Breast Lift and Different Degrees of Ptosis (Sagging)

Because of the different degrees of breast sagging, plastic surgeons are using various types of mastopexy or what is more commonly referred to as breast lift.  In this way, they can address the problem using the shortest incisions possible.

Most doctors categorize breast sagging in three types: ptosis, empty sac syndrome, and pseudoptosis.

* Ptosis

This is the only condition that warrants breast lift surgery.  This happens when the breasts droop far enough that the nipple is at the same level or has even sagged below the breast crease.  Usually, this is often associated with the lack of volume in the upper poles and cleavage that the bosoms appear elongated.

Ptosis comes in three categories: mild ptosis in which the nipple has dropped to the level of the breast fold; moderate ptosis in which the nipple has dropped beyond the level of breast crease; and advanced ptosis in which the nipple is pointing toward the floor.

Advanced ptosis is often treated with full mastopexy, which is also known as an inverted-T or anchor lift due to the shape of its incisions.  Plastic surgeons create an excision that starts at the base of areola and travels to the breast crease, and then cut out a crescent-shaped amount of skin along the breast crease.

Full mastopexy also involves repositioning the areola complex so it sits in a more youthful position.

On the other hand, mild and moderate ptosis can be corrected with less invasive forms of mastopexy.  For those who need the least amount of correction, the Benelli or donut breast lift is often enough to address the sagging by simply making an incision around the areola complex.

But for those who need a little more correction, the lollipop breast lift or vertical mastopexy is a good option.  This technique involves an incision around the areola and another one that travels to the nipple down to the breast crease, resulting to a lollipop-shaped scar.

* Empty Sac Syndrome

This condition can be treated with breast augmentation surgery alone since the areola and nipple have not yet fallen at the same level or beyond the breast crease.  Implants are enough restore the lost volume associated with aging and pregnancy.

* Pseudoptosis

This condition, like the empty sac syndrome, is best suited for breast augmentation rather than breast lift.  Women with pseudoptosis have breasts that have fullness below the nipple but the upper portion appears somewhat “deflated.”

Round Breast Implant and Its Benefits

In terms of shape, breast implants are available in two kinds: round and anatomical (or sometimes referred to as teardrop).  Patients should remember that the implant’s contour has a significant impact on the final result of their breast augmentation surgery.

To date, round implants are more commonly used than the anatomical versions because they come cheaper and are believed to last longer.  But still, the best option largely depends on the patients’ goals and expectations and certain features of the body.

However, anatomical implants are still popularly used on women who had mastectomy or cancer surgery, though plastic surgeons have started using them for cosmetic breast augmentation after realizing that they provide great aesthetic results.

But nowadays, round implants are more preferred by many doctors because they have a lower risk of implant wrinkling since they often come in smooth surface, which cannot pull the tissue.  By contrast, teardrop implants are always available in textured exterior because they are not supposed to rotate inside the breast pocket.

The anatomical implant’s textured surface will prevent it to flip over, which if occurs can lead to visible distortion.  But studies have suggested that this particular design can lead to higher risk of visible rippling, especially for implants that have large “graininess.”

The risk of visible and palpable rippling is particularly a concern for women with limited fat and tissue on their breasts.  For this reason, most plastic surgeons do not recommend teardrop implants for patients with little tissue coverage.

While round implant has all its sides equal, it does not mean the result is always a dome-shaped breast that looks unnatural.  Contrary to popular belief, its shape can still lead to natural appearance with a proper implant placement.

In fact, round implants can turn into a teardrop shape if held on one side and left suspended.

Another advantage of round implant over teardrop is that it comes at a lower price.  In addition, several studies suggested that it often lasts longer particularly those with smooth surface.

Because round smooth implants do not pull the tissue, they are less likely to wrinkle—one of the factors that can weaken the implant shell.

Also, patients who will choose round implants can either use saline (salt and water solution) or silicone filler.  By contrast, anatomical implants are only filled with saline because a cohesive gel like the silicone cannot be used.

Currently, silicone-filled implants are more popular than saline version because they provide a more natural result; this is not surprising because silicone gel is designed to mimic the suppleness of the breast tissue.

                                                  

Can Herbal Supplements Affect My Healing After Plastic Surgery?

Can herbal supplements such as green tea and ginko biloba have a negative effect on my body’s healing ability after plastic surgery?  For this question, the answer is YES.  Even if the package says “all natural ingredients,” it does not always mean that they would not cause some kind of harm.

While taking herbal supplements has its own advantages, this is not the case if you will undergo plastic surgery or any kind of operation.  This is because some of the ingredients used have been known to affect healing and natural blood clothing, thereby increasing your risk of skin necrosis (or gangrene), infection, and increased bleeding during and after surgery.

These are just some of the most commonly used herbal supplements you must avoid at least two weeks before and after your plastic surgery (e.g., breast augmentation, liposuction, facelift, body lift, etc.). 

·         Ephedra

Ephedra is often used in treatments for a wide range of respiratory problems such as asthma and bronchitis, although certain weight loss medications and “energy” supplements also contain this ingredient.

However, the US Food and Drug Administration has banned the ingredient after studies have suggested it can raise the blood pressure and heart rate, something which may lead to heart attack and stroke.

·         Chondroitin

As a treatment for people suffering from osteoarthritis, Chondroitin has been found to increase bleeding during surgery and delay one’s recovery.  Its effect can be further aggravated if you are taking other blood-thinning medications such aspirin and all types of non-steroidal anti-inflammatory drugs (e.g., ibuprofen and naproxen).

·         Glucosamine

The effects of this agent are the same as the insulin, thereby increasing your risk of hypoglycemia during surgery.  This complication happens when your blood sugar drops to a dangerous level. 

·         Echinacea

Commonly used for the treatment of bacterial, fungal, and viral infection caused by ulcers, arthritis, and chronic wound.  But studies suggested that this ingredient can suppress your body’s immune system, leading to delayed healing.

Just to be on the safe side, you should tell your plastic surgeon all about your current medications and herbal supplements during consultation.  Take note that even those which contain garlic, ginseng, gingko biloba, and other seemingly harmless, everyday ingredients can affect your healing ability.

In case that you are taking these herbal supplements and certain medications that can affect your healing, your plastic surgeon will ask you to stop these at least two weeks before surgery.

Are You a Good Candidate for Breast Reduction Surgery?

While breast augmentation aims to increase the bust size, the goal of breast reduction surgery is the total opposite.  This procedure typically involves extensive incisions to remove a certain amount of tissue, fats, and skin, which in turn can lessen the size of the female chest.

Breast reduction surgery is particularly ideal if you are suffering from chronic back pain, limited movement because of the extra weight of your bust, non-healing irritation in the cleavage and along the crease, and shoulder strain, just to name a few.  However, you may also have the procedure even without these symptoms if you like to improve your figure.

But as with any major surgery, you must be in good health as it requires several weeks of recovery.  It simply means that you must not be suffering from serious medical conditions that may delay your recovery or result to undue risks.

You are not a good candidate particularly if you have wound healing disorders, diabetes, heart problems, and kidney disorders.  As much as possible, these conditions should be treated first or at least “controlled” before you undergo any surgery, particularly if it involves extensive incisions.

You should also think twice of having breast reduction surgery if you have a history of irregular mammograms and undiagnosed lumps in the breasts.

Another important requirement is to be in normal weight.  You should remember that if you are obese or are experiencing significant weight changes, the result of surgery may be reversed and/or you may end up with a deflated-looking, sagging bust.  While repeating the procedure is possible, doing so will result to more scarring and higher risk of asymmetrical appearance.

Meanwhile, smokers in general are not a good candidate for any cosmetic surgery as they are very prone to gangrene (manifested by purplish color which doesn’t seem like common bruises) and delayed healing.  Because the nicotine stiffens the blood vessels, the oxygen-rich blood finds it hard to reach the wound.

As with any plastic surgery, you will undergo a lengthy consultation with your doctor so he can determine if your expectations and goals are realistic.  You should remember that breast reduction cannot change the fundamental shape of your bust, and the result will only be a smaller version of your breasts.

You should also accept the fact that scarring is just one of the tradeoffs of having breast surgery.  These are the other things you also have to consider: risk of asymmetrical appearance, puckery skin, infection, and delayed healing; however, these can be minimized or even avoided if you will choose a plastic surgeon certified by the American Board of Plastic Surgery.

Subfascial Breast Implant Placement Overview

With the advances in plasticsurgery, there are many available surgical techniques in breast augmentation to accommodate a specific anatomical feature, achieve the goals and expectations of a patient, create the most natural result possible, and minimize the risk of complications.

Nowadays, there are many breast implant placement techniques available to patients, although the most popular are the submuscular (the device is placed behind the muscles) and subglandular (the device is placed behind the tissues).

Meanwhile, there is a new technique called subfascial breast implant placement which is a compromise between submuscular and subglandular methods; it combines the benefits of the two primary placement options while eliminating the disadvantages associated with them.

The subfascial technique greatly resembles the subglandularimplant placement, with one major difference.  While the pectoral muscle is not touched, the fibrous fascia tissue is dissected from its front wall in order to place the breast implants beneath this layer.

Perhaps one of the possible advantages of subfascial implant placement is that it can isolate the device from the breast tissue, which leads to greater accuracy during mammogram examination.

Another benefit is the shorter recovery because the chest muscles are not disturbed, which is the case in submuscular implant placement.  And for this reason, patients can also expect less swelling, bruising, pain, tenderness, and other postoperative symptoms.

In terms of breast appearance, the technique provides a very natural result because it mimics the innate movement and contour of the tissue.  In addition, it provides added support from the strong fascia layer.

And unlike the subglandular implant placement, the subfascial technique prevents the risk of visible and palpable wrinkling because there is a fibrous fascia that provides coverage to the implant shell.

While the subfascial placement can lower the risk of capsular contracture (hardening of the scar tissue around the implants) compared with the subglandualr technique, it is not as effective as the submuscular implant placement which completely isolates the breast implants from the tissue, which is believed to harbor high levels of bacteria that can potentially increase the risk of complication.

Advocates of this new implant technique believe it works well for patients with small breasts and limited amounts of fats and tissue who want to achieve a smooth and natural-looking bust after breast augmentation surgery.

But for those who want to further minimize the risk of implant visibility, the submuscular implant placement is still the best technique.