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A breast lift at its core is used to lift the breasts when they are droopy. The premise seems simple enough, but the execution of these procedures can be extremely complicated.
There are many variations in the types of breast lift procedures performed and offered among plastic surgeons, and Dr. Hughes has performed them all and performs them all frequently and as indicated. The simplest type of lift is the crescent lift. The crescent lift involves removal of a crescent of skin above the areola. It is seldom indicated as it can elongate the areolae and make them appear very ovoid. Thus, very few of these are performed, and patients should be careful if that type of breast lift is offered as a treatment.
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, donut, 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. Thus, it applies to few patients who are in need of a significant improvement in the skin envelope. The problem with taking too much skin from around the areola is that this can cause the areola to widen over time, sometimes monstrously so. A permanent purse-string suture is frequently placed to help with this issue, but this maneuver is only useful for a smaller percentage of cases. The concentric lift around the areola is very much like pulling on the strings of a drawstring trash bag. Everyone knows that as the strings are pulled the wrinkling increases. This same type of wrinkling occurs with this lift as well.
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The next type of lift can be used for a wide variety of areolar and breast ptosis or 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.
Dr. Hughes does not use the cookbook type of pattern and uniquely tailors the pattern for each breast lift to produce tight and round breasts for each unique type of anatomy.
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. The full breast takes the vertical lift pattern and adds a horizontal incision under the breast and in the inframammary fold. This type of lift is used to remove the most amount of skin and to tighten the skin and tissue envelope maximally. It is frequently necessary in vertically long breasts to remove enough skin to create the appearance of round and tight breasts that do not appear to be hanging.
Breast lifts and breast lift 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. You as the patient will have the ability to decide what you want based upon the recommendations of Dr. Hughes.
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 at Hughes Plastic Surgery in Los Angeles.
In addition, Dr. Hughes is frequently tasked with performing breast lift revisions in cases where the shape of the breasts is suboptimal, the level of lift was inadequate, the scars are poor or widened, or the symmetry needs to be improved. Sometimes the blood supply is compromised from previous surgeries, and these surgeries are complicated by breast implant issues including capsular contracture. Dr. Kenneth B. Hughes is a well-recognized author on the subject and has published in breast augmentation revision in the Annals of Plastic Surgery.
BEFORE & AFTER GALLERY
There are many variations in types of breast lift procedures performed, and Dr. Hughes has performed them all.
Commonly Asked Questions about Breast Lift Surgery
1) Should I get an implant or augmentation with the breast lift?
If you like the size of your breasts, then a breast lift can be performed by itself. If you would like the breasts larger, you can have breast augmentation at the same time. Another reason to add an implant would be to improve the fullness of the breasts, particularly at the top of the breasts.
2) Will I be smaller in size after a breast lift?
Although only skin is typically removed in a breast lift procedure that is a few grams, the breasts will appear smaller. This is due to the fact that the same mass is wrapped in a smaller soft tissue envelope and increases the density. The less dense the breast and the more the surface area of skin that is removed, the larger the apparent reduction in size.
3) What is the difference between a Breast Lift and Breast Reduction?
Both procedures will lift your breasts with similar scar patterns. The breast lift will not remove any breast tissue in general and is purely cosmetic. The breast reduction will remove breast tissue and may be necessary in women with larger breasts (macromastia) to improve back, neck, and shoulder girdle pain.
4) I do not like the size or shape of my areolae. What can be done?
Breast lift incisions can be used to alter the size or shape of the areolae at the same time a lift is performed.
Breast Lift and Variants
PREPARING FOR SURGERY
- STOP SMOKING: Smoking reduces circulation to the skin and impedes healing. It is best to avoid smoking, second hand smoke and cigarette replacements, such as nicotine patches or gum, in the perioperati ve period. While you should ideally stop smoking for 2 weeks before and after your surgical procedure, YOU MUST NOT SMOKE FOR A MINIMUM OF 24 HOURS BEFORE AND 24 HOURS AFTER SURGERY.
- TAKE MULTIVITAMINS: Start taking multivitamins twice daily to improve your general health once you have scheduled your surgery.
- TAKE VITAMIN C: Start taking 500 mg of Vitamin C twice dai ly to promote healing.
- START TAKING AN IRON SUPPLEMENT: A good iron supplement, such as Feosol Spansules, is required starting one week before surgery and four weeks following surgery. Bowel movements may appear darker than usual as a result. Feosol is available without prescription.
- DO NOT TAKE ASPIRIN OR IBUPROFEN: Stop taking medications containing aspirin or ibuprofen. Review the list of drugs containing aspirin and ibuprofen carefully. Such drugs can cause bleeding problems during and after surgery. Instead, use medications containing acetaminophen (such as Tylenol).
- LIMIT VITAMIN E: Limit your intake of Vitamin E to less than 400 mg per day.
- FILL YOUR PRESCRIPTIONS: You will be given prescri ptions for medications. Please have them filled BEFORE the day of surgery and bring them with you.
- CONFIRM SURGERY TIME: We wi ll call you to confinn the time of your surgery. If you are not going to be at home or at your office, please call us to confirm at (310) 275-4170.
- PRESCRIPTIONS: Make sure that you have filled the prescriptions you were given and set the medications out to bring with you tomorrow. Make sure to have the number for your pharmacy ready so that if Dr. Hughes and associates need to call in any special medications for you on your day of surgery they wi ll have that infonnation readily available.
- CLEANSING: The night before surgery, shower and wash the surgical areas with an antibacterial soap such as Dial, Safeguard, pHisoHex, or Phase II I.
- EATING AND DRINKING: Do not eat or drink anything after 12:00 midnight except for a small amount of water to rinse your mouth while brushing your teeth.
- SPECIAL INFORMATION: Do not eat or drink anything! Ifyou take a daily medication, you may take it with a sip of water in the early morning.
- ORAL HYGIENE: You may brush your teeth but do not swallow the water.
- CLEANS ING: Shower and wash the surg ical areas again with an antibacterial soap such as Dial, Safeguard, pHisoHex, or Phase Ill.
- MAKE-UP: Please do not wear moisturizers, creams, lotions, or makeup.
- CLOTHING: Wear only comfortable, loose-fining clothing that does not go over your head. NO TIGHT PANTS. Remove hairpins, wigs, and jewelry. Please do not bring valuables with you.
- CHECK IN/PREPARATION: Surgery Time:
- You should plan to arrive 45 minutes earlier than your scheduled surgery time. Patients less than 18 years old must be accompanied by a parent or legal guardian. When you arrive at our office on the day of your surgery, give the receptionist the phone number of the pharmacy you would like us to call for any spec ial medications Dr. Hughes and associates might prescribe.
- CARETAKER: Someone must spend the first night after surgery with you.
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 can result in the death of the nipple and areolar complex and wound healing issues.
- 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.