Raleigh-Durham Plastic Surgeons

What Sort of Procedure Do I Need For Breasts With Sagging and Volume Loss?

I've lost quite a bit of weight so I have little volume in my breasts and they sag. I'm considering a lift and potentially a small implant to fill them out. I wouldn't mind them being slightly larger, but I want them to still look natural. Not the basketballs taped to my chest sort if thing. What do I need to look for, and around how much would it end up costing?

Augmentation mastopexy surgery is a potentially challenging one which requires thoughtful preoperative evaluation and planning, and careful attention to detail in the operating room. Many surgeons have traditionally performed breast augmentation and mastopexy surgery in stages, usually mastopexy first followed by augmentation at a later date. In the recent past more and more surgeons have adopted a non-staged, single surgery approach to augmentation and mastopexy, and that is what I propose for the vast majority of patients who I see in consultation that need both procedures. I believe that the results of simultaneous augmentation mastopexy are as good or better than a staged approach in most cases, and of course patients quite naturally prefer a single trip to the operating room if at all possible.

Some patients I see in consultation are primarily interested in a breast lift procedure. For those with a significant amount of existing breast tissue, a breast lift alone may produce an aesthetically ideal breast appearance. However, it can difficult to achieve significant fullness in the upper poles of the breasts (the upper aspect of the breasts, above the nipple-areola area) in many patients by means of a breast lift alone. I ask patients who are considering a breast lift procedure how important it is for them to have the appearance of some fullness in the upper part of the breasts, and to thereby achieve a significantly more youthful breast profile. For patients who confirm that this appearance is important to them, and who do not have enough natural upper pole breast tissue to achieve this appearance with a mastopexy alone, I recommend an augmentation mastopexy.

Other patients are primarily interested in increasing their breast volume, but have enough breast ptosis to make the appearance of breast augmentation alone odd and unappealing. Placing implants behind breasts with significant ptosis creates the appearance of breasts hanging off of a pair of implants, which looks distinctly unnatural and aesthetically unappealing. These patients are also best served by augmentation mastopexy, which in addition to increasing breast volume restores the position of the nipple-areola complex to the top of the breast mound, tightens the lower pole and lifts the breast.

Michael Law, MD

Raleigh-Durham Plastic Surgeon

How to Obtain the Most Natural Look With Breast Augmentation For Small Breasts on a Thin Frame? (photo)

I am getting breast augmentation in two weeks, and my head is spinning! I am currently a small A. (droopy from nursing two children). I am 27, 5'9" and roughly 115lbs. I think my BWD is around 11. I want to get 275CCs with a moderate plus profile hoping I will get a small C. My PS said that he would not go higher than 275CCs in the mod+ profile. We are using Silicone Gel implants by Mentor. Should I maybe even consider moderate profile for a more natural look? He said it's rarely used anymore...

A natural-appearing breast is noticeably fuller in the lower pole (below the nipple) than the upper pole. In profile (viewing from the side), the upper pole slopes gradually from where the breast begins in the upper chest down to the nipple, and the lower pole is full and rounded. For any patient considering breast augmentation, there is an implant size above which the upper pole begins to look rounded, convex, and unnaturally full. Mild to moderate upper pole fullness can look beautiful and youthful, but excessive upper pole fullness due to overly-large implants looks decidedly fake, and like what most people think of as a 'boob job'.

View many, many before and after photos and look for patients with a starting pint similar to yours. Do those patients have a result similar to the type of result you'd like? 

Michael Law, MD

Raleigh-Durham Plastic Surgeon

Is a Certification From ABCS the same as ABPS For a Mommy Makeover?

I found a Dr that I really like with an American Board of Cosmetic Surgery Certification.. Is that adequate, or does he need to be a member of different societies? He is also a faculty member of the American Academy of Cosmetic Physicians. I'm doing a Mommy Makeover, and only want to do it once!

Thousands of physicians with no residency training in plastic surgery and without certification from the American Board of Plastic Surgery (the only Board recognized by the American Board of Medical Specialties that certifies plastic surgeons) promote themselves as `cosmetic surgeons' and `plastic surgeons'. Some are primary care physicians, some are emergency room doctors; some have never completed a residency training program in any specialty and are not eligible to take any specialty board exam. Many take `weekend courses' on liposuction, or breast augmentation, or facelifts, then return to their practice and begin promoting that procedure and performing it on patients.

The minimum amount of training in plastic surgery that will allow a physician to be eligible for certification by the American Board of Plastic Surgery is five years, and many board-certified plastic surgeons, myself included, have several additional years of training in general surgery and plastic surgery. There are a number of reasons for such a significant training requirement. Chief among them are the following: one does not acquire sophistication in diagnosis and treatment planning, superior surgical skill, and the capacity to minimize the possibility of complications and unfavorable outcomes by taking weekend courses. It requires years of training experience under the direction of talented mentors. It requires devotion to the art and practice of plastic surgery.

Be careful in evaluating physicians whose `Board Certification' is by a `Board' which is not recognized by the American Board of Medical Specialties (ABMS), and who belong to an `Academy' that does not require residency training in plastic surgery. Some will claim that they are `double-' or even `triple-board certified', when only one (and occasionally none) of those `boards' are recognized by the ABMS. Visit the ABMS website to see which specialties have ABMS recognition.

Michael Law, MD

Raleigh-Durham Plastic Surgeon