Facelift
Mammoplasty, or breast surgery, is one of the most requested cosmetic surgeries in the United States.
There are three types of requirements:
the breast too small or breast hypoplasia
the breast too big or breast enlargement
the breast that sags or breast ptosis
These aspects can work together, for example, breast enlargement can be associated with breast ptosis.
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Breast hypoplasia is defined by an insufficient volume of the breasts in relation to the morphology of the patient. It can be the result of insufficient development of the breast at puberty, or subsequently appear through loss of volume following pregnancy, breastfeeding, weight loss or hormonal disturbances. Sagging of the breast, distension of the skin and areolas, which are too low, can also be linked to the condition. This operation is carried out on an outpatient basis and can be performed from the age of 18 years old.
Operating Procedure
Mammoplasty increases the size of the breasts by inserting implants, which are pre-filled with silicone gel. Their size is chosen in advance, during consultation, by the patient with the advice of Dr Trevidic. Depending on the anatomical characteristics of the patient, several incisions are made through which the implants will be inserted. They will be located either at the level of the lower segment of the areola’s circumference, or where the lower breast tissue meets the chest wall (inframammary fold). Two positions of the implants are possible in relation to the pectoral, pre-muscular or retro-muscular and these choices will be defined during the consultation. The operation lasts about one hour and is performed under general anaesthetic.
Post Operation
The patient will leave the clinic a few hours after the procedure, with a secure elastic dressing, which should be kept on for five days, until the first postoperative appointment. A reinforced supportive medical bra should be worn for two weeks after the operation. There may be pain during the first few days, especially when the implants are large and are placed behind the muscles. Pain relief will be prescribed. A feeling of tension, swelling, bruising and discomfort when raising the arms are common in the early stages, as well as minimal swelling of Sun, sea bathing and sport can be resumed after two weeks. The final results will be seen after 2–3 months. For sagging of the breasts, a reduction of the skin can be carried out to elevate the breasts.
*During your consultation, Dr Ratner will show you examples of before and after cases.
Pregnancy / lactation
It is recommended to wait at least six months after having breast implants inserted to consider pregnancy. It is possible to breastfeed in most cases, but this also depends on the patient. Breast augmentation is possible six months after breastfeeding or pregnancy.
Implants and cancer
Breast implants do not increase the risk of developing breast cancer. They do not interfere with the interpretation of breast radiological examinations. However, it is essential to always specify that you have breast implants at these examinations. Dr Ratner only places smooth implants.
Life expectancy of implants
It is not possible to estimate the exact life expectancy of implants as it depends on how each individual reacts to them. Life-long breast implants should not be taken for granted. Their guarantee in France is 10 years, but the average lifespan of implants is estimated at 15 years or more. Replacements are therefore not considered routine but will only be carried out if the implants show signs of pre-rupture, visible on ultrasound or mammography, which should be performed regularly.
Monitoring
After the post-operative check-ups, it is important to continue to attend any regular consultations with the gynaecologist. A specific consultation of implants is recommended every 2–3 years. Apart from this follow-up, it is essential to consult as soon as a change is detected or after any violent trauma. Breast ultrasound is a non-irradiating and a very accurate examination that can assess the integrity of the implants.
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Also known as breast reduction surgery, this operation is designed to reduce the size of excessively large breasts, correct sagging breasts and possible asymmetry, with or without reduction in areola size. Breast hypertrophy is defined as when the volume of the breasts is too large, when, compared to the patient’s morphology. This is frequently a genetic issue. This excessive volume can have a physical, psychological and functional repercussions: pain in the neck, shoulders and back, or discomfort whilst playing sport. The procedure can be done from the end of growth (17 years) and throughout life. There will be two or three scars, depending on the technique used: – either a scar around the areola and another vertical from the lower pole of the latter to the inframammary fold, which is where the lower breast tissue meets the chest wall . This is the so-called “vertical” technique, – or a peri-areolar scar, a vertical scar up to the inframammary fold and a horizontal scar on it. This is the inverted “T” or marine anchor technique. The length of the horizontal scar, hidden in the inframammary fold, is proportional to the extent of the hypertrophy and ptosis.
Operating Procedure
This intervention, which lasts between 1.5–2.5 hours, is performed under general anaesthetic, and on an outpatient basis. The patient leaves the operating room with a reinforced bandage. The stitches are removed one week later during the post-operation check-up. A reinforced supportive medical bra should be worn for three weeks after the operation. The post-operative effects are not very painful, with swelling, bruising, and a slight discomfort when raising the arms are frequently observed. The scars usually heal well. The removed tissues are systematically sent to a specialized laboratory to be microscopically examined, even if the mammography and / or ultrasound is normal. The final result can only be judged one year after the operation. Although rare, it is important to know of possible complications, such as infections, bruises, delayed healing, etc. Pregnancy after this surgery is possible. Breastfeeding is usually possible but cannot be guaranteed in all cases. Breast sensitivity may also be changed.
*During your consultation, Dr Ratner will show you examples of before and after cases.
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Breast ptosis is defined by sagging of the breast and distension of the skin around it. Mammary surgery for sagging or mastopexy lifts and shapes the breasts when their size is acceptable, but they have become saggy. They have usually become droopy over time, following significant weight loss or after breastfeeding. The size of the breasts can also be increased at the same time of the surgery by inserting a silicone implant or by an autologous fat graft. This procedure can be performed from the end of growth of the patient and throughout life. There will be two or three scars, depending on the technique used and depending on the case: -either a scar around the areola and another vertical from the lower pole of the latter to the inframammary fold. This is the so-called “vertical” technique. -or a peri-areolar scar, a vertical scar up to the inframammary fold and a horizontal scar on it. This is the technique called an inverted “T” or marine anchor. The length of the horizontal scar, hidden in the inframammary fold, is proportional to the extent of the volume and drooping. The scars usually heal well.
Operating Procedure
The operation is performed on an outpatient basis, under general anaesthetic and lasts one and a half hours. The patient leaves the operating room with a reinforced bandage. The stiches are removed a week later. A reinforced supportive medical bra should be worn for three weeks after the operation. The post-operative effects are not very painful with slight swelling and bruising. Slight discomfort when raising the arms is frequently observed. The final result can only be assessed one year after the operation. This surgery does not affect the chances of becoming pregnant. Breastfeeding is often possible, but it cannot be assumed in all cases. Breast sensitivity may be changed.
*During your consultation, Dr Ratner will show you examples of before and after cases.
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Gynecomastia is an increase in the size of tissue in men. It is most often bilateral and symmetrical, of firm consistency and sensitive to palpation. Gynecomastia should be distinguished from adipomastia which is much more frequent and corresponds to a local accumulation of fat. In this case, the consistency is soft, insensitive and bilaterally symmetrical. Adipogynecomastia is a combination of the two problems. Usually there is no cause for its occurrence. However, in some cases, it can be related to a hormonal imbalance or related to the use of certain drugs. Blood and radiological tests are necessary to check for one of these possible causes. The purpose of the surgery is to restore normal anatomy as much as possible by reducing breast volume, by liposuction and / or resection of the breast. It is rarely done to remove excess skin. In obese or overweight men, diet and exercise are started as weight loss can regress or even make gynecomastia or adipomastia disappear.
Operating Procedure
This surgery requires a general anaesthetic and lasts about one hour. It is performed on an outpatient basis. The scar remains hidden in the lower edge of the areola. When gynecomastia and excess skin are very severe, longer incisions may be necessary. In predominantly fatty gynecomastia, excision can sometimes be done with liposuction alone. The scars are very short (a few millimetres) and can be located at a distance from the gynecomastia, such as in the submammary or axillary regions. A reinforced bandage is made and will be kept for five days until the next appointment. Then, a compression band should be worn day and night for ten days.
*During your consultation, Dr Ratner will show you examples of before and after cases.
Post Operation
The post-operative period may be slightly painful in the first few days, an appropriate pain relief will be prescribed. Swelling, bruising, and discomfort when raising the arms are common at first. Sensitivity may occasionally be affected for a few months. The improvement is often marked and immediate; however, a period of 4–6 months is necessary to assess the final result.
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Over time, the effects of gravity along with the loss of the skin's natural elasticity begin to have an effect on the appearance of a woman's breasts. These factors, combined with pregnancies and nursing will often cause the breasts to lose their youthful shape and firmness.
A breast lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts. The procedure can also reduce the size of the areola (the darker skin surrounding the nipple).
FAQ
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The plastic surgeons of Rosenberg Plastic Surgery of New York commonly hear women express their desire to feel more confident with their figures. The breasts are the most feminine feature of the body, and a lack of curvature can negatively impact a woman’s self-image. Breast augmentation patients often seek a higher level of confidence in swimsuits, strapless dresses, or even to enhance their silhouette when fully covered. Women have an innate desire to feel sexy and confident in their own skin, and they can reach their aesthetic goals through breast augmentation. Our doctors notice a newfound confidence in patients who have undergone a breast-enhancing surgery.
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Breast augmentation enlarges the size of the breast while creating a more desirable overall shape through breast implants. The implants, which are composed of a saline solution (sterile salt water) or silicone gel, are available in a variety of models to best suit each patient’s needs. The surgery is completely customizable from the implant construction and material, to how they are surgically placed in the chest. Breast augmentation offers a permanent solution to patients who may have a naturally small cup size but desire a shapelier figure. A consultation with Rosenberg Plastic Surgery is the most beneficial first step to learning more about enhancing your bust. Procedures that may complement breast augmentation are Breast Revision and Breast Lift surgeries. Breast revision is a corrective surgery for patients who may have undergone a breast surgery (such as breast augmentation, breast lift or reduction, or breast reconstruction) elsewhere but are dissatisfied with the results. During a Breast Lift surgery, breasts are repositioned and often reshaped to appear higher on the chest and perkier in shape.
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Adult women seeking to permanently add volume to the breasts who are in good health may be eligible for breast augmentation. Typical requirements are that a patient is not currently pregnant or breastfeeding a child, she seeks the results that breast implants can provide, and has a realistic idea of the surgical outcome. Breast augmentation can create better symmetry among the breasts and enhance the size and shape of the bust.
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A patient will begin the procedure with a visit with the surgeon, who will mark the breasts for placement. This allows the doctor to know how the tissues of the breast will appear when the patient is upright, as breast augmentation is performed while she is laying down. Prior to the surgery, the patient will first be provided with either general anesthesia or twilight anesthesia (intravenous sedation), depending on the preference of both the patient and doctor. General anesthesia will render a patient completely unconscious for the procedure, while twilight anesthesia will provide sedation. These options will be discussed beforehand, typically in the consultation meeting. Next, a small incision is created in the first breast to be augmented. The surgical cut is typically one inch in length or less, and can be disguised under the breast, in the underarm, or even within the bellybutton. The implant may be inserted either under or over the muscle of the breast (pectoralis major), which is often dictated by a woman’s anatomy. Each step is repeated with the second breast. Breast augmentation is commonly performed in under an hour. If the patient elects to undergo additional procedures, such as breast lift, the procedure may be extended accordingly. Most patients are free to return to their regular activities one week after breast augmentation.
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Breast augmentation patients may be fitted with a surgical bra following the operation to provide support to the newly enlarged breasts. Drainage tubes may also be left in place to ensure that fluid accumulation does not interfere with the healing process and can be properly expelled from the surgical site. The surgeon will restrict certain activities, like heavy lifting and workouts, for several weeks postoperatively. Medication will be prescribed and filled prior to the surgery to ensure patient comfort throughout the healing process.
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During breast augmentation, implants are surgically inserted under the natural breasts to create a larger chest in female patients. Breast reduction surgery seeks to remove extra tissue from the breasts, while breast lift elevates their position on the chest.
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Both types of implants can create a natural-looking and feeling breast, and the kind of implant elected for breast augmentation is personal preference for each patient. The saline, or salt water solution, is a sterile liquid, while silicone implants are composed of silicone gel. Each material is housed inside the implant shell, which is biocompatible.
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A common misconception is that breast augmentation must be repeated every 10-15 years because breast implants expire at a certain point. More realistically, implants should be replaced as needed, such as after a rupture or if a patient experiences capsular contracture, a condition in which the scar tissue that naturally surrounds the implant begins to compress.
