La Jolla / San Diego Cosmetic Surgeon Dr. Tom Pousti Talks About Breast Lift (Mastopexy) with Implants
| Frequently Asked Questions
Risks and Complications
Mastopexy refers to lifting and reshaping of the breast. It can be combined with an increase in breast size (augmentation-mastopexy). The operation involves rearranging the breast tissue, shifting the nipple position and increasing the breast firmness by tightening the skin. Modern innovations in breast lift techniques include limited incision techniques, nipple sensation sparing techniques. Many of our post-bariatric patients are in need of breast lifting and breast augmentation to give them fuller, perkier breasts. You have a choice of breast implants and we will discuss the differences of saline vs. silicone gel implants with you at your consultation.
The Surgical Procedure
The operation takes between three to four hours.
Potential Risks and Complications
Breast augmentation / mastopexy (breast lifting) surgery is one of the most commonly requested breast contouring surgeries performed. Patients who seek to have this operation done generally wish to improve the contour of the breast by lifting the nipple-areola complex by tightening up the “skin envelope” and achieve increased fullness of the breasts especially superiorly and along the cleavage area. The combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increase with breast augmentation / mastopexy surgery done at the same time. Revision mastopexy may also be necessary if the patient gains or loses weight or becomes pregnant. Loss of breast skin elasticity may contribute to the earlier need for revisionary surgery (repeat lifting) as well.
When breast augmentation / mastopexy surgery is performed, an implant is used below or on top of the pectoralis muscle. The breast tissue and skin is then elevated lifted) to cover the breast implant. This “lifting” often involves skin excision, the areola, vertically and sometimes horizontally. This skin excision serves to tighten the “skin envelope”. By doing so, a lifted appearance of the breast is achieved and the loose-saggy appearance and feel of breast tissue is eliminated. Herein lies the competition and the potential risks and complications: the mastopexy procedure by definition involves reducing the skin envelope allowing for repositioning of the nipple-areola (and reshaping the breast). Breast augmentation by definition enlarges the breast and expands the skin envelope. Also, placement of an implant necessitates dissection of a “pocket” that reduces blood flow. The blood flow is further compromised by incisions used to reduce the skin envelope.
Because of these factors, while breast augmentation OR mastopexy surgery is relatively simple and complication free, breast augmentation / mastopexy surgery done together carries increased chances of complications and need for further surgery. For example, there is an increased risk of infection, implant exposure, breast asymmetry, loss of nipple-areola sensation, inability to breast feed, mal-positioning of the nipple-areola complex, mal-position of the implants, wound healing problems, tissue necrosis, loss of blood supply to the nipple-areola complexes. Any of these complications may require further surgery, therefore, increasing the likelihood of revisionary surgery. It is important that the patient understands the principles behind any planned procedure of any breast augmentation / mastopexy surgery. An understanding of the procedure will facilitate an understanding of the potential risks and complications when they occur. A well-informed patient may decide to stage the procedures (for example, perform the breast lifting operation initially followed by breast augmentation at a later date). A well informed patient who decides to proceed with single stage breast augmentation / mastopexy procedure should understand the nature of the procedure, the increased potential risks and complication so the combined procedures (compared to the procedures performed individually), and the higher likelihood of revisionary surgery to correct imperfections that arise from the combined procedures. This revisionary surgery may impose additional discomfort, recovery time, time off of work and cost to the patient.
To summarize, single staged breast augmentation / mastopexy surgery carries increased risk compared to either of the procedures done separately. In order for the patient to make a well informed decision, it is necessary for her to understand the potential increased risks and complications as well as the potential need for further surgery when the single staged procedure is performed. This will allow the patient an opportunity to proceed with two staged procedures (procedures done separately) or proceed with the single staged procedure with the increased risk of potential risk and complications and need for further surgery.
What To Expect After Surgery
Pain is rarely strong, more commonly being a degree of discomfort. Swelling occurs but usually begins to subside by the third or fourth day. Some degree of swelling may persist for longer periods. A well-fitted bra is worn day and night for three weeks. While there is probably seldom interference with future breast feeding, women are cautioned that it may not be possible to breast feed in the future.
Resumption Of Physical Activities
Driving may be resumed in 2 weeks.
Non-contact sports in 3 weeks.
Contact sports in 6 weeks.
Sexual activity in 2 weeks.
Breast Augmentation/Breast Lifting
If you have any questions about my procedure, my experience or just want to talk please feel free to call me @ 858 354 0272
Thanks again for my Body by Pousti…!!!
About 2 years ago I woke up one morning weighing in at 165 pounds and on a 5’5 frame that was not healthy or attractive looking! This was the heaviest than I have ever been in my life; that day I made a life decision to get my body and life in shape. I started out on my own eating right and going to the gym, after about 6 months I was down to 155, this still was not where I wanted to be so I called a trainer and he put me on an eating plan and exercise regime. 6 months later I was at my goal weight of 130 pounds!!! I had never felt better about my body but with one exception; my breasts! They had really suffered from the weight loss, they were saggy, I had loose skin and they lost all of their perkiness and fullness. I was completely self-conscience about them; they didn’t look good in a bikini or in shirts and dresses. I considered getting a breast lift/augmentation for about 6 months and finally decided to get a consultation. I saw 6 plastic surgeons over the course of a month and none of them made me feel as comfortable and at ease as Dr. Pousti. He answered all my questioned with even more detail than anyone else and made me feel good and confident about my decision. Dr. Pousti knew I was concerned with the scar that a breast lift would leave but after seeing before and after pictures and meeting patients that had the same procedure I was more than confident than ever that I was going to get the results I wanted!!
The week before surgery
I was a wreck. I was nervous, anxious and excited all in the same moment; no one seemed to be able to calm me down except for Dr Pousti. I went for my pre op the night before and as soon as I saw him and started talking to him I was instantly at ease. I knew he was going to take excellent care of me and that I was going to look great!!
Day of Surgery
Oddly enough the day of surgery I was not nervous, I was ready for my new breasts!! My surgery lasted about 3 hours and when I woke up there was Dr Pousti assuring me again that my breasts were once again perky and beautiful.
Ok so everyone’s pain tolerance is different and I really think the fact that I work out 6 days a week had a lot to do with this but I honesty have to say my recovery was so easy! It was just uncomfortable, there was some pain but nothing like I imaged. You hear all these stories of women who are in excruciating pain and can’t go to the bathroom without assistance; well that was not me at all. I had my surgery on a Wednesday morning and yes the first night was again uncomfortable but the pain was totally manageable with Motrin. The worst part is getting out of bed because of the pressure of the implant under the muscle but once you get up its fine. By Friday I was getting out of bed with little to no assistance and by the following Wednesday I was walking the bay in Mission Beach. I would say the worst part for me was A – not being able to shower for 2 weeks (you need to keep your stitches as dry as possible) so its bath-time and B – sleeping on my back ( I am a totally side/stomach sleeper) but c’mon that is all I had to deal with….. ?
So like I mentioned a week after surgery I was walking the bay and doing light cardio at the gym. When I went in for my 2 week appointment to get the tape removed and to see my breasts for the first time I was speechless!! Dr Pousti did an amazing job, the scars are so small and faint that I can only imagine how they are going to look over time. I am now 6 weeks post surgery and I am pretty much back to all normal activity. I am looking and feeling great both inside and out! I’m loving my new body by Pousti!! If you are still looking for a doctor or you are having any doubts about the procedure please stop right now!! Dr Pousti is amazing and you will be nothing by satisfied with your decision, results and experience with him!!
OK, so we have all been there or we wouldn’t be here. We’ve sat on the beach next to our man and caught him catching a glimpse of a girl in the bikini and wished we were her or at least built like her. Nice shape and all. We are the ones at the swimming pool covered up with the oversized towel to hide what time has either taken away or maybe didn’t give us to start with. I WAS ONE OF THOSE WOMEN. After having several children, my body was definately lacking what once was. But at my age, I thought I was crazy for even thinking about having plastic surgery. I thought long and hard about it and met with several specialists. It was not until I met Dr. Pousti that I was sure this was the right thing to do. Right from the start, Dr. Pousti made it clear to me that he would not do the surgery for my husband’s sake. He would do it if it was for me. I did not know how much it would change my life. Dr. Pousti made me feel so comfortable from the very first visit to his office. His staff was very professional and made me feel very comfortable the way they helped me with the scheduling, the paperwork and the appointments. It was after my first visit with Dr. Pousti that I made the decision to go ahead with surgery. I FEEL LIKE A NEW WOMAN. My confidence is way beyond my expectations! I am proud of my body! Thanks to help from Dr. Pousti, I love the way I see myself when I look in the mirror. I have the confidence in myself that I haven’t had in many years. I thank God for Dr. Pousti, for giving me my woman-hood back. To all of you reading this letter, all I can say is, you are in the right place with the right doctor. GO FOR IT! And enjoy life the way that I am finally enjoying it!!!