Breast augmentation next month but still undecided what incision is best for me. Lollipop, areola or under the breast? (Photos)
Doctor Answers 13
Breast augmentation next month - what kind of lift?
- Hope this explanation helps you through the confusion....
- Two surgeons are suggesting just implants - one via an areolar incision, one via the crease incision.
- The preference today is the crease because fewer germs are in this area but both crease and areolar incisions are acceptable.
- One surgeon is suggesting a vertical lift with your implants -
- I agree with her/him - you have lost weight and your skin is loose. Only a lift fixes that.
- HOWEVER - you don't have to have the lift now. You can have the implants now - and have a lift in six months if you see the need for a lift, which I expect you will.
- As to the kind of implant - tear drop implants give a sloping look that is popular in Europe. Most American women want the upper fullness of the round implant. Since your breasts are flat on the top, a round implant makes sense to me but both are good options.
- You are getting different opinions because there is no right or wrong - we have so many good implants and techniques today to offer you, that all are good options.
- Always see a Board Certified Plastic Surgeon.
Best Incision for Breast Augmentation
Lift or no lift?
In my opinion you would need a vertical lift with implants.
One of the more common scenarios that we as aesthetic plastic surgeons deal with in cosmetic breast surgery is the patient from either weight loss, or post pregnancy has a little bit of drop of the breast off of the chest wall that we call ptosis. The question then becomes in the patient's mind, can we just fill the space with an implant and create a youthful looking breast. It all depends on what the patient's perception of youthful is. My patients, more than likely, would like to have upper pole fullness of the breast without the necessity for wearing a push-up bra. In these situations, a breast lift plus an implant both centers the nipple and areola complex on the breast while replacing the lost volume with an implant. Most patients’ hesitation in doing the breast lift as well as implants, are the potential for bad scars. In my experience, we talk a lot about the scars of a breast lift preoperatively, but hardly ever in the postoperative phase. It seems to me, that when the breast is up high on the chest wall, youthful and perky, that one does not even see the scars. Most of the time, these incision lines heal uneventfully anyway. In the small chance that the scars are more red or thicker than one would like, we have many options in lasers, light sources, and laser assisted drug delivery techniques to mitigate against unsightly scars. Sometimes, patients who I've seen have seen other physicians who have recommended simply placing a large implant to "fill the space". This seems to be a very temporary fix for the situation in that the stretched out soft tissue that the implant is placed into, usually will allow very rapid descent of the breast, such that in just a few months, it looks like a bigger version of the breast that they first started with. They will then sometimes have a secondary mastopexy, and at that time, I would often recommend that they replace the very large implant with a smaller one. In my opinion, a large lift, meaning taking out as much of the stretched out skin as possible, and placing a more modest size implant will make a breast that will remain perky and up on the chest wall for a long period of time. In my opinion, perky breasts, not necessarily large breasts, look youthful. Patients will then ask, "why then does Dr. so-and-so tell me that I can just have implants?" My answer to this is very simple. It is far easier in most plastic surgeons’ skill sets to place a large implant then do a breast lift with an implant. The simultaneous lift and implant procedure is a little more challenging in that you're trying to do opposite things at the same time. One, you're trying to make the skin envelopes smaller and at the same time make the breast larger. One easy way to decide whether a lift is good for you, is to see your image in 3-D on a Vectra camera system. In our office, we can then compare two images: one with mastopexy with implants and the other with implants alone. In that way, both the patient and plastic surgeon can see what the difference in the look of both procedures are. Usually when implant is placed only, and a breast lift was really needed, what the patient will see is a breast that is falling off of a properly placed mound that's higher in the chest wall than the breast is. The breast seems to be falling off the implant. They will commonly squeeze the end part of their breast and ask, “why hasn't the implant filled this space out?” For me, the in between operation is to use a tall shaped implant. These anatomically shaped implants can create the illusion, that although the nipple has not really been raised, that the nipple is now more centered on the breast. While these implants do cost more than round implants, it still less expensive than adding a breast lift. All things considered, it's best to consult with a few talented and busy cosmetic breast surgeons to get different opinions. Good luck with your decision.
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Breast augmentation next month but still undecided what incision is best for me. Lollipop, areola or under the breast?
Which incision is best for my breasts?
Without the benefit of an in-person exam, your right breast looks a little larger and more ptotic than your left. Any of the incision approaches you mentioned are options. The lollipop one would best help to control for the differences in the skin between the right and left sides (the pictures you show suggest that right has more skin and that the left is tighter between the nipple and the lower fold of the breast). But if you are trying to avoid the scar, I would probably go with the tear drop implant with an incision in the lower breast fold. With any of these approaches there is a chance that you may need a touch-up or revision procedure later. Thanks for your question.
Breast augmentation next month but still undecided what incision is best for me. Lollipop, areola or under the breast
Breast augmentation and lift candidate, some advices:
After having analyzed all the information and photos provided to us, I realize that you have very sagging and small breasts. In this regard, you need volume (implants) and projection (the lift): Breast Augmentation w/Breast Lift.
I recommend you to use microtexturized highly cohesive silicon implant ("gummy bear" implants), with high projection.
Finally, to perform the breast lift I recommend a Periareolar Round Block Breast Lift ("Benelli mastopexy"), which has an unnoticed scar around the areola, and if we see (in the surgery) that we can't obtain adecuate projection just with the Benelli Lift, we have to perform a "Lollipop breast lift".
Dr. Emmanuel Mallol Cotes.-
Breast augmentation next month but still undecided.
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