Breast Augmentation AND Breast Lift

Breast Augmentation AND Breast Lift

Breast Augmentation and Breast Lift

One of the most common reasons women seek breast surgery in our practice is to fix the deflated appearance of their chest after having children. Women miss the fullness in the upper half off their breasts that looked good in clothing and bathing suits—the volume that mysteriously went away after breast feeding. Most of these women express a desire to increase volume or fullness, plus they want their breasts to be perkier.

What exactly does perky mean? Perkiness exists when the nipples are in an ideal position. This means they are above the breast crease and centered on the most projecting part of the breast. As your breasts enlarge from pregnancy and breast feeding, the skin stretches. When your size decreases, you are left with extra skin. This causes the nipples to fall from their ideal position as the breasts deflate.

How can we fix it? First, we need to decide how much more volume you want. By using breast implant sizers, we can pick the right implant volume. This is the most accurate way to find the size you will be happy with in the long term. Once you have chosen your size, we need to decide if you need a lift.

Whether you need a breast lift or mastopexy depends on your nipple position relative to your breast crease or inframammary fold (IMF). Basically, if your nipple is above your breast crease, you do not need a lift. If your nipple is below your breast crease, you need a lift. If your nipple is right at your breast crease, it depends. If your nipple is right at your breast crease and you choose a small implant, you will probably need a lift for the best possible shape. If you choose a moderate sized or larger implant, you will probably have a good shape without a lift.

The pictures below show examples of nipple position. Both women show signs of deflation where they could benefit from more volume, but their degree of perkiness if very different. The picture on the left shows a woman with good perkiness—her nipples are above the fold. The image on the right shows a woman lacking perkiness with her nipples below the fold.

In the next blog, we will compare the results when the perkier breast is treated with a breast augmentation and the non-perky breast is treated with a breast augmentation plus a breast lift. As you will see, we can get a nice improvement for both women when we use the right techniques for the situation and your goals. For more information, visit our video about breast augmentation and lift. If you are ready to take the next step, contact us to set up a consultation at one of our convenient Cincinnati, Ohio or Northern Kentucky offices. Follow us on Facebook and Twitter for the latest updates on informative blogs and specials.

In part I, you learned how to tell if you need a breast lift with your augmentation to get the best possible shape. When a breast implant is inserted, its bottom edge is near the breast crease or inframammary fold. Adding a breast implant does not lift the nipple. So, if your nipples are below your fold before, they will be below your crease after surgery, too. That is, unless you have a lift.  What does it look like if your nipples are below your fold and you get a breast augmentation without a lift? Well, not good generally. Since the implant is sitting above the fold, its shape and volume are higher on the chest. The nipples and surrounding natural breast tissue, however, are lower and appear to be melting off of the implants. Not pretty. To summarize, breast implants CAN be used to correct deflated appearing breasts when the nipples are not too low. If the nipples are too low, a lift is necessary, too.

Now, let’s look at our before and after pictures from part I. The perkier patient had some deflation, and the breast augmentation filled out the extra skin, improved fullness and enhanced shape. The less perky patient had an augmentation plus a lift. The implants filled out the breast and improved fullness, but the lift was necessary to maximize shape. You can see that the nipples are above the fold now, and the shape is much better.

Both patients were able to get a nice shape and a result that made them happy. The trade off with a lift is more scars. When faced with severe sagginess, many women would gladly accept the scars for a much better shape. Fortunately, the scars generally improve a lot over time. In most patients, the redness fades and the scars soften. In fact, we take some extra measures in our practice to help these scars fade and soften more quickly with scar massage and a special scar cream.

We hope this blog helped you understand breast augmentation and breast lifting. Contact us to set up a consultation if you are ready to pursue your aesthetic goals!

Will I Need New Implants in 10 Years?

Will I Need New Implants in 10 Years?

Will I Need New Implants in 10 Years?

A popular myth circulating around out there is that implants must be replaced every 10 years.  This is simply not true.  Behind every myth there is a shred of truth (or so they say).  Although you do not have to pencil in an implant switch automatically every 10 years there are some situations where you may need or want to have revision surgery after your breast augmentation.

Implants are manufactured devices just like your TV or the tires on your car.  Eventually they may wear out.  The rupture rate on most implants currently on the market is thought to be around 1% per year cumulative.  So the risk is small initially, but slowly increases with time.  If you are very young when you get a breast augmentation you have a reasonable chance of the implants rupturing by the time you are older.  Unfortunately, no one can predict if and when they will rupture.  It may happen after 5 years, 20 years or never.  If they do rupture they need to be replaced.

Another reason for needing revision surgery after breast augmentation has nothing to do with the shape of the implants and everything to do with the shape of your breasts.  Pun intended.  I’m talking about the actual shape and the condition of the tissues.  As you age, have babies, breast feed, gain weight, lose weight, etc. your breast skin loses elasticity.  After breast feeding you may notice a decrease in breast tissue volume.  If the skin does not contract sufficiently your breasts may appear deflated.  Also, the ligaments that support the weight of the breast (Cooper’s ligaments) stretch and weaken.  These things result in breast sagging.  Plastic surgeons call this ptosis (pronounced toe-sis).    This happens whether or not you have implants.  However, implants add weight to the breast and can accelerate the stretching to some degree, especially larger implants.  There is not an exact cut off, but implants larger than 400-500 cc are probably more likely to do this.

When the condition of the tissues deteriorates the shape of your breasts goes too.  With an implant in place the tissues of the breast can sag lower on the implant creating a “double bubble” or “snoopy-nose” deformity.  This is a problem cosmetically, but only needs to be fixed if it bothers you.  The change will probably not be apparent in clothing.  If you are happy how things look in a bra you may not want to do anything.  If you are unhappy with the appearance a mastopexy (breast lift) is the solution.  If you have had your implants in place for a while (more than five years) it would not be unreasonable to get new implants at the same time.  If they are un-ruptured, however, you do not have to exchange them.

We have discussed a scenario where you need surgery (rupture) and a scenario where you may want surgery (sag).  Capsular contracture is a little of both.  Capsular contracture occurs when the normal thin scar capsule around your breast implant tightens.  This is not a black or white situation—it’s shades of gray.  You may have very mild capsular contracture where the implant feels more noticeable, but the breast looks okay.  You probably would not want surgery for this.  If it progresses, the breast may feel more firm and the shape may become distorted.  If it gets to that extreme you don’t have to have surgery, but you will probably want it.  Sometimes in severe capsular contracture the tightness is very uncomfortable.  In that case you need surgery.

It is not pleasant to consider the possibility that you may need revision surgery in the future.  Some patients have thinner tissues or more sag initially and are more likely to have these problems.  We always point these factors out to our patients before surgery so that they can weigh the pros and cons.  Overall our breast augmentation patients are among our happiest.  When good decisions are made about implant size and proper techniques are used you can get a great result with maximal longevity.

5 Responses To Plastic Surgery Shaming

Dealing with shaming from others is, unfortunately, sometimes a result of getting plastic surgery. You are, of course, under no obligation to respond to them or engage with their trolling. However, if you do feel the need to stick up for yourself, your body, and your choices, here are some tips to help you out.

My Body, My Choices

Plastic surgery model
Much of the shaming women experience when they decide plastic surgery is right for them is because other people feel like they have some sort of say when it comes to your body. Don’t be afraid to remind them that this is your body and you can do what you want with it. Other people do not own it, nor do they have the right to make comments about it.

I’m Not Doing This For Anyone But Myself

I love myself
Some folks may comment that the choice to get plastic surgery must “be for a man” or something along those lines. For this sort of shaming, feel free to tell them, as in point one, that this is for yourself alone. The choice is not to please a man or make anyone like you, it’s because you decided it’s what’s best for your own body.

This Was Not An Impulse Buy

Glasses resting on old book
As you are likely well aware, the choice to get plastic surgery involves plenty of research and long days spent thinking about what is right for you. It’s not like rushing into Target and going on a shopping spree. Anyone who feels like shaming you with the phrase "you’re just doing it without thinking about it” clearly has not done their own research into how plastic surgery works and the process of deciding on doctors, procedures, risks, and rewards.

Yes, I Considered This Important Enough To Save Up For

Money saved up for plastic surgery
Sometimes people may disguise their shaming with phrases along the lines of “well how could you afford that!?” or “aren’t there better things to spend your hard-earned money on?” This might be a perfect time to ask such people if they’ve ever saved up for anything they considered important, like a new car or a fancy tech gadget. If something is important to you, it’s perfectly reasonable to find ways to pay for it.

This Body Is Just As “Real” As Any Other

Authenticity road sign
People have a bad habit of shaming plastic surgery by calling it “fake” and anything else “real.” But that means everything from pushup bras, makeup, and hair curlers to tanning and Spanx can also be called “fake.” This is an arbitrary line to draw. Rather, you body is still as “real” as you say it is, and it is your choice how to frame whatever you decide to do with it.

The Dirty Little Secret About Bra Cup Sizes and Breast Augmentation

The Dirty Little Secret About Bra Cup Sizes and Breast Augmentation

The Dirty Little Secret About Bra Cup Sizes and Breast AugmentationBra cup sizing was introduced in 1932 by the S. H. Camp company. They did not refer to the size of breasts at that time, but how pendulous they were. In 1937 the Warner company introduced four cup sizes, A, B, C, and D and these represented four sizes of breasts. A few more sizes have been introduced since then, but the basic idea has not changed all that much.

The idea behind lettered bra cup sizes is mostly unchanged. To begin, measure over top the breasts and just under the breasts. The underneath measurement is the bra band size, and the over top subtracted from the band is the bra cup size. A one inch difference between these is an A cup, two inches is a B, three inches is a C, a four inch difference is a D. That’s where we get into to trouble. First of all, standardization really only agrees on these four sizes, after that it gets far more loosely defined, and it varies by country. Secondly, even within these sizes, these letters and numbers don’t tell the whole story.

Where It All Goes Wrong

When they come in for breast augmentation, many women tell their plastic surgeon that they would like a “full C cup.” Ostensibly, this is simple enough. That would be a three inch difference between her band size and the final, augmented measurement over the breast.

But this is not always so clear cut. To begin with, bra sizes do not so much represent the size of breasts as the size of a bra. That is to say, they are for fitting undergarments, not for accurately representing the body. Secondly, many people have a misleading idea of what bra cup sizes mean, because many wear the wrong size bra to begin with. Third, it is often difficult to sum up the variety of factors that breast augmentation entails, like implant volume, shape, placement, projection, and more, with a single letter representation.

What To Tell Your Plastic Surgeon

Breast size is a more than a letter-and-number combination for fitting a bra, and working with your plastic surgeon, you’ll go over a variety of factors that influence the final shape and size that will work with your goals and what your body can handle. You’ll discuss implant volume, shape, and placement, along with aesthetics. You may try on various sizers and outfits to see just how variable breasts can be. Instead of relying on cup size, research and think about what will work best for you, and always remember to talk with your surgeon.

Breast Implants? Breast Lift? Both? Which Is Right For You?

A better bosom is no doubt desirable. With the various options available to you, however, it may feel a bit overwhelming and intimidating when trying to decide which procedure to get. With a bit of information about these two types of breast surgeries, they are easy to understand.

Breast Implants

Breast implant, silicone breast implant

Breast implants augment the size of breasts, but not their position on the chest.

Breast implants are silicone or saline medical devices that are inserted either over or under the chest muscles to make the breasts larger. They usually look like small bags, with silicone implants coming pre-filled from the manufacturer, and the surgeon fills saline implants after their insertion into the body.

Implants augment, or add to, the breast and make them physically larger. This is beneficial to those looking for increased volume and a fuller bust. This could be because of a loss of volume due to breastfeeding or simply because you feel your breasts are not at the size you wish them to be. Breast implants come in many varieties of shape, feel, and size and when speaking with Dr. Vennemeyer, you’ll go over these options so that you both can ensure the result will be to your satisfaction.

Breast Lift

Breast lift chart

A breast lift re-positions the breasts on the chest to a more youthful, perky place.

A breast lift moves the breasts up. Sometimes, due to age, pregnancy, or other factors, the breasts can sag and sit lower than their initial natural position on the chest. This can make fitting clothes, bras, and dresses difficult.

To lift the breasts, the surgeon removes excess skin and may also move around and re-position your breast tissue. This procedure creates perkier breasts that look more youthful. If you are satisfied with the size of your breasts, but would like them to be perkier and sit higher on your chest, a breast lift is ideal. When working with Dr. Vennemeyer, you’ll decide on how much lift is right for you.


Breast Augmentation Vennemeyer Plastic Surgery

Both procedures may be right for you if both size and position are concerns.

If you feel that your breasts are both smaller and less perky than you’d like, both procedures combined could be your best route. In a combined procedure, the breasts are moved up and augmented. This combined process is often best when the breasts are smaller than you like and are sitting down further on the chest as well. Dr. Vennemeyer will provide advice and options to determine if a lift and augmentation are right for you. Keep in mind there still may be more than one surgery required.

When going over your options, be sure to ask Dr. Vennemeyer any questions you may have. Breasts that you want and that feel like the truest expression of you are possible, and lifts and implants have their place, sometimes together.

Breast Aug Recovery

Breast Aug Recovery

Breast Augmentation Recovery Tips

Breast Augmentation Recovery Tips from Southlake Plastic Surgeon, Dr. Vennemeyer

In most cases, healing from a breast augmentation is pretty easy, but it is important to follow your surgeon’s instructions to maximize your chances of a normal recovery. Make sure you follow the specific tips your surgeon gives, as instructions can vary by surgeon.

Breast Augmentation Bra

Most plastic surgeons recommend a post-surgical bra. This soft, supportive bra provides support to hold the implants in the right position during healing and compression to help swelling resolve more quickly. The lack of an underwire in post-op bras avoids irritation of incisions in your breast creases (inframammary fold).

We measure you and order your post-op bra to ensure it fits you properly and to save you the trouble of having to order it yourself. For most breast augmentations, I provide my patients with a bra that includes a built-in stabilizer band that helps the implants settle more quickly and evenly. It reduces swelling, too. After a week or two, the band is no longer needed.

Once you graduate from the surgical bra around 6 weeks post-op, I recommend continuing to wear a supportive bra most of the time. The more weight your bra supports, the less weight your skin experiences. This may reduce your risk of sagging or implants bottoming out.

Discomfort and Swelling after Breast Aug

You will experience some discomfort that most of my patients describe as mild to moderate. Typically, people use pain medications for 2-3 days after surgery. Many only need Tylenol. You will probably feel a lot of tightness—this is from the pressure of the implants pushing on your ribs, stretching your pectoral muscles and expanding your breast skin. Don’t worry, this sensation is temporary and usually resolves over the first couple weeks.

Your breasts will swell and look like “torpedoes” for 1-2 weeks and they will feel really firm. The implants will probably seem too high and you might feel like you went too big. Relax! Things will change dramatically for the better over the first couple weeks.

To reduce swelling:

  • Prop yourself up with pillows so you sleep in a slightly elevated position for the first few weeks. A 45 degree wedge pillow works well for this.
  • I instruct my patients with round implants to start massaging their breasts several times a day from the beginning. I have augmentation-lift (mastopexy) or patients with shaped “gummy bear” implants start massage after a week or two.
  • Icing can help reduce pain and swelling, but it is important to protect your skin from getting too cold.

Even after the first few weeks, you will notice firmness in your breasts caused by subtle swelling. This is most apparent the first 3 months. After this, your breasts will feel much softer.

Activity after Breast Augmentation

You shouldn’t exert yourself physically for the first several weeks after surgery. I don’t want my patients to get their blood pressure or heart rate up significantly to reduce the risk of bleeding. I encourage light walking and light range-of-motion exercises for your shoulders to reduce stiffness. After 3 weeks, low impact cardio is fine. If you are into high impact cardio or weight lifting, wait 6 weeks.

Breast Augmentation scars

I put a special compressive bandage on your incisions that stays in place for 2-3 weeks. This helps your scar heal better and look better. When it first heals, your scar appears pink and slightly raised. Massage with lotion helps flatten and soften your scars, and you should start this about 3 weeks after surgery. I recommend it 3 times per day with unscented hand lotion.

I also recommend Scarguard MD, or other similar topical agents containing silicone and hydrocortisone, starting 2-3 weeks after surgery to help the scar soften, flatten and fade faster.

It’s my goal to help you find your perfect implant size and heal beautifully. I stay up to date on the latest studies to guide my techniques and treatment to keep you safe and give you the best results possible. The whole team at Vennemeyer Plastic Surgery is excited to help every patient through this fun process.

Contact us to set up a consultation today!

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