Sunday, January 29, 2012

Combined breast augmentation and breast lift

I have recently returned (not without protest) from a plastic surgery conference on the island of Tortola in the Bahamas where I presented my experience with performing combined subfascial breast augmentation and breast lift and I thought I would do a quick summary on the blog for everyone else.

Everyone knows quite a bit about breast augmentation. There is the understanding that there exists saline breast implants as well as silicone or “gummy bear” breast implants. It is also commonly understood that implants can be placed on top of the muscle or under the muscle and that one option for placing an implant on top of the muscle is called subfascial breast augmentation. This technique of breast augmentation has been proven to be safe, effective, and to give great results if performed in the right group of patients.

Breast lift procedures are any surgical procedure that is used to reshape the breast. The placement of the incision or incisions may vary depending on the need of the patient and the overall effect of the breast lift may also vary, but the common idea is that a breast lift does not remove breast tissue—that is called a breast reduction—and does not add any volume to the breast—that is called a breast augmentation. There are two basic categories of breast lifts.

1) Breast lifts that are designed to lift the areola higher up on the breast mound

2) Breast lifts that are designed to reshape and reposition the lower breast tissue higher by reducing laxity through removal of excess skin.

Of course, there are a large number of women who need both a breast augmentation to replenish volume as well as a breast lift to address the shape and position of the areola and/or breast tissue. About 10 years ago, there was still a sizeable amount of discussion about the safety and efficacy of performing a breast augmentation and breast lift at the same time. Over this period the amount of literature that has been presented to support the safety of performing an augmentation and lift at the same time has been considerable and today most surgeons (this one included) perform the vast majority of their breast augmentation and breast lift procedures together at the same time. Performing combined subfascial breast augmentation and breast lift is now the focus of a little skeptical attention in the plastic surgery community and my research has been an attempt at providing information on the safety and efficacy of doing so.

In essence, the take home point of my research is that combining subfascial breast augmentation and breast lift is definitely safe—as I have not had any complications, and it is effective in that my patients have been overwhelmingly happy with their results. Early long term result—about 1-2 years after surgery—have shown that the combination of the two procedures is long lasting as well. There are some patients however that would likely be better served by placing the implant under the muscle along with their breast lift procedure and these patients are those that are both very thin as well as contain significant breast soft-tissue laxity.

Anyways, I will keep following all of my patients out for longer long term result and report back again. As of now, I think we can begin to conclude, based on the information coming in that subfascial breast augmentation performed at the same time as breast lift surgery is a safe and effective option when patients are selected properly.

All the best,

Dr Remus Repta

Phoenix/Scottsdale, AZ

1 comment :

Dr. Remus Repta said...

Hello Peter,

Subfascial breast augmentation involves placement of the implant on top of the muscle and therefore the pectoralis muscle does not become an issue. Women who do not want submuscular implants may have the implants placed in the subglandular position or in the subfascial position.

All the best,

Remus Repta, MD