Breast Lift – Traditional or Short Scar for Your Mastopexy?

“The Fountain of Youth” – Dr Chris Porter’s inside view of cosmetic surgery where he aims to help you to make the best possible informed choice and achieve your cosmetic surgery goals.

Breast lift surgery (mastopexy) has the goal of reshaping and uplifting the drooped breast, repositioning the nipple higher on the chest and ultimately gaining a more youthful and proportionate bust. Effectively regaining the bust that a woman had prior to pregnancy, breast feeding, weight changes and general aging, and thereby returning the confidence and self esteem previously diminished by body shape change. Mastopexy is the term applied to a number of different surgical techniques that have the same goal of uplifting the breast. Mastopexy can be performed on the breast alone or combined with an implant. An implant is used if an increase in bust size is desired. If the current breast volume is desirable then a mastopexy alone is the option of choice. A mastopexy requires skin incisions to reshape the breast. Skin incisions result in scarring, in the case of mastopexy techniques there are a number of possibilities. All have a scar that encircles the areola, the pigmented skin surrounding the nipple. This scar tends to hide well at the junction of the paler breast and darker areola skin. A circular scar alone is known as the “peri-areolar technique” and is used if only a small amount of nipple uplift is required. If a more moderate amount of lift is required then a lollipop shaped scar is required, this includes a circular scar around the areola and a vertical extension heading down towards the fold under the breast. This is known as a “circum-vertical” technique. There are a number of names attached to this type of scar – Lejour, Lassus, Hall-Findlay or simply marketed as “short-scar”. For more significant degrees of mastopexy then an additional scar is required, this includes the lollipop plus a scar along the fold under the breast. This traditionally is known as a “Wise” pattern scar. This additional scar in the fold heals well and is hidden by the fold. If the Wise scar is recommended by your Plastic Surgeon then you have been assessed as having more significant droop than could be corrected by a shorter scar technique. In this situation if a shorter scar technique was used then the overall shape and uplift result could be compromised for the false gain of a shorter scar. Your Plastic Surgeon will assess your breast size and shape before recommending which technique is best for your individual characteristics and gain the best possible outcome. Overall, a mastopexy is a life changing surgery that will rejuvenate your bust and body shape, improve your appearance and most importantly lift your confidence.

If you have any specific requests regarding cosmetic surgery topics that you would like discussed on this blog, please feel free to email me: chris@breast-body.co.nz

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Natural Versus Implant Breast Augmentation

“The Fountain of Youth” – Dr Chris Porter’s inside view of cosmetic surgery where he aims to help you to make the best possible informed choice and achieve your cosmetic surgery goals.

“Natural” breast augmentation is performed by transferring fat to breasts from another part or the patient’s body. Fat transfer has been used in cosmetic and reconstructive surgery for a number of years. Initially used in facial cosmetic procedures it is being used more in cosmetic breast surgery to provide enlargement and avoiding the need for implants. It seems like a great idea but there are limitations to the technique and not every patient is a suitable candidate. Extra desire is created as the fat is harvested by liposuction from a prominent fat deposit, for example from the tummy or hips, so effectively the patient gets two cosmetic improvements at the same time.

In 2009, the American Society of Plastic Surgeons released a report detailing the use of fat transfer and injection for reconstructive and cosmetic purposes, offering guiding principles to surgeons and patients about the use of fat transfer for natural breast augmentation. The report noted that physicians and surgeons have been using fat transfer successfully for more than one hundred years to treat cosmetic defects, and that natural breast augmentation is just one way of applying these successful techniques. Lipoaugmentation of the breast is an appealing concept for patient and surgeon – soft, supple and natural and presumably safe, but is it?

Fat augmentation for breast enlargement remains highly controversial for a number of reasons:

– fat injected into the breast may calcify and interfere with future cancer surveillance through mammograms

– grafted fat contains stem cells and stimulatory substances that potentially can cause breast cancer to develop

– injection of fat into breast tissue can cause cyst formation and infection

– consideration needs to be given to the results and size of enlargement as the procedure is labour intensive, may require two or three sessions of surgery and anesthesia, plus the resulting expense is more than for an implant based breast enlargement

– cosmetic surgery journals suggest this procedure carries liability for the surgeon decades after the procedure due to the unknown factors listed above

Despite all of these concerns, fat transfer to cosmetically enlarge breasts is an appealing procedure. There needs to be more research showing success and safety before “natural” breast enlargement is accepted as a routine cosmetic surgery procedure. Until then, implant based breast augmentation remains the surgery of choice for cosmetic breast enlargement.

If you have any specific requests regarding cosmetic surgery topics that you would like discussed on this blog, please feel free to email me: chris@breast-body.co.nz