Every plastic surgery procedure has numerous issues that every patient who is undergoing a procedure should know. These explanations are always on a consent form that you should read in detail before surgery. This consent form, while many perceive as strictly a legal protection for the doctor, is actually more intended to improve the understanding of combining breast lifts with implants. (also known as mastopexy augmentation breast reshaping procedures) The following is what Dr. Eppley discusses with his patients for these procedures. This list includes many, but not all,of the different outcomes from surgery. It should generate both a better understanding of the procedure and should answer any remaining questions that one would have.
ALTERNATIVES
Alternatives could include using a breast implant by itself or doing only a breast lift without augmentation. Each of these choices have their own consequences for the resultant breast shape which would not be the same as a combined breast lift with a breast implant.
GOALS
The goal of combination breast lifting with implants is to give the breast more fullness (particularly in the upper pole) and lift a sagging breast to a better position on the chest wall. In addition, the nipple-areolar complex is moved upward to a more central position on the breast mound.
LIMITATIONS
The limitations of breast lifting with implants are those of the final breast size achieved and how much lifting of the sagging breast can be done on top of an expanded breast mound. How much excessive breast skin one has, the remaining amount of underlying breast tissue, the elasticity of the breast skin, the amount of breast sagging and the size and droop of the nipple-areolar complex all pose limitations on the final result that can be achieved.
EXPECTED OUTCOME
Expected outcomes include the following: temporary swelling and bruising of the breast mounds and nipples, breast skin numbness, nipple numbness, permanent breast scars and weeks to months for full scar healing to occur. The initial shape of the breast mounds may look too high, too full or non-round. It may take as long as six months to see the final shape and size of the breasts as both the implants and lifts settle. Scars may take up to one year to fully mature.
RISKS
Significant complications from combined breast lifting with implants are rare but could include implant infection or partial or complete loss of the nipple-areolar complex. More likely occurrences could include delayed incisional healing with some separation and suture reactions, breast implant malposition or asymmetry, breast mound or nipple-areolar asymmetry, recurrent breast tissue sag over the implants, scar widening and no guarantee can be made as to the eventual breast cup size. It is important to understand that the combined breast lift with implants is the most technically challenging of all aesthetic breast reshaping procedures and has a high risk of the need for revisional surgery for optimal results. Any of these risks may require revisional surgery for improvement.
ADDITIONAL SURGERY
Should additional surgery be required to do additional breast lifting, reposition and/or replace the breast implants or perform any scar revisions, these will generate additional costs.