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La Jolla / San Diego Cosmetic Surgeon Dr. Tom Pousti Talks About Breast Lift Surgery: Mastopexy

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Description

A lot of times after our breast have changed due to life changing events, time, gravity, weight gain/weight loss and pregnancies some may ask themselves if breast lifting will also be necessary. Although there are cases where well-positioned breast implants can create the “illusion” of a breast lift, breast implants do not ACTUALLY provide a breast lifting effect. Breast lifting would serve to raise the position of your breasts on your chest wall and decrease breast skin “sitting” on your upper abdominal wall skin. When evaluating the lateral view of a patient’s breast, if the nipple/areola complexes are at the level of or lower than the infra mammary fold, this would indicate that some amount of breast lifting will be necessary to achieving a long-term aesthetic outcome that the patient will be pleased with.

Sometimes, when a patient’s starting point is “borderline”, sometimes a benelli breast lift (incision only around the areola) can achieve the patient’s goals… but careful discussion and measurements are needed prior to surgery.

Of course, breast augmentation/lifting surgery is a more complicated procedure (and more complication prone); the benefits are improved shape/contour, “lifted” breast tissue on the chest, a more defined “perkier” look and longer lasting results. Patients will need to carefully consider the trade-offs (such as additional scarring) associated with breast lifting versus the upsides briefly discussed above.

Patients undergoing the combination operation of mastopexy and breast augmentation should understand that it is a significantly more complex procedure than performing breast augmentation surgery alone, and that it is associated with a significantly higher risk of complications and need for additional surgery.

Mastopexy refers to lifting and reshaping of the breast. It can be combined with an increase in breast size (augmentation-mastopexy) or a reduction in breast size. The operation involves rearranging the breast tissue, shifting the nipple position and increasing the breast firmness by tightening the skin. Modern innovations in breast lift techniques include limited incision techniques, nipple sensation sparing techniques.

 
Communication Tools

Here are some great and effective communication tools.

1. Vectra, is a 3D computer imaging system, where a photo of the patient is taken, then virtually on the computer screen may be modified to achieve patients goals. Its nice way for patients to see what their breast may possibly look like. It is important to know it is a simulation and results will vary.

2. Sizers are a great communication tool as well because patients may try on implants sizers and see what sizes they feel comfortable in and achieve the size they would like.

3. Goal photographs or Visual boards and an excellent communication tool, where patients may project their different goals by providing photos of what they do and don’t like. These boards will be used during the surgery.

 
Patient Goals

Ultimately, which operation the patient chooses will depend mainly on personal goals. Patients undergoing the combination breast augmentation/lifting surgery should understand that there are limits as to how large of a breast implant can be used during this procedure. The breast augmentation surgery is expanding the breast skin “envelope” while breast lifting is (by definition) tightening up the breast skin envelope by removing skin. These 2 forces are counteract each other.

It becomes important to remove the appropriate amount of breast skin and to use the appropriate size/profile of breast implants to balance these 2 forces appropriately to achieve of the patient’s goals as closely as possible while minimizing risks of complications of the procedure.

 
Procedure Techniques

Dr.Pousti uses the “tailor tacking” technique. This is an important part of the mastopexy and mastopexy/augmentation procedure. It involves TEMPORARY closure of the skin ( with temporary skin staples) to double check the amount of skin that is to be excised during the procedure. This maneuver is performed to ensure that enough skin, but not too much, is removed. On the one hand, it is important that enough skin be removed to achieve the aesthetic breast lifting results the patient is looking for; on the other hand, is important not to move too much skin creating tension upon closure and potential wide scars and/or implant exposure.

Here is some advice Dr.Pousti gives his patients when considering breast augmentation/lifting surgery:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals. Dr.Pousti asks his patients to find photographs of what they would like to achieve. Understanding that everyone’s anatomy is different and has its own limitations. The use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. Dr.Pousti has found that the use of words such as “natural” or “DD cup” etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. The use of computer imaging may be very helpful during this communication phase.

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Dr.Pousti usually makes this decision during surgery. The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best
breast implant size/profile relatively easy.

 
 

Breast Lift Before & After

 

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breast lift surgery

breast-lift-techniques

Click To Read More About the Anchor Breast Lift

Click To Read More About the Lollipop Breast Lift

Click To Read More About the Donut / Benelli Breast Lift


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Breast Implant Settling

One of the most frequent questions from patients is regarding breast implant settling. Patients are interested in understanding implant settling expectations immediately post-op, and then over time. Click on the button below to view two cases over time what these patient’s implants looked like immediately post-op, and then how they settled over time.

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Before & After: Breast Lift







See your new body in 3D - Sculpt My Dream

Dr. Tom Pousti now offers Vectra 3D simulations so patients can see what specific implant types, sizes and profiles would look like on their body.

Breast Lifting Surgery with Tailor Tacking Technique


Pousti Plastic Surgery Proudly Offers All 3 FDA Approved Breast Implants To Our Patients Including Allergan, Mentor & Sientra!


Patient Vision Boards Help Achieve the Perfect Look & Results!

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The Surgical Procedure

The operation takes between two and three hours.


 

Note that incision lines that are “puckered” heal smooth.


What To Expect After Surgery

Pain is rarely strong, more commonly being a degree of discomfort. Swelling occurs but usually begins to subside by the third or fourth day. Some degree of swelling may persist for longer periods. A well-fitted bra is worn day and night for three weeks. While there is probably seldom interference with future breast feeding, women are cautioned that it may not be possible to breast feed in the future.

Resumption Of Physical Activities

Driving may be resumed in 2 weeks.
Non-contact sports in 3 weeks.
Contact sports in 6 weeks.
Sexual activity in 2 weeks.

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TESTIMONIALS:

Patient Testimonial:

My motivation for getting this surgery began long before I had my son. Growing up I had always struggled with my weight. In high school I was over 200lbs and was always so self conscious of my appearance. At the age of 16 I realized that my weight could cause me serious health issues that would affect me long term and I decided to make a change. I started with my diet and taking long walks. That turned into a lifestyle dedicated to my health and over a year and half I was able to loose 60lbs. Although I was happy and proud to have lost all the weight and be much healthier, I wasn’t happy with how I looked with my clothes off. My tummy had extra loose skin that no amount of exercise could help, so I just hid i with fitted undershirts or spanx to hold things in place. It was a constant reminder of my past and always affected my self esteem. A few years later at the age of 24 I became pregnant and gave birth to a healthy baby boy.

Throughout my pregnancy I gained about 50lbs. After breast feeding and loosing most of the weight I gained through the pregnancy my insecurities about my body became even worse. I avoided any situations where I felt I could be exposed physically. I wouldn’t go to pool parties, the beach, or dating. The thought of exposing myself gave me anxiety and I would alienate myself because I how I felt. I realized that I couldn’t hide forever. Doing this surgery would improve my confidence and I turn would make not only my life better but my son would never know the insecurities that I’ve dealt with my whole life. Day before surgery: went in to Dr. Pousti’s office for my marking and to review goal pictures. Confirmed with at home nurse to be picked up from surgery and brought home.

Day of surgery: arrived at the surgery center bright and early. Met the nurses and anesthesiologist that would be taking care of me. Reviewed all of the info and got ready for Doc to arrive. Once Dr. pousti arrived we retouched the markings and reviewed more goal photos. Then we were off to the OR. I was put to sleep quickly and comfortably and only remember waking up in recovery. All of my concerns were well taken care off the staff made me very comfortable. Once I was ready to go home the nurse scheduled to pick me up and stay with me for the next 24 hours brought me home got me in bed and got me on my medication routine. She helped me to the bathroom and with my deep breathing and leg exercises. She educated my roommate on how to take care of me and left written notes and her phone number of any questions arose.

Day 2: the major discomfort were my breast. It wasn’t pain just pressure which made it difficult for me to inhale deeply. It took some time to adjust but by the end of the evening the discomfort and pressure in my chest was mostly gone.

Day 3: feeling good. Pain is still under control and able to eat small amount of semi solid food. Walked around The house a bit and even went outside to get some sunlight to help my mood. It helped and I am feeling good.

Day 4: pain is under control and I feel good! I was expecting unbearable pain and complete helplessness but I am doing really well. I’ve been taking my meds on schedule and pain hasn’t been an issue. So far I am happy with this decision and look forward to healing and seeing the new me.

If I had to choose a few words to describe Dr. Pousti (and I wasn’t allowed to say amazing, since everyone does) I would say he’s warm and inviting, intuitive, and professional. All of my experiences with Dr. P and his staff were friendly, inviting, and pleasant. Not once did I feel uncomfortable or judged. I felt like we were all working on my goals not like I was just another patient. Dr. P even came by my home after surgery with his wife to check on me and bought beautiful flowers! Who does that?!?! Dr. Pousti is amazing and truly cares about the people that he takes care of his patients.


OK, so we have all been there or we wouldn’t be here. We’ve sat on the beach next to our man and caught him catching a glimpse of a girl in the bikini and wished we were her or at least built like her. Nice shape and all. We are the ones at the swimming pool covered up with the oversized towel to hide what time has either taken away or maybe didn’t give us to start with. I WAS ONE OF THOSE WOMEN. After having several children, my body was definately lacking what once was. But at my age, I thought I was crazy for even thinking about having plastic surgery. I thought long and hard about it and met with several specialists. It was not until I met Dr. Pousti that I was sure this was the right thing to do. Right from the start, Dr. Pousti made it clear to me that he would not do the surgery for my husband’s sake. He would do it if it was for me. I did not know how much it would change my life. Dr. Pousti made me feel so comfortable from the very first visit to his office. His staff was very professional and made me feel very comfortable the way they helped me with the scheduling, the paperwork and the appointments. It was after my first visit with Dr. Pousti that I made the decision to go ahead with surgery. I FEEL LIKE A NEW WOMAN. My confidence is way beyond my expectations! I am proud of my body! Thanks to help from Dr. Pousti, I love the way I see myself when I look in the mirror. I have the confidence in myself that I haven’t had in many years. I thank God for Dr. Pousti, for giving me my woman-hood back. To all of you reading this letter, all I can say is, you are in the right place with the right doctor. GO FOR IT! and enjoy life the way that I am finally enjoying it!!!

~C.E.Wilson

Patient Testimonial:

Dear Dr. Pousti & Staff

“This is very long over due but I wanted anyone that is contemplating either a breast lift and/or labia reduction from Dr. Pousti, the two procedures I received, that he is a true artistand professional. It took me about 2 years just to find the right Dr. and build my confidence since a labia reduction is quite an insecure situation but as soon as I entered his office I felt at ease and Dr Pousti is the most calm, sweet spirit you could ask for. I know he sees many many patients but he makes you feel like his closest friend. I had my surgeries in March 2011 and I have never been happier with my outcome back then and still to this day. I use to have problems with my labia since I ride horses and complete insecurity with intimacy. Now, I know this is funny, but I love that area and I am very proud of it and the fact that it doesn’t get in the way or hurt me anymore. And my breasts…. I can finally wear a bikini and not have floppy boobs… And I can do something I always wanted to do. Wear my night shirt with out a bra! They still sit so nicely on my chest and I can not say enough about how happy and lucky I am to have had Dr. Pousti as my surgeon! Now I’m planning on getting an other procedure and looking forward to fabulous results. And I’ve also referred friends that are just as happy!”

Patient Testimonial:

Dear Dr. Pousti & Staff

I’m a 45 year old who had been seriously thinking about having a breast reduction and lift for approximately 4 years, secondary to a lot of cervical discomfort. The fact that I couldn’t wear a half bra in the summertime because of the heaviness, really limited my attire and didn’t hurt the cause. My cup size was a double D and I wanted to reduce my size to a C cup. After consulting with Dr. Pousti, we decided to go to a D cup instead since by nature, I’m not what you call a petite girl. I’m very happy that I listened to his professional opinion because I’m very pleased with the results. I’m in the medical profession so I tend to be slightly picky but I found Dr. Pousti and his staff to be overwhelmingly accommodating, continuously professional and very pleasant. Hence, my whole experience was wonderful.

Thank you so much Dr. Pousti & Staff

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Click here to learn more about San Diego Cosmetic Surgeon, Dr. Tom Pousti. To schedule your
cosmetic surgery consultation in our San Diego office, call (619) 466-8851 or email appointments@pousti.com.

Medically reviewed by Tom Pousti, MD, FACS, and written by The Pousti Plastic Surgery Team.



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Pousti Plastic Surgery of San Diego
8851 Center Drive, Suite 300
La Mesa, California 91942
Phone: (619) 466-8851 or Email
 
Dr. Tom Pousti is a San Diego and La Jolla Plastic Surgery specialist. He has provided plastic surgery treatments to many San Diego and La Jolla facelift, tummy tuck, liposuction, breast augmentation, and rhinoplasty patients. His office is located in San Diego, serving the La Jolla, Riverside, Inland Empire and Temecula areas. Disclaimer


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