Concept
Aesthetic surgery of the breas-t encompasses a spectrum of options from mastopexy to mastopexy-augmentation. Reducing the discrepancy between skin envelope and breas-t tissue can either be addressed from “outside-in” with skin redraping, from “inside-out” with parenchymal augmentation, or a combination of the two. Mastopexy aims to create a beautiful breas-t by primarily addressing the shape and differs from augmentation where the primary goal is to alter the size of the breas-t. The two procedures are, however, not completely discordant and can actually complement one another as they address different parts of the breas-t (skin vs tissue).
At consultation
The preoperative consultation is an opportunity to understand the patient’s goals and anatomy, and help the patient navigate a treatment choice that will help them achieve a beautiful appearing breas-t. Patients is are asked if they are bothered by the shape or size of the breas-ts or both. This can help differentiate between the need for a mastopexy, augmentation, or mastopexy-augmentation. However often the patient’s complaints may not match their physical exam. Objective assessment (with precision measurement) by the plastic surgeon needs to be made in the context of a patient’s goals to optimize the outcome that they are seeking. History includes a summary of previous surgeries, existing asymmetries, and a breas-t health evaluation. This includes past history of breas-t cancer, abnormal mammograms and desire for future breas-t feeding. Patient’s weight history is documented including any major changes or surgical weight loss.
Candidates
1) Mommy Make-Over candidates2) Massive Weight Loss patients3) Older women who seek B-Lift along with some added volume4) Deflated breas-ts due to any other reason/condition
Grades of breas-t ptosis
Periareolar / Donut Mastopexy and final scar location
Circumvertical / Vertical / Lollipop Mastopexy and final scar location
Wise pattern / Anchor Mastopexy and final scar location
Mastopexy – Augmentation
Augmentation of the breas-t can be combined with mastopexy in a single or two-staged fashion using autologous breas-t tissue (auto augmentation), silicone implants or your own fat.
Post Operative Care
Limit exercise for 4 weeks
Take antibiotics and analgesics as prescribed
Encourage hydration – 8 glasses of water a day
No smoking (active/passive)
Postoperative exercises
Wear sports bra 24×7 for support for 2 weeks
Silicone sheeting postoperatively for 3 months for scar reduction
