Over the muscle 600cc - need breast lift and Implant change in 2 procedures

When a large implant is use over the muscle, most of the blood supply going from the muscle to the overlying skin is interrupted. The blood supply going to the nipple is now mostly coming from the surrounding skin. To do a breast lift, one needs to cut around the areola. If this cut is deep below the dermis and the skin has to be mobilized substantially, the blood supply to the areola and nipple will be compromised. The tension on the skin resulting from the lift will also contribute to less blood getting to the nipple. Many factors can influence the decision about doing this procedure in one or two stages. These are situations where I may consider doing the procedure in one stage. 1) If the lift is minimal and the areola doesn’t have to be moved a long distance, the dermal connection from the surrounding skin to the nipple could be mostly preserved. 2) If no capsulectomy is necessary the capsul would allow some additional blood supply to the breasts tissue and the nipple. 3) If the patient accepts a smaller implant to reduce tension in the skin closure. I hope this is helpful. Please let me know if you liked this answer and if there is any other questions.

Dear Phenomenal111817,
I understand your concern. It is best however that you consult with a board certified plastic surgeon to determine whether you can have several aesthetic surgeries in one session, as this would depend on various factors including but not limited to your general health condition, the type of anesthesia that will be used, and the type of surgeries that will be performed among others.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery