Breast Lift or Breast Implants + Tummy Tuck + Full Liposculpture
It is not uncommon to have some sensory changes after breast augmentation, especially if there is a larger implant. Most of the time, sensation does return, especially if placed below the muscle, therefore, one should wait 3-6 months for the sensation to return. However, it is acceptable to have some nipple sensation loss with breast augmentation. The ratio of sensory loss from breast augmentation is 5-10% with the inframammary fold incision having the lowest ratio of nipple sensation loss.
The decision is based on a number of factors, including the member’s desires, reasons for the surgery and overall health. For example, are you doing it because you feel your breasts are too small relative to your body contour or are you unhappy with the size and firmness of your breasts following pregnancy, breastfeeding or major weight loss? Unevenness between the breasts can also be a motivating factor. Your surgeon can help you make the right decision during your pre-surgical appointment(s).
The ideal option to prevent rippling is to decide preoperatively what type of implant you need and whether it should be placed above or below the muscle. The optimal way to prevent rippling, or at least minimize rippling, is to place the implant below the muscle, make sure there is adequate breast tissue and not oversize or underinflate an implant if you are using saline or silicone implants. Sometimes the use of silicone implants may be better, especially in patients with no breast tissue as well as placement below the pectoralis major muscle. If you are using saline implants make sure you maximally fill it and not overfill or underfill, as that can cause more scalping or rippling. If you underfill, it can cause more deflation in saline implants. Remember, one can almost always feel any implant in the lower outside quadrant of your breast. Your surgeon will be the best person to advise you after examination.
Most doctors ask that women wait 3 months before wearing under wire bras after implant surgery. Your body will be forming scar tissue around the implant for 3 months. During this time the pressure of the wires could cause the scar tissue to form in such a way that an indentation from the wires could become permanent. After this initial healing time under wire bras should be worn intermittently to avoid permanent indentation.
There is very good scientific evidence in medical literature to show that a breast implant looks more natural and feel better if placed below the muscle. It also does not obscure mammography and there is good evidence-based data to support that the implants stay softer longer by a significant margin if placed below the muscle.
Replacement of implants that have ruptured is not an emergent operation, but it is one that should be undertaken as soon as possible, from the diagnosis. Over time silicone implants that have ruptured tend to leak and can cause more scar tissue formed by interaction around the implant. The procedure requires removing the implants and also the scar tissue around the implant. Therefore, in most cases, you do need a drain when replacing the implant. The recovery is brief â€“ about 3-5 days. It would be advisable for you to see a surgeon to get a proper prognosis.
The problem with high-profile implants is that they have not been adequately studied and may have much higher incidence of breast tissue and glandular thinning and subsequent long-term rippling effects, whether they are silicone or saline, although this has not been studied extensively.
In regards to the types of implants used, and the placement: In the majority of cases, the surgeon places the implants under the muscle, as this produces a more natural look and also reduces the risk of capsular contracture (when a skin forms around the implant). He usually makes the incision under the breast, so your folds of the skin should hide the scars. He will assess you at the consultation and determine the best placement of the implants.
One should never underfill a saline implant because there is a higher chance of having a deflation or rupture because of full flow problems. You should always maximally fill the implant so that it will get less scalping and no rippling in this area, plus it will deflate much less.
Yes, this can occur since we did not know the real cause of capsular contracture (breast implant hardness). It is uncommon for capsular contracture to occur, especially with saline implant below the muscle, but if saline implants do get hard they will begin getting hard earlier than later â€“ usually in the first several months. If silicone implants get hard, they will get hard progressively over time. One can attempt to do early aggressive breast massaging for perhaps 6-8 weeks. However, if capsule contracture develops then a simple inferior capsulotomy or release of the scar tissue may be all that is needed, especially with saline implants, to restore shape and symmetry. This is done easily as an outpatient under IV sedation.
Many women with breast implants have successfully breast fed their babies. Current studies indicate that women with breast implants, either gel or saline, do not have any higher levels of silicone in their milk than women without breast implants. Breast implants can, however, interfere with the ability of some women to breast-feed. The peri-areola incision site is more likely to affect this ability. Some women experience mastitis, inflammation in the breast ducts, during this time, which can also cause capsular contracture. Taking antibiotics when symptoms first appear may minimize the potential for this problem. You should always report signs of inflammation to your physician.
It is somewhat a myth that breast implants will create significant cleavage. It depends more on the shape of your breasts and the diameter of your breasts preoperatively, as well as the degree of breast augmentation and the amount of breast tissue that you have. Often, if you have an average chest wall size, there is a better chance for having improved cleavage. However, it is not a guarantee and just increasing the size does not necessarily increase breast cleavage. It is actually counter-intuitive since the implant actually pushes the breast to the side, diminishing the amount of cleavage one would anticipate.
Most surgeons recommend only round, textured implants these days, as the tear drop shape is more prone to rotate and distort the breast shape. The surgeon will discuss with you the look that you want, and based on your current breast shape and tissues, he will recommend an implant size. Please note, that your current build and breast size and shape may mean that you may have to go larger or smaller than your ideal size. For example, if you have had pregnancies and have droopy breasts with a lot of tissue, it usually requires a biMedawayer implant to fill to create a nice shape. It is not only the size that is important, the surgeon also suMedawayests an implant size to give a nice shape.
Yes, if there is radiographic evidence or an MRI it should be replaced for several reasons. Primarily, because long-term the silicone can cause small granulomas or small masses in the breast which can mimic breast tumors that may be similar to breast cancer and can disseminate throughout the breast. It is optimal to remove the implant with the capsule and attempt to replace with a new implant below the muscle. All implants need to be considered for removal at 10-15 years, whether the implant is saline or silicone.
It usually does not since it depends on the size of breast that you are beginning with. The resulting cup size does not directly correlate with the implant size. Just as different sizes, whether it is a B, C, or D cup, vary from patient to patient and from retailer to retailer, there is no way to guarantee that one will have B, C, or D cup breasts after implants. The goal is to make them proportionate to the patient’s chest wall diameter, the amount of breast tissue the patient has and the size and shape. It is very important not to over-augment patients, as they will then have further movement of their breast tissue out to the outside (or lateralization) which will cause distortion and the breast will look too large for the patient’s body and chest wall.
The major riskÂ of breastÂ augmentation is capsular formation – when a fibrous layer forms around a foreign body -Â but this occurs in only about 5% of patients. We have had no patients with this problem, and we put this down to the fact that the surgeons use the safest and highest quality implants (you may find that other surgeons use cheaper copies to keep the prices down). Also, the surgeons nearly always inserts the implant underneath the muscle, rather than in front, as this gives a more natural appearance, while also reducing the risk of capsular contracture. In most cases, breast implants last a lifetime, although gravity will have its usual effect with age, and patients can get their implants replaced after 10 years, but this is to give a better shape, not because of implant problems.
Should one use high-profile or moderate-profile implants for sagging breasts rather than a breast lift?
In most cases, surgeons won’t recommend using high-profile or moderate-profile implants (saline or silicone) to correct sagging breasts, as this is not the solution. If you truly have breast ptosis or sagging breasts, you should do a breast lift with or without implants. Obviously, if patients want a lift and more upper fullness they should do a lift with (moderate-profile) implants in most cases.
Ask a Question about Breast Augmentation. It will help other members. :)
Tummy tucks are often associated with ugly scars producing a deformed appearance of the pubic and lower abdominal areas. Although the lower abdominal area is usually covered when a bathing suit is worn, the scars are quite apparent without clothes. The removal of a large segment of lower abdominal skin requires that the belly-button be repositioned and surgically reconstructed. A surgically altered belly button often does not have a natural appearance. Tummy tucks are far more dangerous than abdominal liposuction. Tummy tuck surgery has a much higher risk surgical complications such as blood clots in the lung (pulmonary embolism) compared to liposuction. In most cases, liposuction alone, without a tummy tuck, produces excellent cosmetic results and avoids the risks and additional expenses associated with a tummy tuck.
A tummy tuck is a procedure in plastic surgery that removes excess skin and tissue from the abdominal area and tightens the underlying loose or separated muscles to create a firmer and more contoured abdomen.
A tummy tuck can be performed again with removal of excess skin, tightening of the abdominal wall and liposuction of any excess fat. However, we recommend that it is best for women to be done having children before undergoing a tummy tuck.
The length of time the drain needs to stay in depends on each patient. Â The drain is there to collect blood and fluids from the surgery site so as the amount of fluid decreases, the drain(s) Â can be removed.
If the abdominal skin has become loose and/or the abdominal muscles are separated, exercise will not help reverse these effects.
While abdominoplasty is not a weight reduction procedure, some patients will see a slight loss in weight due to the removal of excess tissue and skin. Many candidates for this plastic surgery are patients who have previously been through a significant weight loss and opt for tummy tuck to remove excess skin and achieve a tighter, smoother contour. Â It is best for tummy tuck candidates to be at a stable weight before surgery.
A mini tummy tuck is not based on the length of the incision, but rather by the amount of repair that is needed. Â A patient that does not need any rejuvenation of the abdomen above the belly button may be a good candidate for a mini tummy tuck.
Yes, often times plastic surgeons may perform a tummy tuck in conjunction with a breast surgery,Â liposuctionÂ or other lifting procedures like anÂ arm lift.
Its always best to choose the options thats going to give you the best overall result as opposed to the shortest incision. Going with a shorter incision is not recommended and can result in a less than desirable outcome. Â However, a qualified plastic surgeon will be able to place the incision so that it is hidden by most bathing suits.
As every patients procedure is different and every patients pain tolerance is different, this can vary greatly. Â Immediately after surgery, patients will be very sore and pain medication should be taken as prescribed. The second week is better but patients will still experience some discomfort with certain movements and many patients still use pain medication at this time. By the third week, most patients are off pain medication and mostly able to take care of themselves.
While some plastic surgeons tout a â€œdrainless tummy tuckâ€, it is really more of a marketing gimmick than good medicine. Â The development of tissue glue is a wonderful advancement, but when used without a drain, the incidence of complications like seroma (the collection of fluid at the surgical site) is dramatically increased. Our plastic surgeons use drains, sometimes in conjunction with tissue glue. While a drain a can be inconvenient, it really is the best option. Â
When a tummy tuck is indicated, some surgeons believe it is safer to first do a liposuction and then, several months later, do the tummy tuck. Often the patient is so pleased with the initial liposuction that she no longer sees a need for a tummy tuck. Second, if the results of the liposuction are not sufficient, then dividing liposuction and tummy tuck into two separate relatively minor surgical procedures is usually much safer than one major surgery.
Abdominal liposuction is safer, gives superior cosmetic results, and has a more natural appearance without disfiguring surgical scars. Thus, liposuction has now largely replaced tummy tuck surgery as the preferred technique for improving the silhouette of the abdomen. There is another reason why a surgeon might recommend a tummy tuck. Some surgeons and some patients believe the aesthetics benefits of a maximally flat tummy outweigh the disadvantages of an abnormal appearance of the belly button and the unnatural appearance of the lower abdominal scar. Patients should be aware of this issue when evaluating liposuction vs. tummy tuck.
The best thing you can do to improve your healing after a tummy tuck is to take care of yourself. Â Not smoking is a key factor in good healing. If you smoke, you need to STOP at least six weeks before surgery. Â In addition, get plenty of rest, eat well, stay hydrated and follow the doctors instructions. We provide all of our patients with a scar recovery gel/treatment plan to help make sure the resulting scar heals well.
A tummy tuck recovery is a process, the length of the recovery time after a tummy tuck depends on what type of tummy tuck is performed. Â Two to six weeks is the average amount of time someone should plan to be limited in day-to-day activities. However, some patients do take longer to reach the same recovery comfort level as other patients.
The only patients for whom a tummy tuck is superior to abdominal liposuction are the relatively few women having extreme degrees of lower abdominal skin laxity, unusually extensive stretch marks, or severely stretched abdominal muscles (as a result of pregnancy). Tummy tuck surgically removes skin with severe stretch-marks (striae-distensae). Liposuction does not remove stretch marks. A tummy tuck can produce a flatter abdominal wall by tightening the abdominal muscles. Liposuction is appropriate for patients who have abdominal muscles that have not been excessively stretched out of shape by pregnancy. A tummy tuck can remove excessive amounts of loose abdominal skin. However, loose abdominal skin does not mean that a tummy tuck is necessary. After liposuction, abdominal skin often contracts to a surprising degree so that an excision is not necessary.
The majority of patients who have excessive abdominal fat find that they are very happy with the results of a simple abdominal liposuction. Several months after having had an abdominal liposuction, the vast majority of women are so happy with their results that they decline a subsequent tummy tuck.
Liposuction of the abdomen removes most of the fat found under the skin and above the abdominal muscles. When patients have good abdominal muscle tone, liposuction can provide a dramatic improvement, with a natural appearance of the abdomen, and with minimal scarring. In the vast majority of liposuction patients, the natural elasticity of abdominal skin contracts smoothly, and there is no need to surgically remove skin. Tummy tuck usually involves liposuction to remove fat plus the surgical removal of a large section of skin from the lower abdomen, together with a surgical relocation of the belly button. A tummy tuck can result in an unsightly scar that extends across the entire lower abdomen, just above the pubic area in addition to an unnatural appearance of the belly button. The recovery after liposuction is much safer, quicker and easier than the recovery after a tummy tuck.
Tummy tucks are more expensive as liposuction of the abdomen. The recovery time required before a person can return to work after a tummy tuck is typically two to four times longer than after liposuction of the abdomen.