Boston Breast Augmentation
Boston Breast Augmentation and Mastopexy Surgery
Dr. Richard A. Moss, Boston Breast Augmentation expert explains the surgical procedures available to women who are considering cosmetic surgery for their breasts. For some residents of Boston, breast augmentation surgery is the surgery that will most likely address their needs. For others, a breast lift, commonly referred to as mastopexy will better help them achieve the desired goals. Dr. Moss also addresses what would be considered realistic goals and expectations for patients considering breast implantation surgery and breast lift surgery.
There are many ways to treat the patient who has breasts that are both deflated and saggy. The usual cause of this problem is pregnancy and/or breast feeding. It can also be caused by losing large amounts of weight. Dr. Moss approaches this common situation in a way that will address the patient’s needs and also let her undergo as much or as little surgery as she feels is necessary to get the result that she wants.
Women who are considering breast augmentation surgery should be aware that if they did not have cleavage before surgery they might not after breast augmentation surgery. If a woman’s breasts were close together before surgery, then she has a greater chance of cleavage after being implanted with breast implants.
The surgery that addresses the problem of deflated small breasts is called breast augmentation. It is also known by the terminology of breast enlargement, breast enhancement and clinically as augmentation mammaplasty. This surgery is also commonly performed on women who have never experienced any deflation of their breasts but nevertheless still want larger breasts.
Breast augmentation is currently the most popular cosmetic surgical procedure in the United States. In 2006 there were 329,000 breast augmentation surgeries performed in the United States.
Thin athletic women who have small breasts with little sag before surgery tend to have more fullness to the top of their breasts after surgery.
If a woman has a large amount of sag to her breasts it would be unrealistic for her to expect to have “perky” breasts after breast augmentation surgery.
One of the reasons that breast augmentation is so popular is that the surgery has a very high patient satisfaction rate. Most patients usually achieve the result they want. Another reason for the popularity of this surgery is that the scars are minimal. Dr. Moss performs breast augmentation from either an inframammary incision or a peri-areola incision. Neither of these incisions are very noticeable post-operatively.
Another factor that is increasing the popularity of breast augmentation surgery is the re-introduction of silicone gel breast implants. These implants received approval from the FDA in November 2006 for sale in the United States. Many women prefer the silicone gel implants because they are more natural feeling than the saline implants. Silicone gel implants account for about 90% of the breast implant sales in Europe and have for some time.
Many women who have breast augmentation surgery are hoping to achieve results that are proportional with their body. These women will often choose a smaller size implant.
The surgery that addresses the problem of breast sag (ptosis) is called a breast lift. The clinical term is mastopexy. A breast lift neither increases nor decreases the size of the breast but rather reduces the sag of the breast. The surgery addresses the sag of the breast from the lower portion of the breast. It also raises the position of the nipple. What a breast lift does not do is give the breast a lot of fullness on the top (superior position) of the breast.
Actual Boston Breast Lift Patient
Mastopexy Before and After
There are limiting factors to a breast lift. As discussed above a patient’s end result is not one of an appearance of “perky” breasts of an eighteen year old. Rather there is a reduction in the sag from the lower (inferior) position of the breast. Another limiting factor to a breast lift (mastopexy) is that it is not permanent. A woman who has had a breast lift may have a reoccurrence of breast sag (ptosis) later on in life. This would result in the surgery having to be performed again if the patient wanted the sag reduced.
Probably the most limiting factor in the popularity of breast lifts (mastopexy) is the scars that are left on the breasts. The scars resulting from a breast lift can be minimal or quite extensive (run under the entire length of the breast and also run around the nipple and then go vertically down to the inframammary crease). Therefore patients need to compare the improvement in the reduction of sag in relationship to the newly acquired scars. This is probably the main reason that the number of patients who undergo breast lifts is far less than the number who have breast augmentation surgery.
So what surgery(s) does a patient have if she perceives she has both problems? Does she have both surgeries (breast augmentation and breast lift) at the same time? In most situations Dr. Moss prefers to perform these surgeries sequentially rather than at the same time. The one exception is that if the patient has so much sag that her nipples are pointing down towards the floor (referred to as Grade III ptosis), then Dr. Moss will perform both surgeries at the same time.
In most instances Dr. Moss will ask the patient “what bothers you the most, the size of your breasts or the sag?” If it is the size of her breast then Dr. Moss will perform the breast augmentation surgery first, if not, then the mastopexy is done first. In Boston, Breast augmentation is usually what most women choose to have first.
Another reason that most women choose to have breast augmentation first is that many times they do not feel the need to have a breast lift after they have been augmented with breast implants. While breast implants do not “lift” the breasts per say, they do fill them out enough that most women do not want additional surgery. They often feel that the scars that would result from a breast lift would negate any improvement resulting from the lift. One of the main reasons that Dr. Moss prefers to wait on the breast lift (mastopexy) is that so many women prefer not to have the breast lift and therefore he can avoid putting unnecessary scars on their breasts.
Actual Boston Breast Augmentation Patient
This patient had a small amount of sag to her breast before surgery. However after breast enlargement she felt that her breasts were fine and opted not to have a breast lift. Picture same pt. breast aug before side
Mastopexy side profile before and after
There are other reasons that Dr. Moss prefers to perform breast augmentation and mastopexy surgeries separately rather than together. On a national basis the complication rate of these two surgeries performed together is higher than when they are performed separately. Some of these increased complications include infection, nipple malposition, loss of nipple sensation, and implant exposure. Dr. Moss has a very low complication rate for both surgeries and feels that the increased rate of complications makes it more desirable to perform the surgeries separately.
If a woman does want a lift after breast augmentation then Dr. Moss will often be able to accomplish this in his office with a local anesthetic. This is not as large a surgery as a breast augmentation and the recovery is usually easier. By having the surgery in the office, Dr. Moss can provide the patient a significant savings on the cost of the surgery. If the patient does want to have her breast lift surgery in the hospital under general anesthesia, Dr. Moss can accommodate the patient’s wishes.
Dr. Moss spends considerable time with patients, discussing the goals of their surgery. He finds that when a cosmetic surgery patient has an accurate understanding of what realistically can be achieved, the level of patient satisfaction increases dramatically.