This wonderful patient had been seen in the office previously for evaluation of postpartum breasts, or breast sagging caused by pregnancy and breast-feeding. She presented with a minimal amount of actual breast tissue and ptotic breasts with the nipple areolar complexes pointing significantly in the downward direction. After much discussion regarding the options, she elected for a breast lift and breast augmentation combination. A breast augmentation alone would have left natural breast tissue hanging over the breast implant with the nipple slightly pointing downward. Dr. Caridi has performed a large number of these breast lift with implants procedures. If your surgeon doesn’t have extensive experience, he or she may suggest that you “stage” the procedures. This means you would have the lift or augmentation first followed by a second procedure to complete the operation. Always visit with several qualified surgeons if you are considering a breast lift with implants.
High-profile, smooth-walled, 400cc silicone breast implants were inserted under the muscle with the assist of the Keller funnel on one side and without on the other. The Keller funnel is a cone shaped plastic sleeve that is used to facilitate the insertion of silicone breast implants. The incisions for saline implants are quite small (usually about an inch or so) because they are inserted beneath the breast in a deflated state and then filled by the surgeon. Silicone implants, however, are pre-filled so the incision required is considerably larger to ensure that the implant can be inserted without too much trauma. As seen in the video, the Keller funnel allows the surgeon to insert the implant much quicker and through a smaller incision.
As always when relocating the nipple-areola complex, a “cookie-cutter” stencil is used to measure the appropriate size of the new nipples. During the procedure, a vertical breast lift incision is made between the nipple and the inframammary fold. The vertical breast lift results in a scar that is shaped like a lollipop. It is a powerful technique that shapes the breast nicely and limits the length of the scar compared to the Inverted T or Anchor technique often used in a breast reduction. This alternative is particularly suited to the simultaneous use of a breast implant with a breast lift. The procedures work together to help shape the breast and move it higher on the chest wall, while allowing flexibility in the breast shape and reducing the size of the scars.
The risks of this procedure include, but are not limited to bleeding, infection, hematoma formation, scar deformity, contour deformity, pain, paresthesias, numbness, asymmetries, nipple areolar necrosis, revisional surgeries, and a host of breast implant related complications.
The recovery after a breast lift with implants is similar to that of a breast augmentation alone. The breasts will look unnatural at first but will settle into the expected shape after 6 weeks as the tissues relax. Silicone scar strips should be used ten hours a day for four months. Topical application of any cream or ointment is unlikely to improve scars. Silicone gel is simply not the same as silicone strips or tapes when it comes to improving scars. Allow two years for the scar to fully mature and look its best.
Another successful mastopexy with breast augmentation procedure by Dr. Caridi at Westlake Plastic Surgery in Austin, Texas!
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