Utah Breast Implants, Breast lift, Breast Augmentation, Breast Augmentation - Fat Grafting, Breast Reduction :: Envision Cosmetic Surgery

BREAST

Breast Augmentation - Implants

Breast augmentation enhances the contour and size of a women’s breasts. Though most commonly performed because the patient would prefer a larger sized breasts, breast augmentation may also correct volume loss after pregnancy, improve breast symmetry, or reconstruct the breast after surgical removal. Most women know someone who has had a breast augmentation. However, much knowledge about breast augmentation is obtained during a consultation.
Breast implants may be placed directly under the breast tissue (subglandular), or it may be placed under the pectoral major muscle (submuscular). Submuscular placement though making recovery longer, has the benefits of better impalnt concealment, a more natural look and less risk of the breasts becoming firm, called a capsular contracture. Occasionally subglandular placement is considered in certain instances.
Implants come in two major types, saline or silicone. Though concerns about silicone gel safety existed in the past, more than ten years of study established their safety and led to FDA re-approval. All implants will be palpable and ripple. Rippling is when a fold in the implant shell can be felt or seen. Silicone implants ripple less and feel more natural. Saline implants are less expensive and can be placed through a smaller incision.
Implants can be placed through four different incisions; the crease under the breast (infra-mammary crease), next to the areola (peri-areolar), the arm-pit (trans-axillary) and through the belly-button. At Envision Cosmetic Surgery only the infra-mammary crease and peri-areolar incisions are used. The most common incision site chosen is in the crease under the breast. However, the incision next to the areola heals less noticeable.
Most women have slight differences in size or shape between their breasts. Major asymmetries are always improved. Minor asymmetries are often improved, however, subtle differences between the two breasts may persist after surgery. Not often are two breasts exactly the same.
The surgery itself lasts about an hour. The patient is usually asleep or sedated although from the patients perspective it feels the same. Patients are able to go home shortly after surgery. Initially the implants will be slightly high and the breasts firm. The implants settle into position after two weeks to two months. Once the implants have settled your breasts feel soft and natural. Patients are typically thrilled with their results.

Breast Augmentation – Fat Grafting

Though practiced in Europe for a number of years, fat grafting to the breasts for augmentation purposes has been uncommon in the United States. As fat grafting has obtained more attention, The American Society of Plastic Surgeons formed a task force to determine its safety. The task force relied on study and expert opinion to make its’ decision. In the summer of 2009 they released their conclusions that though more research is needed, it appeared that fat grafting to the breasts was safe.
The practice of fat transfer for volume correction has been performed for some time. Fat has been used for buttock augmentation and to improve scarring or to fill out depressions from trauma or surgery. The concern about using fat in the breasts stemmed from the calcifications left behind when some of the fat is re-absorbed. Mammograms detect cancer by noting the calcifications cancer produces on the x-rays. It has become increasingly clear, however, that the calcifications from cancer and the calcifications from fat transfer appear very different. 
Fat is colleted by liposuctioin before re-injecting it into the target area. Thus another benefit of fat grafting is contour improvement in the donor area. Because fat is a living substance, it must establish a new blood supply where it is injected. Before this can occur, typically 30 to 50% is re-absorbed by the body. Hence fat grafting is less predictable than implant placement when it comes to final breast size.
The surgery itself is usually performed with the patients sedated or asleep. It will likely take two to three hours to perform. The majority of the swelling is gone in one to two weeks but changes can continue up to two months. Differences may exist between the breasts may exist before surgery and may persist after surgery as well. The benefits of larger breasts and better contour somewhere else leave patients thrilled.

Breast Lift

Breast lift surgery, or mastopexy, restores a more youthful appearance to a woman’s breasts. With time and gravity, breasts can loose their shape and droop. Pregnancy, nursing, weight gain or loss, and decreased skin elasticity can all contribute to sagging breasts. A mastopexy is designed to reverse these effects, repositioning the breasts higher on the chest.

Many types of lifts are available to improve the contour of the breasts. A crescent lift leaves a small incision on the top half of the areola from the 9:00 to 3:00 position and is primarily used in conjunction with augmentation when only a small amount of lift is needed. A Bernelli or donut lift leaves an incision around the areola only. This lift is also limited in nature but can be used alone and not in conjunction with an augmentation.

More extensive lifts include a vertical lift and the Wise lift. A vertical lift leaves an incision around the areola and a vertical line from the areola to the crease below the breasts. A Wise or traditional lift leaves an anchor shaped scar. The incision will be around the areola, from the areola to the crease under the breasts and from side to side in the crease under the breast. Though no significant tissue is removed with a lift only, patients often notice a decrease in breast size, therefore, mastopexy is commonly performed with breast augmentation (implant placement).

The operation is performed with the patient completely asleep and lasts about two hours. Patients are able to go home shortly after surgery. As with all cosmetic surgery, realistic expectations are important. Small differences from breast to breast exist before surgery and will exist after surgery as well. Despite what seem like long scars, the improved shape makes breast-lift patients some of our happiest.

Breast Reduction

Overly large breasts can cause problems in many aspects of a woman’s life. Back pain, neck pain, shoulder grooving, and interference in certain occupations or sports are some of the issues frequently mentioned. Large breasts can also be difficult to assess for lumps or masses, making cancer detection more difficult.

The goal of breast reduction is to reduce and reshape the breasts. To accomplish this goal the nipple & areola are repositioned higher on the breast while excess skin and breast tissue are removed from the breast. The most common reduction leaves a final incision around the areola, vertically from the areola to the bottom of the breast and within the crease beneath the breast.

Every effort is made to make the breasts as identical as possible, but as with all cosmetic surgery, realistic expectations are important. Small differences from breast to breast exist before surgery and will exist after surgery as well. Initially the breasts will be high and firm, however, as the swelling dissipates and the skin relaxes, the breasts settle. With time the incisions fade. The improved shape and decreased weight make breast reduction patients some of our happiest patients.

Revision Augmentation / Re-Augmentation

Many patients ask when implants need to be replaced. The easiest answer is when the individual is no longer happy with the breasts. Pregnancy can dramatically change the shape of the breasts leading to re-augmentation within a short period of time. Alternatively, other patients return after 20 or 30 years to have something done. Undesirable shape, suddenly becoming firm or implant rupture are the usual reasons for replacing implants.

Breasts change shape with time. If you have implants and you are no longer happy with the shape of your breasts, you have options. Sometimes the capsule around your implant negatively affects the shape of your breasts. Other times, the breasts have succumbed to the effects of gravity and droop. Whatever the cause, replacing your implants and making adjustments to the breast pocket can significantly improve the look of your breasts.

Surprising to most patients, re-augmentation is more difficult than the first time surgery. When an undesirable shape is present or implants have ruptured, replacing the implants is more involved. Often the capsule and pocket need to be modified, removed or changed. Sometimes the plane of the pocket is even changed. The surgery usually takes one to three hours, which can be much longer than the first time augmentation surgery.

A number of Utah residents have had breast augmentation. Breast augmentation is the most common plastic surgery performed. Therefore, a number of people will need re-augmentation. Discover once again how happy you can be with natural, shapely breasts.

ADDITIONAL PROCEDURES

Even more procedures are offered at Envision Cosmetic Surgery. If your procedure is not listed try finding information through the American Academy of Cosmetic Surgery’s (AACS) website; www.cosmeticsurgery.org. Click on the “For Patients” tab and then select cosmetic procedures.