There’s no doubt that breast surgery is one of the most common plastic surgery procedures requested when seeing a plastic surgeon in New Jersey. It can be a little confusing as to what these procedures are and what they can do to improve the shape of your breasts.
As women, our bodies and breasts change with weight loss, weight gain, pregnancy, breastfeeding and, of course, with aging. These are natural changes that occur over our lifetime and can not only change the size your breasts but change the shape. Unfortunately, once these major changes occur, our breasts never really revert back to what they looked like before.
If I had a dollar for every time a woman came to me and said all she wants are the breasts she had before, I’d be a very rich woman and I would not be writing this blog right now, LOL! All jokes aside, I thought this would be a good thing to discuss on this blog and answer some questions I typically get during a complimentary breast augmentation consultation. First, let’s review the main breast procedures.
Breast Augmentation
Breast Augmentation enhances or increases the size of the breasts. It can be done with the use of a breast implant or with fat grafting in which fat is removed via liposuction from another part of the body and injected into the breast tissue for a natural breast boost. Breast implants are either silicone or saline and are placed under (or over) the pectoralis muscle through a small incision in the breast crease, armpit, or areola most commonly. Results can be natural or have that augmented appearance depending on its placement and size. Typically, we want to choose an implant that fits your current chest and breast dimensions to avoid future problems. Fat grafting places fat uniformly within the breast tissue and is natural in appearance. It most often only will increase your size 1-2 cups.
Breast Lift
A breast lift also known as a mastopexy is the removal and tightening of extra breast skin and repositioning of the nipple. Patients who typically need this have that “sagging” appearance where the nipple is at the lower portion of the breast and the breast feels deflated. This is commonly seen after pregnancy, breastfeeding and with aging. This procedure lifts the nipple back to the center of the breast and removes the extra skin that has stretched causing the sagging. Typically breast tissue itself is not removed. The incisions can vary to just around the areola, a vertical incision, or an anchor incision depending on how much the nipple needs to be lifted and how much skin needs to be removed.
Breast Lift with Implant
Sometimes the two procedures above can be combined. This is ideal for the patient that wants a lift but wants to be bigger in size or wants that fullness at the top of their breasts or cleavage area. As you can imagine, when you combine procedures you double the risks so it’s important to consult with a board-certified plastic surgeon.
Breast Reduction
Breast Reduction makes your breasts smaller. It can be done for appearance (you just don’t like your larger breasts) or if you have pain from the weight of the breasts causing muscle strain or rashes. The extra skin and breast tissue are removed through vertical or anchor incisions to create a smaller breast and the nipple is again repositioned.
Common Q&A
Q. Can I get a mammogram if I have implants?
A. Yes, you should continue to undergo normal screening via mammogram. Typically, the radiologist obtains special views to look around the implant.
Q. Do implants increase my risk of cancer?
A. No, not the traditional breast cancers we typically see (ductal and lobular invasive cancer). The caveat to this is there is a rare blood cancer called ALCL or Anaplastic Large Cell Lymphoma that is associated with textured breast implants. Again, this is rare and only seen so far in textured implants. Treatment would include removal of the implants and capsule and referral to an oncologist.
Q. Will my breasts be lifted with a breast reduction?
A. Yes, this is one in the same with a breast reduction procedure. When we remove extra skin and tissue, we are also lifting and making the breast “tighter.” The nipple is also moved to a higher position.
Q. How do I know if I need a lift?
A, Typically, the nipple is below your crease or along the lower portion of your breast. If that is the case, a lift is recommended with or without an implant.
Q. Is fat grafting permanent?
A. Yes, however, over 6 months-1 year it’s common for 40-50% of the fat to dissolve. The remaining will stay in place.
Q. If I lose weight, will my breasts get smaller after fat grafting?
A. Yes, it will act like fat anywhere else in the body. So, if you gain or lose weight, you might notice a change in your breasts.
Q. Can I breastfeed?
A. Typically, yes but you may not produce enough milk requiring supplementation with formula. Some may not be able to breastfeed at all.
Q. Will I lose sensation in my nipples?
A. This is a complication of any breast procedure. More often, especially with reductions, you may be more sensitive in the initial healing period.
Q. How long do implants last?
A. Generally, 10-15 years but that does not mean that you must exchange your implants at that time. It really depends on if you are having any complications or symptoms from the implants or your breast shape has changed. Typically, this occurs since we age significantly during this time so many of us will need a lift.
Q. Can my breasts say high and tight after the surgery?
A. While this may be the case immediately after the surgery, unfortunately, no. Our skin stretches, we cannot change that. So as the swelling improves, gravity kicks in and the skin stretches, your breasts will settle down to a more natural position, typically within a 3-month period.
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This is a good start for now. Have any other questions? Ask us!
