Breast Lift with AugmentationMastopexy with Mammoplasty Augmentation
Augmentation mastopexy is a surgical procedure to reshape the breast and add volume where needed. It is most commonly performed in women who have a history of pregnancy and/or breast feeding but may be seen in patients as they age or have weight fluctuations. Most women are simply looking to rejuvenate their breasts and restore them to where they were previously and not necessarily looking for dramatic size changes.
Dr. Jeffrey Kenkel is a *Board-certified plastic surgeon specializing in cosmetic surgery. He is Chairman of the Department of Plastic Surgery and Director of the Clinical Center for Cosmetic Laser Treatment at UT Southwestern Medical Center at Dallas.
* Board-certified by the American Board of Plastic Surgery
Am I a good candidate for the surgery?
The best candidates for augmentation mastopexy are women who are looking for improvement, not perfection, in the way they look. If you're physically healthy and realistic in your expectations and have a reasonable desire to have your breasts reshaped, you may be an appropriate candidate. Ideally, patients are at a stable weight. In extreme cases of ptosis (droopiness of the breast), Dr Kenkel may recommend that these procedures be done in stages for safety reasons. Your visit with Dr. Kenkel will determine if you are a good candidate.
Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Kenkel.
What should I expect from my consultation?
During the consultation, you will be asked about your desired breast size and anything else related to the appearance of your breasts that you feel is important. This will help Dr. Kenkel understand your expectations and determine whether they realistically can be achieved. He will examine your breasts and will consider such factors as the size and shape, the quality of your skin and the placement of your nipples and areolas. He will explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. Afterwards a photographer will take photographs for your medical record.
You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries including breast biopsies, and medications that you currently take. You will be asked whether you have a family history of breast cancer and about results of any mammograms. It is important for you to provide complete information.
How is the surgery performed?
The method of inserting and positioning your implant will depend on your anatomy, individual factors and personal preferences. Dr. Kenkel will help you determine your appropriate breast size, the location of incisions, and whether the implants will be placed on top of or underneath the chest muscle. The incisions for the breast lift are a necessary compromise, trading a scar for shape. The most common incisions for augmentation mastopexy are an incision around the areola with a vertical scar down towards the breast crease. This incision helps increase the projection of the breast and narrow its width. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible.
Working through the incision, Dr. Kenkel will first place your implant into its position, most commonly under the muscle. Once your new breast mound has been established, he will then reshape your breast tissue overlying your implant. The surgery usually takes two to three hours to complete. Sutures are used to close the incisions, which may also be taped for greater support. A tissue glue is used, and you are placed in a supportive bra.
How will I learn about the safety of breast implants?
Breast implants are not lifetime devices and cannot be expected to last forever. If a saline-filled implant breaks, the body harmlessly absorbs its contents within hours. A definite change in the size of the breast is clearly noticed. Rupture can occur as a result of trauma to the chest, but more commonly it occurs spontaneously with no apparent cause. Surgery will be required to replace the implant, if desired.
It is possible that the presence of breast implants could delay or hinder the early detection of breast cancer. Some women with breast implants have reported problems including certain connective tissue and immune-related diseases. Women without implants also have these disorders, so the key question is whether breast implants increase the risk of developing the conditions. Several large studies have been completed that provide reassurance that women with breast implants do not have a significantly increased risk for these diseases.
What happens the day of surgery?
Your augmentation mastopexy will be performed in a hospital on an outpatient basis. Be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery. The "Patient Care" link provided will give you instructions to prepare for surgery, including guidelines on eating, drinking and smoking. If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery.
Prior to the procedure, medications are administered for your comfort and to lessen the anxiety if need be. General anesthesia and intravenous sedation are used for patients undergoing breast augmentation. When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Your breasts will be wrapped in gauze dressings or a surgical bra. You may be permitted to go home after a few hours, unless you and Dr. Kenkel have determined that you will stay in the hospital overnight.
What is the recovery like?
You will feel tired and sore for a few days following your surgery, but you'll be up moving around. Most of your discomfort and/or pain can be controlled by medication prescribed by Dr. Kenkel. Antibiotics are administered just prior to your surgery.
The surgical bra will be removed after 2-3 days and you will be permitted to shower. You will see Dr. Kenkel after 3-4 days where you will learn how to perform breast exercises. It is often possible to return to work within 5-7 days, depending on your job and you may begin driving 7-10 days after surgery. Vigorous activities, especially arm movement, should be restricted for 2-3 weeks as well as lifting anything over 10 pounds. Most residual swelling will resolve within a month. Dr. Kenkel may place you in steri-strips may be worn to decrease the appearance of scars.
For exercise, you may begin walking after 2-3 days but exercise that may increase your heart rate above 100 beats per minute should be avoided for 3 weeks.
What should I know about my results?
Except in the event of implant deflation requiring surgical replacement with a new implant, the results of your breast augmentation surgery will be long-lasting. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman's breasts. Pregnancy can alter breast size in an unpredictable way and could affect the long-term results of breast augmentation as well.
Dr. Kenkel may recommend a baseline mammogram before surgery and another mammography examination some months after surgery. This will help to detect any future changes in your breast tissue. Following breast augmentation, you will still be able to perform breast self-examination.
How many visits do I have after surgery?
You will usually return in 3-4 days following surgery to review your implant exercises. He will then see you again in another couple of weeks. During your postoperative visits, Dr. Kenkel will discuss further postoperative activity and concerns you may have. Following this visit you will return in approximately 3 weeks, 6 weeks, 3 months, 6 months and one year. If you have questions or concerns during your recovery, or need additional information at a later time, you can always contact Dr. Kenkel.
What does the surgery cost?
At the time of your initial consultation, you will be quoted a price that will include Dr. Kenkel's fee as well as hospital and anesthesia fees. Fees are due three weeks prior to your surgery. Checks, money orders, cash and credit cards may be used for payment. A $500.00 deposit will reserve a specific time and date for our surgery.