Ptosis and breast augmentation
Patients who benefit from a straight Augmentation don’t have ptosis and they can choose from rounds implants or tear drops depending on the look they want.
What if you have a bit of Ptosis.
The best test for this is to raise your arms up. If the Ptosis is corrected and the nipple sits in a better position and the overhang disappears, then you would only need an augmentation. In this case the implant would be tear dropped shape and we would have to do a few surgical maneuvers to get the implant to sit in the right place and adjust the breast tissue over it.
What if you have a lot of ptosis.
So, you have done the arm lift test and the breast is still sitting a big low. Then you need an augmentation mastopexy. This means we put the implants under the muscle and then arrange the breast tissue higher. This give us more control about nipple position and breast shape but does involve more scars.
If the implant is a larger implant, it would be better as a two stage procedure. Lift first and allow the scars to settle and then implant insertion a minimum of 3 months later. Of course, if you don’t want to go bigger, then a breast lift alone may suffice. This can be combined with fat grafting to breast.
Best practices in plastic surgery
Breast Lift with Augmentation Techniques
1. Traditional Augmentation Mastopexy
The traditional Augmentation Mastopexy combines a breast lift with the placement of breast implants. This procedure is ideal for individuals who want to address both sagging breasts and loss of volume. The surgeon will remove excess skin, lift the breast tissue to a higher position, and then insert implants to achieve the desired volume. This approach provides comprehensive rejuvenation for a fuller, uplifted appearance. This can be performed as one stage or two stages.
2. Periareolar (Donut) Lift with Augmentation
The periareolar lift, also known as the "donut lift," involves making an incision around the areola. This technique is suitable for patients with mild sagging and aims to lift the nipple-areolar complex to a higher position. During the same surgery, breast implants are placed to enhance volume and projection. The advantage of this approach is the inconspicuous scarring that results from the incision's placement along the areolar border.
3. Vertical (Lollipop) Lift with Augmentation
The vertical lift, often referred to as the "lollipop lift," involves two incisions: one around the areola and another extending vertically downward towards the breast crease. This technique is effective for moderate sagging and provides a more significant lift. It also allows for precise reshaping of the breast tissue while concurrently adding volume through breast implants. The vertical incision results in a more lifted and youthful appearance.
4. Anchor (Inverted-T) Lift with Augmentation
For individuals with significant sagging, the anchor lift, or "inverted-T" lift, offers comprehensive rejuvenation. This technique involves three incisions: around the areola, vertically down to the breast crease, and horizontally along the inframammary fold. The anchor lift provides the most extensive lift and reshaping while allowing for substantial volume enhancement with implants. This approach is recommended for those seeking comprehensive transformation.
Best Practices in Surgery
- Use of the 14-point plan of infection prevention
- Use of the Keller funnel. This is used to insert the implant with minimal contamination and shortest possible scar. It has become the new standard in Breast implant surgery to try and minimise risk of capsular contracture. You will be able to see and feel the funnel during your consultation.
- Prevention of breast implant animation (through careful muscle dissection)
- Prevention of bleeding through Meticulous haemostasis
- Special blocks to prevent post operative pain
- Use of the internal bra sutures. These are used to anchor the tissues down to near the rib cage. These reinforce the inframammary fold which help prevent implant migration downwards with time.
- Use of fat grafting as needed. This can give you fuller cleavage or help hide the upper part of the implant in very thin patients.
What are the implant options?
Where to place the implant
In augmentation mastopexy, the implant is best positioned under the muscle and the breast tissue is rearranged on top. It will still result in a natural look as the breast tissue is lifted higher.
How to choose the right implant for you
When you come to see us, you will have two consultations with Dr Hadi This includes listening to what you want, assessment of your breast, chest and body shape.
You will then have 2-D photographs and 3-D photographs with the vectra camera system. Different implants can then be placed into the system allowing you to see what you can expect with different implant shapes and sizes.
These can be combined with a mastopexy so you can see what augmentation alone looks like vs augmentation mastopexy.
Your images are treated with utmost privacy and respect. They will only be used for you. Imagine the You will also be able to see and feel examples of different implants. So you can choose the right implant for you. You will then be able to think about your options and are welcomed back for a second consult with Dr Hadi at no extra charge to go through what you have chosen and to answer all your questions. Once you have decided to proceed to surgery, you will be looked after by Dr Hadi every step of the way. You will have an all-female theatre for your comfort.
How can I prepare for surgery?
When you decide to proceed, there are a few things you can do to prepare:
- Eat healthily by avoiding excessively fatty foods and foods high in sugar.
- Stop smoking as this significantly increases complication rates. No smoking for 6 weeks prior and 6 weeks after surgery.
- Stop all blood thinners such as warfarin, Plavix, aspirin unless discussed with Dr. Hadi. Also, avoid over-the-counter medications that may thin the blood.
- Shower with a medicated soap like phisohex, sebomed, or sapoderm the night before or morning of surgery to reduce bacteria on the skin.
- Fast (do not eat anything) at least 6 hours prior to surgery, as instructed by Kareena Hospital.
- Wear loose, comfortable, dark clothing and remove all jewelry.
How long will the operation take?
You will need to be fasted at least six hours before surgery. The operation will take around four hours and is performed under general anaesthetic. A Specialist Anesthetist will be present during the operation. Kareena Hospital is the preferred hospital.
Our surgical technique
- 14-step plan of infection prevention to reduce the chance of capsular contracture.
- Use of the Keller funnel to minimize contamination and scarring.
- Prevention of breast implant animation through careful muscle dissection.
- Meticulous haemostasis to prevent bleeding.
- Special blocks for postoperative pain prevention.
- Use of internal bra sutures to anchor tissues and prevent implant migration.
- Use of fat grafting as needed for improved results.
What is a Keller funnel?
A Keller funnel is a tool used to insert implants with minimal contamination and scarring. It's a standard in breast implant surgery to reduce the risk of capsular contracture.
What is the 14-point plan?
The 14-Point-Plan is endorsed by the Australian Society of Aesthetic Plastic Surgeons. It minimizes bacteria during surgery to prevent capsular contracture. The plan includes steps like using antibiotics, avoiding specific incisions, and more.
How long will I stay in the hospital?
The surgery is usually performed as day surgery or overnight stay. You'll receive antibiotics and pain relief tablets. Contact Dr. Hadi if you have concerns postoperatively.
Do I need to wear a post-operative garment?
You'll be provided with a soft crop top to wear for comfort. It should be worn as much as possible for 4 weeks.
What about the sutures?
Your wound is closed with dissolvable sutures. An internal bra technique is used to anchor tissues, and overlying sutures are also dissolvable.
What about scar management?
Post-operatively, wounds will be dressed with white hypafix, changed to brown tape after two weeks. Apply tape for at least 6 weeks, and protect scars from sun exposure for 6 months using tape or sunscreen.
When can I shower?
You can shower from the next day. If dressings get wet, blow dry them after showering.
When can I drive? When can I exercise?
Don't drive for 24 hours after sedation. You can drive once comfortable, generally after one week. Gentle walking is encouraged from the next day. Leg exercises can start after two weeks, and upper arm/chest exercises after six weeks.
When can I go back to work?
Depending on your work's physical demands, take 1-2 weeks off before returning to work.
What can you do after surgery?
Your role in the operation is essential:
- Follow post-operative exercises as shown.
- Do deep breathing exercises to prevent pneumonia.
- Take prescribed antibiotics to avoid infection.
- Avoid smoking for at least 6 weeks.
- Tape the wound for around 6 weeks to achieve the best scar.
- Attend regular reviews for healing progress.
- Take antibiotics before dental/medical procedures to prevent implant contamination.
- Keep your implant card containing implant details.