Can I get implants under twilight? (Photo)

Question

Will implants under twilight improve my breast appearance? I don't want to get a lift under general anesthesia, do I have to? My boobs are saggy. I'm 35 with 2 kids over 5 years old.

John L. Burns Jr., MD · Answer

You have Grade II breast ptosis and need a lift to allow alignment between the implant and breast.  You'd also benefit from an areola reduction.  Most surgeons would prefer general anesthesia for this procedure.

Donovan Rosas, MD · Answer

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision. 
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.   
A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure.  Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based upon your photos, you will benefit from a lift in conjunction with an augmentation to improve areolar dilation as well as breast position.
There are costs and benefits to all types of anesthesia. General is an option but sedation is a viable alternative.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon Patient should discuss their concerns with their physicians in order to make an educated decision.

Gianfranco Frojo, MD · Answer

I would recommend implants with a lift. I would not recommend to do anything under twilight anesthesia in general. This is because there is no formal airway protection.

Daniel Barrett, MD · Answer

Dear AmandaMariexo777,
in some cases it is possible to avoid general anesthesia. Based on your photo, it looks like you might also need breast lift. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Emmanuel Mallol Cotes, MD · Answer

Thanks so much for your question,

Yes, it is possible to get breast implants under twilight anesthesia, also known as conscious sedation.  You will likely remain aware of your surroundings but feel no pain. Some patients may not remember parts of the procedure due to the sedatives.

Discuss your interest in twilight anesthesia with your plastic surgeon. They will assess your medical history and the specifics of your surgery to determine if you are a good candidate for this type of anesthesia.

Sincerely, 
Dr. Emmanuel Mallol

Luis A. Mejia, MD · Answer

Dear AmandaMariexo777, thanks for sharing your concern and pictures, after evaluate your case you need a Breast lift to improve the assymetry and shape of your breast and at the same time we can reduce your aureola size. We dont need to go under general anesthesia for this can be perform with sedation. Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia.

Carlos Marciales, MD · Answer

Hello, thank you for asking, you need a breast lift, with implants to improve the shape and size of the breasts, you do not need to be under general anesthesia, I do these procedures with epidural, and sedation, I do not do it with general. Thank you.

Michelle Zweifler, MD · Answer

Most patients get general anesthesia for breast implants under the muscle. At times some breast lifts, some breast implant exchanges, some implants above the muscle, and fat grafting to the breast may be performed under twilight in appropriate candidates.

Ronald J. Edelson, MD · Answer

You definitely need a lift. If you just get implants the result will be terrible. And a donut or crescent lift won’t be enough. You need a full anchor lift

Tek Przylecki, MD, FACS · Answer

Hi!Thank you for your question. Although the quality of your breast tissue and skin cannot be assessed from photos, the amount of ptosis (droop) you have would make you a good candidate for a breast lift (mastopexy) and implant augmentation if you would like to have larger breasts. Most surgeons would do this under general anesthesia. I do not believe you would be happy with the result if you had an augmentation alone. I personally would not recommend just an augmentation and would not offer it. I hope this helps! Best of luck in your journey!

Can I get implants under twilight? (Photo)

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