Breasts tend to droop with time and multiple births. If the nipple is above the crease of the breast, an implant is usually sufficient correction. When the nipple is at or below the crease of the breast, correction with an implant and a lift is necessary. Many women require a lift because they have gained weight, and weight reduction alone may correct the problem. If you can or intend to loose weight, this should be addressed before such breast surgery. Very large breasts can require incisons around the nipple and a T shaped scar after resecting skin. I like to avoid scars around the nipple and the T shaped scar using a procedure I have been doing since 1990. I have avoided such scar by using a lower breast or nipple incision to place an implant and then resect and shape the breast tissue inside through this small incision. This is not for everyone. It is wonderful not to have a scar around your nipple or in your cleavage if you are a candidate for this procedure.


Surgery time: 3 –4 hours

Preparation: If you are going to lose weight, do so before the surgery. This office will help you with that if it is necessary or desirable with instructions on diet and supplements. You want to prepare for surgery by avoiding anticoagulants and having a high protein diet for weeks before the surgery. You should be well rested. You need some one to take you to your first appointment since you can’t drive for the first five days after surgery. You may need some help with childcare in the first week or so.

Procedure: The result of breast lift with simultaneous augmentation is very satisfactory and lasts a very long time if you are weight stable. The presence of the implant provides shape and support to the breast at its upper quadrants. People requiring a breast lift are usually flat there and full at a level lower than they want to be. I avoid unpleasant scar by doing a technique I devised some time ago using a single incision either below or in the nipple (depending on the size of the breast) and doing the breast lift by moving breast tissue from the inside. Some sculpting is done with suction if necessary. By splinting the skin for 3 weeks I find the skin will contract and scars can be avoided. This is not suitable for every breast and some exceptionally large breasts cannot be done this way. Most breasts are suitable candidates for this procedure.

Care: You need to prepare for surgery in the usual way, which is avoiding anticoagulants, having a physical, and being weight stable. The surgery is done asleep, and pain is not generally a factor when you wake up. You need to be quiet for several days, propping your head on several pillows so you will not roll over onto your breasts. Five days after surgery you can drive. You need to leave your tape dressing on for three weeks even though you will be checked frequently. You need to shower around your dressings.

Results: This is a long lasting procedure. Textured gel implants tend to be long lasting and do not readily become firm (capsule). They have a natural feel. If your posture is good, your breasts will sit high on your chest and have little or no crease below the breast.

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