Options for Breast Enhancement Surgery


If you are considering surgery to enhance
the appearance of your breast we are going to talk today about the various options that
include breast augmentation breast reduction breast lift and a combination procedure which
is a augmentation with a lift the way that we choose whether a patient needs to have
an augmentation or a reduction is we ask a few key questions so the first question is
are you satisfied with the size of your breast in a bra and if the answer is yes you are
satisfied with the size of the breast in a bra we are probably just going to talk about
doing a lift and a lift if going to change the shape of the breast alone so it’s going
to take a nipple that is low and it’s going to take extra skin that is saggy and it’s
gonna lift things up and make the tight and firm and perky if the answer is no you are
unsatisfied with the size of your breast in a bra then we are going to talk about a reduction
if you feel like your breast are too large in a bra or we are going to talk about a augmentation
if you feel like your breast are too small in a bra and there is a couple caveats there
are women who feel like their breast are too small in a bra but they also have sagging
tissue and for that woman we are going to put a breast implant in so we are going to
augment that breast with an implant and we are also going to lift the nipple and tighten
the skin so that is an augmentation mastopexy also known as a breast augmentation with lift
a reduction on the other side is going to make the breast smaller obviously it’s going
to reduce the size and part of a breast reduction is doing a lift so large breast that are saggy
or just breast that are large a breast reduction is going to lift those breast and make them
smaller. for the woman that has chosen a breast augmentation
she knows that she wants to have an implant to have a larger breast we have to key questions
one is the look that patient is going for we want to know if they want to be very augmented
or if they want to be very natural or somewhere in between two is we need to talk about using
either a silicone or saline implant so we need to figure out which one of those they
prefer and we can talk about that in great detail. third is we talk about the incision placement
because if we are just putting a breast implant in we have few options like placing an incision
under the nipple or placing the incision underneath the crease of the breast itself and the fourth
thing we need to talk about putting the implant either above the muscle or below. and those are lengthy conversations depending
on if you don’t know what you want though most women do a fair amount of online research
and they come in and they tell me i want a natural looking submuscular implant that’s
silicone and i want it placed through a creased incision and then we just pick the size from
there. and the way we pick the size is we do measurements
of the breast and we choose an implant that is going to fit your breast at the same time
keeping in mind how much bigger you want to go so if you know you are an A cup and you
want to be a C we are going to have a different recommendation for you in terms of size of
implant then if you are an A cup wanting to go up to DD. when we are talking about the
incision placement or where the final scar is going to be it’s the incision that we are
going to put that implant through there are 4 options historically one option is pretty
much never done anymore and that is going in through the belly button so that used to
be a thing it is no longer a thing the next one is the least common is putting it in through
the armpit makeing the incision in the armpit where there is sweat glands that’s a remote
incision and some women like that because they have no scar on the breast it’s really
fallen out of favor because it does have a lot higher complication risk the two most
common are making an incision right under the areola what the darker skin meets the
lighter skin or making the incision right underneath the crease of the breast and so
those are the four options and depending on which one of those sounds better to you or
which one suits you with your anatomy we choose that during the consultation that way you
know exactly where your scar is going to be after the surgery so something we do a little
bit different here at Austin-Weston is waranty our breast augmentation results this is for
women that are getting a primary breast augmentation so it is for a woman that is getting an implant
for the first time this is not doing a lift of anything else fancy it is just doing a
breast implantation or breast augmentation surgery that warranty is that if the implant
were to get hard or get high or get low move in any way we fix it for free and it is very
rare that we have to do that but we want patients to be satisfied and we guarantee our results
so if it does move or anything like that we will fix it for free no surgeons charge no
OR Charge or anything like that that’s for 3 years after the day of surgery a caveat
of that is you have to come in for your post operative photos and you post op exam for
you photos in 3 months and we see you every year after. size changes are warrantied in terms of we
are not going to charge you as a surgeon for changing the implant but you are going to
have to pay for the cost of those breast implants to put in so if we put in breast implants
you feel that they are too small we will adjust the size for you but you need to pay the cost
of the implants and that is unique as well and that is because we stand by our results. so an augmentation mastopexy is doing a breast
augmentation with so that’s placing a breast implant at the same time as doing mastopexy
which is also known as a breast lift. So it is a aug masto augmentation mastopexy
breast lift with implant these are all refering to the same operation this is for the woman
that feels like her breast are too small and so we are going to put an implant and she
also feels like they are too saggy or droopy and there is a spectrum here if there is just
the tiniest about of sag and droop well putting an implant and filling out that skin can rejuvenate
the breast and make them look quite young so we have to examine you in person to figure
out whether or not you are a candidate or not for the procedure but the implants are
the same we are going to place them through the lift incision and this is what is different
about a breast lift of mastopexy is that we are going to make incisions that there is
going to be scars on the breast that help us lift and tighten the tissue and so there
are three kinda of lift there is what is called the circumareola lift which is an incision
that goes around the areola around that part of the nipple there is a lollipop lift which
is an incision around the areola and down the front of the breast and there is and anchor
list and that is around the areola down the front of the breast and then underneath so
if you were to draw that flat out in 2 dimensions it looks like an anchor. and if the breast
is more saggy you get an anchor if it is a little bit less it’s a lollipop and if it
is even less then that’s a just an incision around. and then though that same scar throught that
same scar we place the breast implant the recovery after augmentation mastopexy is very
simular to augmentation in terms of it mainly has to do with the breast implant because
the implant is behind the muscle and when we stretch the muscle it hurts and therefor
you are going to be taking pain pills for a few days to maybe one week there is going
to be more scaring though there is a scar on the front of the breast and so we are going
to do scar care for a full 6 weeks after the surgery until that scar starts to fade to
a degree but it doesn’t hurt necessarily there is a longer scar to heal but they generally
heal really well and thin and flat and they fade with time. when a patient is considering a breast reduction
we are usually doing it for either the look they just don’t like the look of their larger
breast or we are doing it because of symptoms and some of those symptoms are like neck pain
shoulder pain, constant headaches grooving from a bra strap digging in and rashes underneath
the breast from skin on skin contact. and so regardless of the reason we are doing it
the conversation for breast reduction is going to include where your current cup size is
and where you would like to be and sometimes women come in and they want
to be an A cup well if you are starting out at as G we are probably not going to be able
to make you an A and the reason behind that is the health of the nipple so after doing
a breast reduction because part of the reduction is we are doing a lift we are actually lifting
up the nipple and tightening the skin and after moving that nipple and lifting it up
we want it to stay alive and have good blood flow and have healthy nerves to it. if the nipple is really low we are going to
preserve a lot more blood vessels and a lot more nerves going to that nipple than if that
nipple was really high so a low nipple is going to require us saving a lot more tissue
that is going result in a bigger cup and so if the breast are quite low and you can see
some of these examples on out before and after gallery on the website if the breast is quite
low your results after a breast reduction might be a D cup. or even a DD it will still
be significantly smaller but that’s kind of the limiting factor as to how much we can
remove is the safety and health and viability of the nipple after surgery. From a recovery standpoint after breast reduction
it is no a very painful operation the recovery after breast reduction is typically easier
than after an augmentation because a reduction doesn’t involve the muscle we are just operating
on the breast gland and the skin and those are typically not very painful so a few days
of pain medication afterward and then you are just wearing a bra and working on scar
management after the procedure that is all assuming perfect healing but the typical is
they heal very well and very easily and the recovery is shorter after a breast reduction
there is going to be a scar though and the scar is going to be around the areola and
down the front of the breast and underneath and so there is much more scar management
in terms of there is more area that we massage the silicone cream on more areas to tape but
we will help you with all that stuff with scar management in the immediate post op period. part of a breast reduction usually involves
the size of the nipple not all the always but it definitely depends on how big the nipple
is because if the nipple is large and the breast is large well when we reduce that breast
we are also going to reduce the size of the areola so it looks natural so we have that
discussion at the consultation. and to a degree it’s based on the patients aesthetic but we
usually when we make the breast smaller we make the areola a little smaller there is
one small caveat where patients actually get a reduction and an implant which doesn’t make
sense at first because you are thinking well you are making the breast smaller with reduction
why are you making it bigger with an implant it’s for the patient that wants an augmented
look but they have large breast and so if you have a really large breast but you want
to have a very lifted perky and round breast then what we do is we first make the breast
smaller with and we tighten up all the skin and the is basically a breast reduction and
we would over reduce we would make it smaller then the patient wanted then we would let
it heal then we put the implant in the reason you can’t do a big reduction and place the
implant the same time is that it’s too much surgery for the health of the breast it’s
too traumatic on the breast at once so every now and then we will see a patient that wants
to have a very augmented round perky look but they have very saggy large low breast
and in that patient with just a lift alone it is not as augmented when you just do a
breast lift it still looks kind of natural and you can see some examples on our website
but if you know you want round and you want a lot of fullness especially up near the mid
line in the cleavage region then what we would do we would come up with an idea in terms
of what your ultimate final cup size would be we would over reduce you to smaller than
that and then we would come in an put an implant to get you back up to that capsize and by
putting that implant in you get that cleavage up here in the middle and that doesn’t happen
a lot but it happens some you know so that’s kind of a small subset of patients it’s certainly
not the norm but it is something we can do if that’s what you’re interested in. go ahead and hit the like button if you enjoyed
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