Women who choose breast augmentation want to enhance the size and shape of their breasts. The goal is to create a natural-looking appearance. Women who undergo breast enhancement surgery do so to change the size, shape and contour of their breasts. The procedure can enlarge a naturally small bust, restore breast volume lost after weight reduction or pregnancy, achieve a more rounded bust shape or improve symmetry between the two breasts.

A woman’s breasts are one of the most important physical features that give a sense of femininity and sexuality, but for many women, their breasts are not as large or shapely as they would like. Breast augmentation is the best way to enhance your breast size and contour without a major operation.

• Undersized breasts which may have been present since birth or after pregnancy
• Loss of breast volume due to breastfeeding or weight loss
• Asymmetrical breasts
• Age-related droopiness

A breast lift is a cosmetic surgery procedure that raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new contour of the breasts. This is usually performed on women who have drooping breasts due to breast-feeding, age, or weight loss. The procedure can also be used to reduce areolar size (the dark skin around your nipple).

Breast lifts are typically performed as an outpatient procedure using general anesthesia or intravenous sedation with local anesthesia. There are three common types of incisions used during this type of surgery: crescent, lollipop, or anchor (also referred to as inverted T). Incision patterns depend on how much sagging there is in your breasts.

Breast Enhancement Options and Considerations

Choosing the appropriate procedure for you is a critical part of your breast enhancement experience. Patients should have a realistic and positive attitude about their results, as well as an understanding that additional surgery may be needed to achieve their goals.

Although breast augmentation is the most popular plastic surgery procedure performed in the United States, it’s not right for everyone. You need to have good general health, realistic expectations and a specific motivation for undergoing this procedure.

To help you make an informed decision about having breast augmentation, your consultation with your surgeon should thoroughly address all aspects of the operation, including:

• Your expectations from surgery
• The kinds of implants available and their differences (saline vs silicone vs gummy bear)
• The medical risks associated with breast implants
• Your incision options

Breast augmentation continues to be one of the most popular procedures for women with almost 300,000 performed in the United States.  According to the American Society of Plastic Surgery, 72% of breast augmentations were performed with silicone gel implants versus 28% with saline implants.

Breast augmentation is a cosmetic procedure with the aim of increasing the size, changing the shape or fullness of a woman’s breasts. Breast implants are placed in the breast pocket under the breast tissue or under the muscle during the surgery.

Who is a candidate?

Any healthy woman who is able to undergo breast augmentation. Breast augmentation is available to any female over the age of 18 years old without the consent of an adult. A female’s growth should be complete and stable. If choosing silicone gel implants and you are less than 22 years of age it would be considered an off label use.

That being said, we recommend a thorough understanding of the risks, alternatives and benefits of undergoing a breast implant augmentation and possess the maturity to make the right decision.

How is it performed?

An incision is made in the fold of the (inframammary) or along the areola of the nipple (peri-areolar) most frequently. Some surgeons will also make an incision in the axilla (trans-axillary). The implant is then placed in a pocket that is dissected underneath the breast tissue (subglandular) or the pectoralis major muscle (submuscular).

Dr. Koumanis will discuss incision options with you and the advantages and disadvantages associated with the different methods. The biggest advantage of putting them under the muscle is that there is less chance of a capsular contracture (hardening of the breast capsule around the implant).

The surgery usually takes 1.5 to 2 hours and is performed most frequently under general anesthesia but sometimes under intravenous conscious sedation where the patient does not require a breathing tube and is given medication to make them very drowsy.

Where is the incision made?

The most common place for the incision is hidden just under the breast fold. The incision is usually under 2 inches. Another common place is a small incision around the areola if the patient is a candidate. The implants are then introduced through this small space in a safe and sterile manner.

Breast lift surgery also called mastopexy is used for drooping or sagging breasts (“ptosis” in medical terms). Drooping or saggy breasts usually occur with advanced age, after breastfeeding and pregnancies. Women usually come to our practice seeking an improvement in the way their breasts look and feel.

Who is a good candidate?

All healthy women are candidates for breast lift surgery if they have sagging ptotic breasts. The following situations are seen frequently in women who desire breast lift surgery:

• sagging breasts after significant weight loss
• lifting of the breasts after aging, post-pregnancy or breast-feeding
• repositioning of nipples that have dropped to give a more perky appearance

Do you sometimes combine other procedures with breast lift surgery?

Yes, sometimes breast augmentation with an implant is needed if significant volume has been lost and need to be regained at the same procedure as a breast lift. Additionally, some women desire mommy makeover procedures which can combined breast surgery with liposuction, tummy tuck or torso lift and possibly a thigh lift. This is not an exhaustive list but a combination of any of these procedures is sometimes performed at the same time as your breast lift surgery.

How is breast lift surgery or mastopexy performed?

A circular incision around the nipple is carried out along with different patterns in order to lift the nipple-areola complex, skin, and breast tissue up. The pattern and length of the incisions are varied depending on the type of procedure needed and how much of a breast lift is required. Dr. Koumanis will go over all the options with you during your appointment and consultation.

What are the results like for breast lift surgery?

Most women are very pleased with their breast lift surgery. However, results are never guaranteed. That being said breast lift surgery is a common and frequently performed surgery with true and tried results for the most part. The results usually last for a significant period of time but again every case varies depending on age skin quality etc. Dr. Koumanis strives for all his patients to be happy with their results.

What are some of the complications?

As in any procedure complications sometimes occur. It is not common in surgery. However, infection bleeding, scarring, sensation issues have been known to occur. Dr. Koumanis prides himself on low complication rates and will discuss all of these issues during your consultation.

What is the recovery time?

Most candidates will experience some discomfort for the first few days to about a week. This is usually tolerable and pain control prescriptions are used to help with postoperative pain. The pain is not usually significant with this procedure but everyone is different.

Patients are usually okay to begin some activities within 48 hours. Walking, sitting can occur the next morning. Some light exercise can usually begin at around four weeks and unrestricted activities usually at six weeks. That being said, patients are different and so Dr. Koumanis will discuss each postoperative step in person with you.