Breast lift with implants

WHO IS A GOOD CANDIDATE?

Patients who have excess breast skin and want to go larger in size are ideal candidates for a breast lift with augmentation at the same time. Sometimes, a breast augmentation alone with an implant can lift the breast enough to avoid having to do a full lift. Each patient's situation is unique, so options for each patient will be decided after meeting with Dr. Kayan.

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CHOOSING IMPLANT SIZE

Everyone has different shaped breasts and different degrees of ptosis. This does influence how the patient will look post operatively. Sizing in our office is done first by asking the patient’s current breast size and seeing what their goal breast size is. On the day of the consultation, we will go over this, and we will size the patient either at the time of consultation or at the time of their pre-surgery appointment, depending on available time. Bring a sports bra and clothing such as a tank top, as this will help most with seeing the appearance with different sized implants. We will try on various sizes under the clothing to help narrow down the range. We usually order a range of sizes on the day of surgery, so the patient is not committed to any size until the day of surgery. Photos of desired size/shape as well as what the patient feels is too small or too large are helpful.

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*Up/Downsizing Policy: Patients wanting to upsize or downsize within 1 year after surgery will just need to cover the cost of the implants and operating room/anesthesia, the surgeon's fee is waived. Our primary goal is to ensure the patient is happy with their results.

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THE PROCEDURE

The surgery is done at an outpatient surgery center under general anesthesia, and usually takes around 2 hours. The augmentation is typically done first as an incision within the area that will be incised for the lift, so there is no separate incision for the augmentation. The lift is either done as a Wise (anchor) pattern or a lollipop pattern which does not include the scar underneath the breast, depending on the patient's goals and preferences. All incisions are closed with dissolvable sutures and glue, and patients are wrapped tightly with gauze padding and an ACE wrap. Drains are not typically used.

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IMPLANT TYPES

Both saline and silicone implants are commonly used, and both are FDA approved and safe. In addition to the price difference (saline implants are less expensive), there are other important differences. Both have an outer shell made of silicone. Saline implants come deflated and are filled with sterile saline during your surgery. Silicone implants come pre-filled and with set sizes. Projection refers to how much the implants project forward from the body - moderate, high and extra high. We have sizers for each one to determine what the patient's goal look is. Silicone also comes in different levels of cohesivity and in textured and anatomic types. The most commonly used implants in our practice are smooth round silicone implants, and among this group, it is the patient's choice if they want regular gel, the most cohesive gel, or the hybrid type. Prices differ between each type, with a higher price for each level of extra cohesivity. The advantage of a more cohesive implant is the silicone gel is less likely to leak into the surrounding tissue in the case of a rupture. More cohesive implants also have less tendency to ripple, which is advantageous if a patient is very thin with very little breast tissue. The only difference in feel is that more cohesive implants can feel firmer.

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RECOVERY

The ACE wrap and gauze can be removed after 24-48 hours, and patients may shower. After showering, if there is a lot of swelling, it is advised to wear the ACE wrap, or transition to a front closure sports bra if it is easier or more comfortable. Overhead reaching is not permitted for 2 weeks, nor is high-end exercise or lifting more than 5lbs. permitted for 4-6 weeks after surgery. At first, the breast implants will appear to sit high up on the chest but will settle into place over 1-3 months. Scars will fade after about a year, and final results are visible anywhere from 6 to 12 months, depending on patients age and skin elasticity.

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LONG-TERM MAINTENANCE OF IMPLANTS

If a saline implant ruptures, it is noticeable quite quickly as the breast will return very quickly, usually in less than a week, to its original size. If a silicone implant ruptures, it is not obvious. The FDA recommends that patients with silicone breast implants get an MRI 3 years after their initial surgery, and every 2 years thereafter to screen for implant rupture. The lifespan of a breast implant is 10-15 years.