Breast Augmentation & Lift Procedure Los Angeles, CA
Dr. Hughes performs breast augmentation and breast lift combination procedures routinely. Some plastic surgeons will stage the procedures and separate the procedures into two surgeries (a breast augmentation at one time and a breast lift at another). Dr. Hughes has not found that to be necessary based upon the low complication rate and predictability of result of the combination procedures in Dr. Hughes’s hands. Performing both procedures at the same time also reduces exposure to the number of general anesthesia procedures and results in a single recovery time.
Dr. Hughes can perform breast augmentation through the belly button (transumbilical augmentation, TUBA), the armpit (transaxillary), or incisions made under the areola (periareolar) or in the fold of the breast (IMF or inframammary fold). Dr. Hughes performs breast augmentation both above the muscle (subglandular) and under the muscle (submuscular), and he offers saline, silicone, and gummy bear implants in a broad array of volumes and profiles. Implants can be textured or smooth, round or tear drop (anatomic). If you have a particular way in which you would like your procedure performed, Dr. Hughes has done it for other patients. Dr. Hughes will provide his recommendations to each patient based upon the patient’s anatomy and desires, but the patient can select among what Dr. Hughes finds reasonable with regard to incision placement and implant size.
In most patients, the breast augmentation with an implant is intended to both increase the size and upper pole fullness of the breast. Thus, most patients are very good candidates for a round implant and not a tear drop or anatomic implant. These anatomic or tear drop implants were originally developed for reconstructive purposes after patients who had undergone mastectomy. Thus, the goal of the augmentation was to recreate the breast mound from a flat surface. This was certainly a reasonable thought.
Now compare this goal to the goal of most women who want breast augmentation. Most women have more breast tissue at the bottom of the breast and do not need more proportionally more augmentation at the bottom of the breast. This essentially creates a more matronly look, which most patients do not appreciate as the aesthetic ideal. Thus, the round implant creates the more pleasing aesthetic.
There is essentially no benefit to textured implants over smooth implants for any submuscular augmentation. Textured implants were initially used to combat unacceptably high capsular contracture rates when implants were placed above the muscle or below the gland (called subglandular augmentation). Textured implants essentially result in more rippling and greater palpability and thus do not have a benefit outside of subglandular augmentation. Textured implants have also been linked to a rare type of cancer, so at this time, Dr. Hughes does not use textured breast implants.
The volume of augmentation frequently engenders the most trepidation among patients, as volume is rather uniformly difficult to appreciate among humans. It is helpful to have different sized implants for both viewing and sizing (trying on various implant sizes). In addition, Dr. Hughes vastly simplifies the process by creating a narrow range from within patients can choose based upon patient breast diameter and the diameters of available implants in their various profiles. The goal is to match the diameter of the breast to the diameter of the breast implant and then modulate the volume within that group based upon the profile. For instance, a higher profile implant is a taller implant for a given diameter. Thus a higher profile implant for a given diameter will have a large volume than a lower profile implant of the same diameter.
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The periareolar lift involves making an incision around the areola and lifting the nipple areola complex (NAC). This is referred to as a circumareolar, concentric, or Benelli lift. This lift only works for a small amount of breast droop (breast ptosis). It can also be used to improve symmetry of the areolae or to reduce the size of the areolae. This lift tends to flatten the breast to some degree. It should not be used in cases with more breast or areolar droop.
The vertical lift can be used for more severe droopiness. This lift involves a vertical and a periareolar incision and is referred to as circumvertical, or lollipop lift. Dr. Hughes always tries to minimize the scars and will only use the full breast lift pattern if it is absolutely mandatory for the best shape and lift.
The last breast lift pattern is the Wise pattern mastopexy also referred to as the inverted T lift, the anchor lift, or the full breast lift.
Breast lifts and scar patterns are complicated. Do not worry about this. Dr. Hughes will help select the breast lift pattern that is right for you and will make this process easy.
Dr. Hughes performs hundreds of breast lifts each year. Patient anatomy varies greatly from perfectly round breasts that are close together to constricted breasts that are far apart. Some breasts have a little droop or ptosis, and some breasts have a lot of droop. Viewing the breast lift galleries will give you an idea of what type of transformation you can expect.
Breast Augmentation & Lift
BEFORE & AFTER GALLERY
Dr. Hughes can perform breast augmentation through the belly button (transumbilical augmentation, TUBA), the armpit, or incisions made under the areola or in the fold of the breast.
Article 2: The Evolution of Saline and Textured Implants
Article 3: Silicone Implants and Implant Controversies
Article 4: Evaluation of the Breast Augmentation Surgery Patient
Article 5: Determining Implant Size and Incisions in Breast Augmentation: Inframammary and Infraareolar
Article 6: Incisions and Approaches to Breast Augmentation: Transaxillary and Transumbilical
Article 7: Capsular Contracture in Breast Augmentation
Article 8: Complications of Breast AugmentationContinue on to Dermal Matrices in Breast Augmentation Articles available: Part I: Types of Dermal Matrices in Breast Augmentation
Part II: Dermal Matrices in Breast Augmentation
Part III: Complications of Dermal Matrices in Breast Augmentation
Part IV: Dermal Matrices in Breast Reconstruction
Part V: Dermal Matrices in Breast Augmentation Summary
View Other Scholarly Articles by Dr. Hughes Related to Breast Augmentation
BREAST AUGMENTATION AND BREAST LIFT POST-OP INSTRUCTIONS
- The first week you will need to rest frequently. You need to walk around the house every 2 hours as tolerated. Avoid stairs if possible.
- For the first week post-op sleep on your back with your head elevated.
- Avoid picking anything up greater than 1-2 lbs the first two weeks. The doctor will advise you when you can start lifting anything heavier.
- DO NOT EXERCISE FOR 4-6 WEEKS.
- You may not drive the first week or while you are taking pain medication. After that it will depend on your ability to handle a car without causing any discomfort. You should wear your seatbelt at all times.
- Do not engage in sexual activity at least 4-6 weeks after your surgery.
- No smoking. This will interfere with your healing and can lead to open wounds and nipple and areolar loss or death.
- Eat light the first 24 hours, clear liquids advancing to a regular diet as tolerated.
- If you have persistent nausea stick to a bland diet until it subsides.
- Avoid foods that can cause a lot of gas. This can cause abdominal distention and undue discomfort. Small frequent meals are best. Stay away from sweet and salty food.
- The pain medicine may cause constipation. Drink plenty of fluids, such as water and Gatorade (dilute 50/50). You may take any over the counter laxatives or stool softeners as needed.
- It is normal to have numbness over the surgical sites for several weeks or months.
- Do not use a heating pad or ice around the surgical sites. It could cause a burn.
- You may not shower for 3 days – sponge bathe only, until dressings are removed at your first post-op visit.
- Take your antibiotic until it is completed. Antibiotic should be taken with food at each dose.
- If the pain medication is a narcotic it should be taken as prescribed. Do not take any Tylenol while on pain medication. The medication we prescribe may already have Tylenol in it.
- Do not drink alcohol or drive a car while taking pain medication.
- The pain medication may cause nausea and should be taken with food at each dose.
- You may resume your regular medication after your surgery except for Vitamin E, Fish oil and Ibuprofen (wait at least 5 days post-op).
- If you take aspirin or coumadin check with the doctor to see when you may resume them.
CALL THE OFFICE IF YOU HAVE:
- A temperature greater than 101.5 degrees.
- Excessive bleeding from the incision.
- A sudden increase in drainage, pain, or swelling around the incision site or the surrounding area.
- If you have persistent vomiting.