases, asymmetries may remain, which may be improved with further procedures. Nipple sensation is generally not changed as a result of these procedures, but there may be a temporary increase or decrease in sensation. Rarely are these changes permanent.
Mammograms may be performed and read using special techniques after you have had breast augmentation surgery. Breast augmentation has not been shown to increase the risk of or delay the diagnosis of breast cancer. Dr. Rubinstein requires a mammogram prior to your breast augmentation surgery as a baseline so that subsequent mammograms can be compared to it.
If you plan to lose a substantial amount of weight, you should postpone breast surgery until after you have reached your goal weight. Breast surgeries do not affect pregnancy or breast feeding, but pregnancy may cause additional sagging.
Breast implants may not last forever, and trauma to the chest can cause an implant to rupture, although ruptures also occur in rare instances for no apparent reason. If this happens, the saline is absorbed safely into the body, but the implant will have to be replaced, requiring another operation. In many instances, the manufacturer of the implant will provide financial assistance for the replacement of the implants.
Some women have reported immune disorders following the insertion of breast implants, but these disorders also occur in women who have not had implants. This has been studied extensively both in the United States and internationally, and to date, no studies have shown a correlation between breast implants and immune disorders.
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