For many women, their breasts symbolize their most feminine physical characteristic. With the increasing acceptability of cosmetic surgery, more and more women are choosing to enhance their breasts to achieve a more aesthetically pleasing appearance.
Aesthetic plastic surgery of the breast is a compilation of procedures that ranges from simple augmentation to more complex lifting. Breast lifting can be done alone or combined with an implant. In fact, breast reduction is a form of breast lifting associated with removing breast tissue.
Given the spectrum of breast shapes and conditions, it is becoming increasingly obvious to the plastic surgeon that simply using breast implants alone will not always produce aesthetically acceptable results.
In assessing breast geometry and design, the plastic surgeon must consider three crucial parameters:
1. Breast volume and shape
2. Skin condition
3. Nipple position
Although augmenting breasts can to some extent rectify the volumetric problem in otherwise perfectly shaped breasts, the issues relating to nipple position and excessive skin envelope cannot be addressed.
Breast ptosis, or droopiness, is a condition that affects women of all ages. Although we tend to associate breast ptosis with old age, young women are often faced with varying degrees of droopiness after breastfeeding or significant weight loss. For these women, wearing a supportive bra is essential in order to disguise their saggy breasts.
Breast lift surgery is therefore designed to restore breast shape to a more youthful appearance in three ways:
1. Moving the position of nipple-areola complex
2. Removing excess breast skin
3. Reshaping the breast tissue
Although mastopexy does not change the amount of breast tissue a woman has, it can change the shape dramatically and this, in turn, can affect the overall breast size and projection. However there are cases where breast lifting needs to be combined with an implant to produce a desirable breast size. The combined breast lift-augmentation is considered one of the more difficult operations in plastic surgery. It can be performed in either one stage or more commonly in two stages.
Modern plastic surgery is about creating a minimal scar in return for achieving the most desirable aesthetic outcome. The prospective patient should be aware of this delicate balance prior to embarking on this procedure.
The breast lift surgery is basically performed using three types of incisions:
1 Donut-shaped scar around the nipple-areola complex (Benelli-Goes) 2 Lollypop scar from the areola to the breast crease (LeJour-Hammond) 3 Traditional anchor-shaped scar (Wise pattern).
Further to the skin scarring pattern, breast tissue must be surgically contoured from an elongated shape into a more youthful conical structure. This manoeuvre is an integral part of the breast remodeling process. Given the right patient selection, mastopexy can be a very rewarding procedure. Patients must stop smoking for at least four to six weeks before and after the operation. Mastopexy is not usually a painful operation, but discomfort can persist for a week or so. Time off work from this procedure is usually 10 to 14 days for recovery and healing.
When performing surgery to improve the appearance of the breasts, it is important the surgeon considers the patient's individual physiology. Breast lifting will usually result in more aesthetically pleasing breasts while restoring them to a more youthful and desirable position.
About the Author
Dr Kourosh Tavakoli - Cosmetic Plastic Surgeon, MBBS, BSc (med), MS (unsw), FRACS (plast.) Dr Kourosh Tavakoli is a fully qualified Australian trained Plastic Surgeon
