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Breast lift in 35 year old woman after weight loss surgery

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after

This 35 year old woman reached her plateau weight after losing 56 pounds following bariatric surgery.  She had breast lift or mastopexy using a short scar technique which leaves behind scars in the shape of a “lollipop.”  Some breast lifts or mastopexies are performed using a technique that results in scars that look like an “anchor,” but I prefer to use this shorter scar technique because scars are never visible in the cleavage nor on the side of the body beneath the arm.  This makes swimsuit selection much easier. 

This woman has a history of poor scar healing.  It is relatively easy to see dark and thickened scars on her abdomen from her bariatric procedure.  I feel that it is especially advantageous to avoid the “anchor” shaped scar in individuals whose scars do not heal well.

When performing a breast lift or mastopexy, very little breast tissue is removed.  Instead, the existing breast tissue is rearranged so that the new breast shape is typically shorter and rounder than it was previously. 

Performing a breast lift in an individual who has lost a great deal of weight is often very challenging.  They tend to have an extreme amount of skin excess and relatively little breast tissue.  As such, a great deal of skin must be removed while significant effort is made to preserve every bit of breast tissue possible to achieve a natural looking breast.

Tuberous breast deformity

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after

This case depicts a 24 year old woman with a tuberous breast deformity who underwent breast augmentation with 330 cc smooth, round, saline implants placed beneath the pectoralis muscles via a periareolar approach.

Her areolas were reduced simultaneously, necessitating an incision completely around the perimeter of the areola.The post-operative photographs depict her appearance at two weeks after surgery.

Questions Related to Areola

Dr. Belsley's Philosophy of Breast Augmentation

When it comes to deciding what approximate breast size you wish to achieve, the best advice I can give you is that you should be guided by your physical frame.  Indeed, you may in fact be limited by it.  In my practice, I select implants based upon your chest measurements, the quality of your breast skin and the size of your breasts prior to surgery.

I perform breast augmentation through a peri-areolar or inframammary approach and I place that vast majority of implants at least partially beneath the pectoralis muscle.  My patients are welcome to select either saline or silicone filled breast implants.  Silicone filled implants can in some cases achieve a more natural feel and may be a particularly attractive option for women with less breast tissue prior to surgery. 

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Breast Reduction Ideals

Once I have removed enough tissue to achieve an appropriate breast size, the nipple and areola are repositioned, which means that the new, smaller breast also has a “lifted” appearance. While this is not the primary goal of this procedure, it is a fantastic secondary benefit of it. I strive to achieve the same aesthetic standards when I perform medically necessary breast reduction as I do for cosmetic breast lift or mastopexy. Since stretching of the areola is a common problem in patients with very large breasts, I typically reduce the size of the areola during breast reduction.

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Dr. Belsley's Philosophy of Breast Lift (Mastopexy)

In my practice, I perform breast lifts using incisions that result in a “lollipop” shaped scars. With good care and a bit of luck, these incisions heal well and the scars are difficult to see from a distance. Nevertheless, a woman who undergoes a cosmetic breast lift must be prepared for scars that are visible. This is one example of a “trade-off” in plastic surgery and of course, there are many others. This is one, however, that I feel is more than worthwhile in appropriate candidates.

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Dr. Belsley's Philosophy of Breast Revision

I apply the same criteria to patients who have had their surgery elsewhere as I do to my own patients. I am typically reluctant to re-operate on a breast augmentation patient for minor issues, because each time one undergoes revision, many of the risks of surgery tend to be multiplied. This is why I spend a great deal of time discussing size preferences and the likely outcome of surgery with my patients pre-operatively. It is said frequently that the most common reason for re-operation of the breasts in women who have had breast augmentation surgery is that they wish to “go bigger.” Ultimately, I feel that this is a poor reason to undergo repeated surgical procedures that can only result in more scar tissue, which is unpredictable, and thinning of the native tissues, which are necessary to cover the implant and provide a natural looking result. I encourage patients to think carefully about the risks of revision in cases where there is not a major problem.

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Dr. Belsley's Philosophy of Male Breast Reduction

Treatment for gynecomastia can be approached in several ways and is largely dependent upon the “type” of tissue in the chest that needs to be reduced. A physical examination is necessary to create a plan for treatment. Most of the time, I treat these individuals with a combination of ultrasonic liposuction and removal of glandular and breast tissue through a small incision on the border of the areola. Some individuals will be able to achieve excellent results with ultrasonic liposuction alone. Others, may require more extensive incisions. My goal is to give you a natural looking masculine shape that is well proportioned with the rest of your body using the shortest incision possible.

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