Breast Lift

Breast augmentation seems very simple. You make an incision and place an implant but it really is rather complex. We’re going to touch on a few things that really are important to know about breast augmentation and implants, and how to choose a great breast surgeon. Implants come in several different flavors, so to speak. They come in saline, they come in silicone, they come in different shapes now, they come in round, they come different textures. Smooth or a fuzzy Velcro-like texture which has really fallen out of favor and frankly it’s an implant that I’ve never really used, and I don’t think it has the benefits that it was supposed to have.

Silicone implants come in also various, we call levels of cohesiveness, so those implants can be very firm and that’s known as a gummy bear implant or they can come very fluid and that’s more of a standard implant. I prefer one that’s in between which we call a soft touch. So it has the benefits of being a little bit firmer but it’s still very, very natural and it’s very soft. And so that’s really a newer … in fact, that is the newest cohesive level of implant sold by one of the manufacturers that I use.

The saline implants, again, I like them, I use them very often. They have the benefit that when they pop, they just deflate so it’s pretty simple. There’s no test, there’s no MRIs, there’s no studies. And the implants that I use are smooth and round and a newer implant that’s also on the market that is smooth and round is called the Ideal Implant. And again, they named it the Ideal Implant. It was created by a plastic surgeon because they wanted something that was very similar to silicone and how it felt and how it was shaped but was made with saline so when it did pop, it just would dissolve in the body and it would be very natural and you would have no problems. And that’s a very nice implant. I’m using more and more of them. And those are the general implants that we have on the market in the United States today.

Let’s talk about breast augmentation and breast lift. It is a little bit of a different animal than breast augmentation alone, and the reason why is because you’re doing two separate things that are really on opposite ends of the spectrum. You’re trying to lift and tighten and remove breast tissue and tighten the skin envelope. At the same time, you’re putting essentially a balloon underneath the breast tissue and blowing it up. So, those are two opposing forces. And so really, you have to be cautious and careful and really understand those dynamics and make sure you size the patient appropriately and remove tissue appropriately so you don’t have a disaster where you take out too much skin and then put a big balloon in there and blow it all apart, and the implant is popping out through the skin because someone took too much skin and didn’t realize that they were going to have to put that big of an implant in.

One of the things that I counsel all my patients on is that what I do, is I do this in a very step-wise fashion to stay out of that problem. And so, what I do is I mark where I think your nipple needs to be and I put the implant in initially, and it’s typically what we call sizer implant, not the real implant, and then I can elevate the back of the bed, so to mimic you standing, and then I can draw and actually tighten the skin and temporarily hold it in place. And so, I can evaluate how tight the skin needs to be around the implant size that we’re currently going to use. Because obviously if I used a 200 CC implant, I can tighten the skin more than if I used a 600 CC implant.

So, where many surgeons draw and cut, close it, and then put the implant in, what takes me a little bit longer time but I think is much safer is to place the implant, put the bed, the stretcher that you’re in up and so I can evaluate your breast, evaluate your tissue, and then I can mark and draw, and tighten it accordingly to the breast implant we’ve selected and also place the nipple appropriately in the best position. And that way, we really limit the risks of over-resecting skin with an implant.