Advanced Art of Cosmetic Surgery Thomas M. DeWire, Sr., MD, FACS Specializing in Cosmetic Plastic Surgery Richmond, Virginia, USA
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Body Contouring |
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| Augmentation Mastopexy: Breast Enlargement with Breast Lift |
| Breast Enlargement with Breast Lift or Augmentation Mastopexy: | ||
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Breast Augmentation in the presence of breast ptosis or skin droop requires correction of the excess of skin and the breast disproportion, in addition to enlargement of the breast volume. True ptosis of the breast is seen when the level of the nipple falls to a point at, or below, the level of the fold beneath the breast. There is usually too much breast skin and too little breast tissue volume in this situation, leading to the appearance of elongated and flattened breasts. A variant is seen where there is adequate breast volume, but a high positioning of the lower breast folds, and the resultant appearance of low - positioned nipple areolae. In either instance, upward relocation of the nipples, and tightening of the skin is needed, along with adjustment of the position of the lower and lateral breast folds. I always prefer placement of implants beneath the pectoral chest muscles, to prevent mammogram interference, and to prevent surface wrinkling of the breasts that is often seen with implants above the muscle (directly behind the breast gland tissues). By approaching breast implant placement via the Trans-Axillary technique (via the armpit), I am also able to prevent potential contamination of the breast implants with germs that are known to reside in the breast tissue ducts, and are probably responsible for the frequent finding of firm scar formation around implants that are placed above the muscle. Also, the axillary route to the submuscular plane will preserve the intact muscular fascial envelope from the chest muscles to the abdominal muscles, maintaining "internal bra - like" support. Breast Lift in concert with Breast Augmentation Mammaplasty is a more complex procedure than breast enlargement alone, and thus will require a longer period of skin adjustment until the absolute final result is apparent. Mastopexy or Breast Lift at the time of Breast Augmentation always requires some type of incision, or incisions, in the breast skin, and thus there is a trade-off in achieving improved breast shape and breast size, in exchange for some scars. Depending upon the degree of sag present, several different mastopexy approaches may be used to tailor the skin, while placing the least number of scars on the surface of the breast. Mastopexy seldom leads to loss of nipple sensation by the techniques that I favor. Fortunately, breast scars, if necessary, will fade and flatten out with the passage of time. Examples of several techniques are shown below and on the linked pages. |
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Follow the Links below to Photo Illustrated explanations of each mastopexy technique:
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Mastpexy Type |
Considerations | |
| Degree of Ptosis to be Corrected | Synonyms and similar procedures | |
| Crescent Mastopexy | Mild apex sag Grade - I | Nipple lift |
| Link to Crescent Mastopexy and Photos | ||
| Benelli Mastopexy | Mild to moderate sag - Grade I-II | Donut mastopexy; apex lift |
| Link to Benelli Mastopexy and Photos | ||
| Vertical Mastopexy | Moderate sag - Grade II | Modified Benelli, LeJour, Lollipop |
| Link to Vertical Mastopexy and Photos | ||
| Full Anchor Mastopexy | Severe sag - Grade III | Inverted-T,
Weis Pattern Lift, Full Mastopexy; Anchor Lift
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| Link to Full Anchor Mastopexy and Photos | ||
| Maps to Office |
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E-Mail Dr DeWire | ||||||
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| ©Copyright 1997-2013 Advanced Art of Cosmetic Surgery: Thomas M. DeWire, Sr, MD, FACS Revised: January 11, 2013 11:19 AM |