Breast Lift Type for Excess Skin and Large Areolas?
- Asked by breastconfused in Florida
- 4 years ago
I have decided to remove my implants after 15 years without replacement. I have opted not to have any further surgeries and know I will have smaller breasts. I have textured saline 330cc implants over the muscle with a capsular contracture on right breast. Knowing that I will need to take care of the excess skin and larger areola, what type of breast lift would you recommend in my case?
Breast lift and removal of breast implants
The decision to remove your breast implants and have a breast lift is a difficult one, because you trade your implant problems for scars on your breasts. Looking at your photos it appears you will need a lift and the type depends on how much extra skin you have after implant removal. This is based on measurements before hand and during the operation, as well areolar reduction should be part of this procedure. I have a tendency not to push the verticle technique as it can leave bunching of the skin below the breast. I usually remove this excess at the time of the operation. Also discuss how your nipple will be supported, and it will depend on where your scars are. I would typically use a superior pedicle for your nipple movement. The main thing with this procedure is giving you shape to your smaller breasts and this is created with deep internal sutures in your breast tissue and moving the existing tissue around to give you projection. Safety is the main part of any procedure, so if you smoke: stop, and consider a pre-operative mammogram!
I hope this helps. Dr. Trussler
Breast Lift After Implant Removal
Removal of breast implants leaves sagging breasts with significant amounts of excess skin. Your enlarged areolas are likely the result of the implants. The surgery entails resizing the areolas to the normal size of 38-45mm. This incision is then used to access the breast pocket. The implant and capsule are removed. Once this is done the excess skin is removed from around the the areola. The scars are going to end up around the areola, then a vertical scar down to the crease then possibly a transverse scar in the crease. It's unlikely that you could undergo anything but a standard mastopexy and obtain a good result.
Breast lift for excess skin and large areolas depends
There are two types of surgical procedures:
Circumareolar lift (incision around the areola alone) -- with lifting and reshaping of the breast tissue.
Vertical scar mastopexy (lollipop incision) -- with lifting and reshaping of the breast tissue.
The Circumareolar lift can be done for those ith the sternal notch to nipple distance of less than 25cm after removal of the implants So the ability to use this procedure will be decided at the time of implant removal. The vertical scar mastopexy does not have this limitation.
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Hi Breastconfused. I recommend a superior pedicle mastopexy with a lollipop scar. You might need a very short horizontal scar in the inframammary fold/crease. I also suggest some internal work on the breast mound, using sutures to lift and shape the breast itself. This will help improve the longevity of the lift. In addition, I favor using Quill sutures to produce a pretty scar, especially around the areola. Hope this helps.
Tracy M. Pfeifer, MD, MS
You need a vertical breast lift with a lollipop scar.
The vertical breast lift gives you the best long term result because it shapes the breasts INTERNALLY, without relying on tightening the skin. Skin stretches, after all. And nobody needs the old fashioned "anchor" scar.
I believe you will probably do well with a vertical ift or lollipop incision. I don't think you wil need anything fancy since most of your issues will be related to volume loss not excess skin. I don't think you will have enough tissue to move around to make a significant difference and each extra manuveur adds certain risks. You don't want to make a mountain out of a mole hill. Scars are permanent and will your black skin I would want to minimize scars initially. You can always add scars later if you are dissatisfied.
Mastopexy Breast lift with implant removal
SEE VIDEO BELOW FOR MASTOPEXY WITHOUT IMPLANTS BY CLICKING "MORE":
I would recommend implant removal with a superior pedicle and transposition of redundant lower pole parenchymal tissues to the evacuated capsule using a vertical mastopexy approach or LeJour Modification.
Web reference: http://www.bodysculptor.com/lift.html
Breast lift choices
You will need a full lift to reduce the areolas and tighten the lax skin. You will see controversy about using a lollipop incision with no crease component or using a modified anchor incision with some crease element. Personally, I have not seen results from other surgeon's versions of the lollipop that in my opinion I like better than the results I get with the freehand central pedicle lift which has some scar in the crease.
Web reference: http://wwww
What kind of lift after removing implants?
Thank you for your question and for your photographs. As you know when the implants are removed the breast will deflate and it will be more drooping. You certainly have a few options here. You could remove them and wait for a while. When the implants are removed some of the sagging will tighten up a bit and you may find yourself in a position where you are comfortable without a lift. You have certainly burned no bridges with this option. For option number two you have to like your plastic surgeon. Some of my patients will allow me to remove the implant and allow me to use my discretion about the type of lift that I think will benefit them when the implant is removed. With a small amount of droop I might perform a Peri areolar lift, crescent lift, or no lift at all. If the breast is very droopy and my patient has given me the option I may perform a full lift. This option certainly takes a little bit more trust in the judgment of your plastic surgeon. Choosing your plastic surgeon carefully will certainly help you to making a decision. Best wishes.
Breast lift and removal of implants
It is not an easy decision to remove your implants because you have lived with a fullness above the braline that you will now lose. In the immediate breast lift period, there will be a fullness that will decrease over time.
In looking at your pictures, you need an agressive asymetric mastopexy to compress your remaining tissue and with this, the areolas are decreased. The tighter the better in the immediate period because you will loosen up over time.
Always discuss your full options with your doctor. I know you are tired of the capsular contraction and the hardness of the right breast but have you thought about the insertion of implants under the muscle? This would soften up the breasts and give you another layer of coverage to the implants. This is not to say you cannot develop another capsular contracture, but just a thought.
Good luck with it all.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.