Breast augmentation with a lift (augmentation/mastopexy) is a combination procedure that is very common in cosmetic breast surgery. While the goals of a breast lift involve tightening the breast by removing skin and a breast augmentation involves stretching out the breast to increase size, combining the two can give a very nice full and perky look to the breast. The risk of complications can potentially increase by combining the two procedures, but if performed properly and with good planning, the results can be stunning. It is important to consult with a board certified plastic surgeon such as Dr. Setty to make sure the complex procedure is planned and performed properly.
A typical candidate for breast augmentation with lift is a woman who has lost some fullness after pregnancy and breast feeding or with weight loss. She will often want to restore fullness to her breasts as well as improve the overall shape to her breasts. The skin elasticity will often be poor and the nipple and areola will be low on the breasts. Good candidates will not be smokers and will usually be done having children. Also, the ability to rest and be off work for at least one week is helpful.
Typically, the breast implants are placed in the breast first. The type of implant and shape of implant will be chosen prior to surgery. Also, a long discussion on size of implant will be had prior to surgery so Dr. Setty will have a good idea on your goals. It is helpful to bring pictures of women’s breasts that you find attractive to the initial consultation. At the time of consultation, you will try on breast implants that fit your anatomy and you will gain a sense of what your final result may be. One important consideration is that a more conservative breast augmentation is often suggested by Dr. Setty since the forces of an augmentation are opposite a breast lift. If too large an augmentation is performed, early complications can occur. For more discussion on types of implants, see the breast augmentation page.
After the implant is placed, the breast lift is performed. The excess skin from the breast will be removed around the areola and along the lower central portion of the breast. Typical incisions/scars will be of the “lollipop” type around the areola and straight down the breast to the crease under the breast. The areolar size will be decreased in size and the nipple will be raised in a more “perky” position. A drain may be placed to prevent fluid collection. All sutures will typically be absorbable and skin glue will be placed on the incisions. You will be placed in a surgical bra at the end of the surgery.
The surgery is commonly performed on an outpatient basis unless it is combined with a tummy tuck. The procedure is performed at a hospital or state-of-the-art surgical unit with board certified anesthesiologists. The surgery will take anywhere from 1 to 3 hours. All incisions are closed with absorbable sutures and covered with skin glue. This allows the patient to get in the shower the same day of surgery if she wishes. A surgical bra is placed at the end of surgery and the patient is instructed to wear this bra or any other bra without an underwire for a total of six weeks.
Postoperative instructions include no upper body exercises of any kind for a total of 6 weeks. Oral pain medications, muscle relaxants, and sometimes antibiotics are given as prescriptions for the postoperative period. Generally some pain is experienced for the first week, especially if the implants have been placed under the muscle. Swelling can persist for 4-6 weeks but is usually mostly resolved by two weeks. Most patients can have a good sense of their final result anywhere between 6 weeks and three months.
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