Traditional Breast Lift Surgery Vs Surgical Mesh

Traditional breastlift surgery is conducted by making incisions around the areola, across the breast crease, and vertically down from the nipple to the fold, thus allowing plastic surgeons to excise some of the loose skin and tighten the tissue.  However, one tradeoff a patient should remember is that while it can raise and reshape the bust for a period of time, it cannot stop the effects of gravity and skin laxity.

But recently, plastic surgeons from South Africa have developed a new technique called Internal Bra System which uses a “support” to prevent future sagging.  This method is now also used in Europe.

The new breast lift technique uses a mesh-like device called Breform which is similar to the one used in hernia repairs.  Meanwhile, plastic surgeons who developed the method said the material can take the strain off the scars and skin, preventing the breasts from sagging.

While Breform has not yet been approved in the US, experts believe that it will be introduced to the market within the next coming years.

Breform is a cone-shaped polyester mesh that is placed underneath the breast skin and is attached to the fascia using internal sutures.  The procedure is conducted under general anesthesia that puts a patient to sleep.

Plastic surgeons in Europe who are using Breform said the device is incorporated into the breasts over time, with the body naturally producing fibrous tissue holding the new structure in place.  With this technique, they believe the result is like a permanent support bra under the skin.

However, patients should remember that the new technique also involves the same incision sites used by the traditional breast lift surgery.  This means that the risk of scar and the length of recovery of these two methods are almost the same.

While Breform is approved in Europe, it has not been permitted by the US Food and Drug Administration, which is noted for its strict regulations on medical instruments.  And because the breast surgical mesh is quite new, there is no long-term study proving its effectiveness and safety.

Some US plastic surgeons are also concerned if the mesh-like device may affect the accuracy of screening tests for breast cancer or if it may lead to serious complications.

However, a four-year study involving 170 patients in Holland found no serious complications following the procedure.  The trial also revealed that breast X-ray examinations were still possible after the internal bra surgery.

Can Silicone Breast Implants Correct Mild Drooping?

Silicone breast implants are increasingly becoming popular these days as they provide a more natural result than saline implants.  This is not surprising because they are filled with a cohesive silicone gel designed to replicate the “feel” and move of glandular tissue and fats; another bonus is that the filling does not evaporate—unlike the saline solution—which means the patients can maintain their breast volume unless in the event of leak or rupture.

The good news is that breast implants—particularly the silicone-filled versions—can correct mild or pseudo ptosis (sagging) which is caused by breastfeeding.  It happens when the mammary glands put pressure on some glandular fats, but after the enlargement resolves, the breasts somewhat “deflate.”

On the other hand, true ptosis is caused by stretched and damaged suspensory ligaments in the breasts.  Oftentimes, the problems can only be addressed by mastopexy or more commonly referred to as breast lift; this can be performed as a standalone procedure or as a complementary to breast implantsurgery.

To correct mild or pseudo ptosis, it is highly recommend to use small implants (300 to 350 cubic centimeters would be the right range) because introducing large ones can aggravate the problem as the tissue is forced to carry the extra weight.  And over time, the stretched tissues will worsen.

By using large implants, there is a higher chance that the patients will need breast lift sooner rather than later.

It is important to note that even small implants can provide upper pole fullness in the breast, the area which is often affected by childbirth and breastfeeding.  But as mentioned earlier, silicone implants are better than the saline versions because they do not have a natural deflation rate.

By contrast, saline implants have been found to lose about 10 percent of their volume after a decade because of evaporation and other factors.  This simply means that patients with these devices are more likely to need revisions sooner than those who have silicone implants.

Meanwhile, there is still a debate whether the subglandular or submuscular implant placement provides more lift.

In the subglandular implant placement, the device is positioned above the muscle which is believed to provide a more lifting effect.  But one downside is that only the tissue and skin support the implant, something which may aggravate the ongoing ptosis.

On the other hand, the submuscular implant placement is said to prevent future ptosis because the device, which is positioned under the pec muscle, is being supported not only by the tissue and skin but also by a thick amount of muscle.

Too Young for Breast Augmentation?

In the US, the legal age requirement for breast implant surgery is 18—and that is if you are going to have saline implants which are filled with a sterile saline (saltwater solution).  But if you want to use the silicone implants, you should be at least 22 years old.

The main reason why silicone breast implants require a higher age limit is that they pose risk in the event of rupture or leak.  For this reason, you have to undergo regular MRI screening to detect any “silent leak.”

By contrast, the examination is not necessary if you will choose the saline implants because in the event of implant failure, your breasts will deflate within hours after the rupture, thus allowing you to seek revisions right away.

Generally speaking, female patients under the age of 18 cannot have breast augmentation surgery unless there is an issue of breast deformity.  The problem with younger people is that their body is still maturing and they may not yet fully understand the ramifications of cosmetic plasticsurgery.

It is important to note that even if you are flat-chested at the age of 15, there is still a chance that your breasts will enlarge as years pass by.  And with large implants and ongoing breast development, you may end up having oversized busts that look unnatural and asymmetric to the rest of your body.

Another concern is that patients below the age of 18 are not emotionally mature.  In fact, a study has suggested that teenagers see cosmetic surgery as a way to fit into their crowd.  By contrast, adults seek the procedure to stand out from the rest.

As mentioned earlier, your plastic surgeon may allow you to have breast augmentation at a younger age if you are suffering from certain types of deformity including tuberous breasts in which they appear too pointy because of the unusual structure of their base.

Breast augmentation performed at a younger age may also be necessary if you develop a very large breast on one side while the other is too small or even “absent.”  In general, age is not an issue in reconstructive plastic surgery.

While the US is quite strict when it comes to cosmetic breast augmentation, certain countries allow the procedure on patients as young as 16.  This lower age limit is not acceptable to many American surgeons who believe that the body should be allowed to mature first before any aesthetic or elective surgery is conducted.

Breast Implant Size and Things to Consider Before hand

The size of breast implants is measured via cubic centimeter or cc instead of “cup” since every bra manufacturer follows its own standard.  Meanwhile, it is important to note that the volume is not the only thing that affects the final results as there are other contributing factors such as implant profile, shape, and placement.

During the previous years, a significant number of women who asked for breast augmentation wanted larger implants even if it meant having a “heavy” top look.  However, plastic surgeons today see a shifting trend toward smaller sizes to achieve the natural look.

The growing trend can be seen on some Hollywood celebrities who replaced their breast implants with smaller ones.  For instance, Denise Richards and Pamela Anderson have been reported to have undergone revision plastic surgery to downsize their implants.

Another good example is Kate Hudson who has been reported to receive small breast implants in 2010.  And because of the subtle changes in her bust size, no one would even know that she had the procedure if not only for her previous photos and videos showing how flat-chested she was back then.

As a general rule, very large implants will obviously look “fake” in addition to higher risk of complications as the body, especially the back and upper torso, has to carry more extra weight.  For this reason, a good plastic surgeon will make every effort to convince his patient that inappropriate implant sizes can lead to many problems.

The problem with inordinately large implants is that they may lead to premature sagging and tissue thinning as the breasts are forced to carry more weight.  To correct such complications, a revision plastic surgery—which may involve implant replacement or permanent removal of the device—is the only effective solution.

For thin patients, particularly those with limited amounts of glandular fats and tissue, very large implants can significantly predispose them to visible and palpable rippling, or sometimes even traction wrinkling especially if they will receive the textured implants with large size “graininess.”

Another consideration to make is that large breast implants can upset the center of gravity of women, which can affect the way they move.  With this consideration, athletes and patients who live an active lifestyle are generally advised to choose smaller implants to maintain their performance and good posture.

Because of the risk of excessively large bust size, implant manufacturers in the US do not sell silicone breast implants that are over 800cc.

Study Shows the Benefits of Reconstructive Breast Augmentation to Cancer Survivors

When breast augmentation is mentioned, the first thing that comes to mind is a cosmetic procedure to improve one’s figure.  While it is true that a significant number of patients seek this to increase their bust size, the surgery is also a way to reconstruct the breasts of cancer survivors who had mastectomy.

In 2010, approximately 93,000 breast reconstructive surgeries were performed in the country.  Most of the patients were cancer survivors who wanted to regain their normal appearance.

According to the American Cancer Society, female patients who have undergone breast reconstruction via breast implants, tissue-based method, or combination of both procedures, have experienced dramatic improvement in their social and sexual wellbeing after their traumatic experience with cancer and disfiguring surgical treatment.

A recent study, which is conducted by researchers from Memorial Sloan Kettering Cancer Center and The University of Toronto, examined the wellbeing of post-cancer patients who had DIEP flap breast reconstruction, a procedure in which their own abdominal tissue was used to create new breast mound.

Before and after breast reconstruction, the respondents were required to answer questionnaires that would determine the status of their wellbeing and self-esteem.  According to the findings, majority had experienced significant improvements in terms of their emotional health just three weeks after the reconstructive plastic surgery.

But as with any tissue-based breast reconstruction in which the patients will likely experience muscle weakness in the donor site, most patients had reported weakened abdominal wall three months after surgery.  However, the symptom is usually tolerated well by many.

While muscle weakness is one of the tradeoffs of breast reconstruction via tissue-based technique, plastic surgeons can prevent this by placing surgical mesh or support over the donor site.

Apart from using a person’s own tissue, plastic surgeons also use breast implants, either filled with silicone gel or saline solution.  But in case that there is little tissue left after mastectomy, they will first insert temporary implants that is inflated with saline solution every two weeks; once there is enough room, they remove the tissue expander and replace this with a permanent implant.

The appropriate breast reconstruction technique largely depends on the amount of tissue left—or the lack of it.  And in general, patients who had invasive cancer surgery will likely need tissue-based surgeries.

On the other hand, women who are left with more amounts of glandular tissue and skin after their cancer surgery will often have the opportunity to choose breast implant surgery, which is less invasive and results to less scarring than the tissue-based reconstruction.

French Implant Manufacturer Warned by US 10 Years Before the Scandal Broke

It has been estimated that 300,000 women have the defective breast implants manufactured by the now bankrupt French company Poly Implant Prothese (PIP).  According to reports, the devices are extremely prone to rupture as they lack a protective coating that prevents silicone gel from migrating to other parts of the body.

Fortunately, the defective silicone implants were not approved and sold in the United States.  In fact, the US Food and Drug Administration has warned PIP in 2000—10 years before the scandal broke—about its failure to follow “good manufacturing practices.”

However, reports show that 80 percent of PIP breast implants were exported to other countries including UK, Chile, Germany, Venezuela, Spain, Argentina, Colombia, and Brazil.

According to the FDA warning sent to PIP founder Jean-Claude Mas, the company’s plant in La Seyne-sur-Mer in the south France has 11 deviations from “good manufacturing practices.” 

The organization also warned him about the “adulterated” saline breast implants, and cited his company’s failure to investigate the deflation of its products in addition to failure to report 120 complaints in France and other countries.  Currently, there is global manhunt for the 72-year-old company founder who is a former butcher.

With the FDA warnings, consumer groups in France ask why their authorities did not conduct an investigation on the safety of PIP’s breast implants.

The US is one of the countries that require very strict guidelines when it comes to implants and devices used in cosmetic plastic surgery.  In fact, Mentor and Allergan Natrelle are the only two companies allowed to manufacture and sell breast implants in the country.

To allay the concern of patients in the US who had breast augmentation surgery, the American Society of Plastic Surgeons (ASPS) has released a statement saying that the defective implants did not reach the country.  The organization added that only those who had the procedure outside the US should be concerned with the defective product.

Because of the fiasco, the French government has promised it will pay for the implant removal surgery of women affected by the defective products.  It has been estimated that 30,000 patients in the country had the PIP silicone-filled implants.

Reports show that PIP’s cheap silicone implants were filled with an industrial silicone gel designed for mattress rather than for human.

On the other hand, the British government still insists that there is no need to require all women with PIP’s silicone implants to undergo implant removal surgery although they are advised to immediately consult their doctor to determine if there is a leak.

Breast Implants with Lift for saggy boobs

Even small breasts can sag due to the natural effects of aging, weight fluctuations, and previous pregnancies.  Fortunately, plastic surgeons have come up with a new technique which combines the benefits of mastopexy (or breast lift) and breast augmentation in one operation.

The sagging of the breasts primarily happens when the amount of tissue decreases and the skin becomes lax.  Contrary to popular belief, breast augmentation surgery alone is less likely to provide a lifting effect especially if there is a severe case of ptosis (drooping).

Mastopexy with breasti mplants starts by making incisions to remove a small amount of skin, which in turn corrects the sagging appearance.  With this technique, less tissue is excised than if breast lift is performed alone; for this reason, patients will enjoy less scarring on their chest.

Because less skin is removed, plastic surgeons need shorter incisions to perform mastopexy-augmentation surgery.  In most cases, they use the crescent-shaped incision around the areola complex, although patients with severe breast ptosis may need the lollipop incision in which the surgical cut is made around the areola and vertically down the breast crease.

The good thing with mastopexy-augmentation is that most patients can get more cleavage, although they should bear in mind that the final result also depends on their chest width and rib cage.  For example, women with a concave chest are likely to enjoy more medial cleavage and upper pole fullness as the implants tend to settle toward the center.

On the other hand, patients with convex chest will achieve less cleavage because their implants will likely settle opposite with each other.  However, there is a solution to the problem: use breast implants that offer more projection off the chest wall.

While some surgeons prefer simultaneously performing breast augmentation and mastopexy, others would rather wait for three months before another surgery (augmentation) is conducted.

Some doctors argue that breast augmentation with mastopexy—if performed on the same day—can lead to higher risk of asymmetrical breasts and complications since the skin is being removed and tightened while at the same time the implants stretch it even further.  Another concern is the tension on the incision site can adversely affect the blood supply.

They also argue that it is challenging to position the nipple and breast crease if mastopexy and breast augmentation are performed simultaneously.

Regardless if breast augmentation is performed on the same day of mastopexy or at a later date, most plastic surgeons recommend placing the implants totally under the pec muscle which can provide good coverage and strong “support.”