At Gabbay Plastic Surgery, we understand that a woman can have a variety of personal reasons to undergo breast surgery and we are committed to helping you attain your individual goals. There are many reasons to choose breast surgery: you wish to correct the sagging of your breasts, have your clothes fit better, increase the projection and fullness of your breasts, restore the breast volume you have lost after pregnancy or weight loss, refine your contour and silhouette, rectify the balance and proportion of your figure, improve the symmetry between your breasts, or enhance your self-esteem and confidence. We understand that the barrage of information regarding breast surgery can be confusing, and choosing the right procedure can feel overwhelming. We offer one-on-one consultations to answer your questions, determine your candidacy, and help you make an informed choice about your body and your health.
Many prospective patients are often confused about what the best procedure is for them: breast augmentation, breast lift or a combination of the two procedures.
According to The American Society for Aesthetic Plastic Surgery, more than 285,000 women had augmentation mammaplasty (also known as breast augmentation, breast implants, or breast enlargement) performed in 2014. While breast augmentation maintains its #2 rank in the top 5 cosmetic surgical procedures performed in the United States (second only to liposuction), mastopexy (breast lift) procedures have grown rapidly at a rate of 70% since 2000.
Breast augmentation is a procedure to increase cup size or restore breast size by utilizing breast implants or fat transfer.
- It has a proven track record with high satisfaction rates.
- It is a long-term solution to correct your figure, make you look better in clothes and swimsuits, and give you larger breasts with a more youthful appearance.
- Scarring is inconspicuous.
- The implants require regular monitoring and may eventually need to be replaced.
- As with any surgery, there are surgical risks associated with the procedure.
Breast lift is a procedure that lifts the breast tissue and areola to improve contour and correct sagging breasts and nipples, reduced volume of breasts, or widened areolas (the darker area surrounding the nipple).
- Improved shape, projection, and symmetry of your breasts for a younger perkier contour with better fit of clothes and improved confidence.
- Scars are hidden beneath the breasts with only light scarring visible on top of the breasts.
- Results can last for decades if significant weight fluctuations do not occur.
- The effects of the procedure may gradually diminish over time with aging and gravity.
- The procedure leaves scars that may be hidden in a bra or swimsuit, but may be visible without clothes.
- Subsequent pregnancies may stretch your breasts or reduce their volume, changing the surgical results.
- Large and heavy breasts can be lifted, but may also need a small breast reduction
BREAST AUGMENTATION OR BREAST LIFT – WHICH IS THE RIGHT CHOICE FOR ME?
The technique you choose will depend on the specific anatomic features of your breasts and the outcome you hope to achieve.
If you feel your breasts are too small for your body; if you feel self-conscious wearing swimsuits or low-cut tops; if clothes fit well at your hips but hang loosely at the bust line; if you’ve lost volume of your breasts after childbirth or weight loss; or if one of your breasts is significantly smaller than the other, then breast augmentation may be the right choice for you.
If your breasts have sagged and drooped as a result of pregnancy, nursing, weight loss, hereditary predisposition, or the effects of aging and gravity; if the area surrounding the nipple and areola has become stretched; if your breasts are normal in size but are pendulous and lacking in firmness; if your breasts appear different from one another or unequal in size; or if the nipples and areolas point downward and are positioned below the breast crease, then a breast lift procedure may be the right choice for you.
Breast augmentation alone is appropriate when:
- Your drooping is mild.
- Your nipples/areolas are in the center of the breasts and do not point downward.
- There is visible skin below your nipples/areolas when looking straight at the breasts.
- You would like larger breasts.
Breast lift alone is appropriate when:
- Your drooping is moderate to severe.
- Your nipples/areolas are at the bottom of the breasts and point downward.
- There is no visible skin below your nipples/areolas when looking straight at the breasts.
- Your areolas are too large and you would like them reduced.
- You are happy with the volume of your breasts and do not want them to be larger.
- You want to increase the size of your breasts.
- The upper potion of your breasts has lost volume (commonly after pregnancy or weight loss).
- Your drooping is severe.
- You want larger perkier breasts.
- You want to maintain good projection and roundness of the breast mound.
- Pre-filled silicone breast implants that come in a variety of shapes and sizes and contain a soft, elastic gel.
- Cohesive gel silicone implants (gummy bear or form-stable implants) that contain crosslinked molecules of silicone for a firmer and thicker implant that holds its shape better.
- Saline-filled breast implants that contain sterile salt water that are modifiable at the time of surgery.
- Autologous fat transfer with removal of fat by liposuction from your thighs, abdomen or hips, refinement of the fat cells, and then injection into your breasts.
- A scar-less lift is suitable to correct volume loss more so than sagging.
- A crescent lift (with the scar at the top of the areola only) is suitable for correction of minor sagging when done in conjunction with or without breast augmentation.
- A donut lift (with the scar entirely around the areola) is suitable for mild to moderate sagging when a breast lift is performed in conjunction with breast implants.
- A lollipop or keyhole lift (with the scar around the areola, and from the bottom of the areola to the bottom of the breast) is suitable for moderate to severe sagging.
- An anchor lift (with the scar around the areola, down the bottom of the breast and along the lower breast fold) is suitable for severe sagging.
A paired breast augmentation and breast lift is appropriate when:
Based on his evaluation of your individual anatomy and your aesthetic goals, Dr. Gabbay may recommend breast augmentation, breast lift, or a combination of the two procedures for the best results and a comprehensive rejuvenation. In general, if you are in good health and have realistic expectations, you are likely a good candidate for breast augmentation, breast lift, or a combination of the two.
HOW ARE THE PROCEDURES PERFORMED?
For a breast augmentation procedure, Dr. Gabbay will create a pocket to place the implant using access point underneath the breast or through the areola. The implant may be placed under or over the pectoralis major muscle. The implant can be have silicone or saline inside. An alternative to breast augmentation with implants is augmentation with fat transfer, in which fat is removed by liposuction from your tummy, thighs or flanks, processed, and then injected into your breasts. Dr. Gabbay will make a recommendation on technique based on your individual anatomy, personal preferences, and aesthetic goals.
For a breast lift, Dr. Gabbay will determine the location of the incisions and select the appropriate technique to remove excess breast skin and reshape your breasts based on the size and shape of your breasts, the size and position of your areolas, the degree of sagging of your breasts, the amount of excess skin present, and the elasticity of your skin. The procedure involves removal of excess skin, reduction in size and shifting of the nipple and areola to a higher position, reshaping of the breast, tightening of the loose breast skin, and placement of supporting sutures to make the procedure long lasting. Incisions used are a combination of those made around the areola, vertically from the areola to the breast crease, and horizontally along the breast crease. Some of these incisions are concealed in your natural breast contours, while others are visible.
WHAT ARE MY OPTIONS?
Depending on your body shape, your aesthetic desires and preferences, and your medical history, Dr. Gabbay will suggest one of the following options for breast augmentation surgery:
For a breast lift procedure, Dr. Gabbay will discuss with you different incisions and techniques and their respective pros and cons:
WHAT SHOULD I EXPECT AT MY INITIAL CONSULTATION?
Successful results depend on good communication with your surgeon. Dr. Gabbay will give you the opportunity to discuss your aesthetic goals and the size and shape of breasts you desire. He will perform an evaluation to assess your candidacy for breast augmentation, breast lift, or a combination of the two. Dr. Gabbay will take measurements and a 3D scan of your breasts to assess their current size and shape, the quantity of breast tissue, the quality of your skin, and the position of your nipples and areolas. Using the 3D imaging will allow Dr. Gabbay to show you how you can expect your breasts to look after your operation.
Dr. Gabbay’s consultation will include a discussion of your complete medical history including previous surgeries, breast biopsies, past and continuing medical conditions, allergies, current medications, family history of breast cancer, and mammography results. Dr. Gabbay will complete a comprehensive evaluation and then make recommendations about the type of procedure, anticipated outcomes, options of anesthesia, preparation for the surgery, and followup care. His office staff will also discuss the financial aspects of the procedure and show you before and after photographs to help you make an appropriate choice.
WHAT SHOULD I EXPECT BEFORE, DURING, AND AFTER THE PROCEDURE?
Both breast augmentation and breast lift procedures are usually performed on an outpatient basis. You will be given detailed preoperative instructions and the estimated length of your surgery. Dr. Gabbay will answer any questions you may have. A mammogram (an x-ray study of the breasts) may be necessary to document your breast tissue before and a few months following surgery. You should stop smoking at least six weeks prior to surgery, limit alcohol consumption, maintain excellent hydration, and avoid taking aspirin and other drugs and supplements that can result in increased bleeding. Under normal circumstances, you will be permitted to go home after a short period of observation following the surgery. Dr. Gabbay will provide you with detailed instructions about postsurgical care of wounds and drains, the expected normal symptoms, and the potential signs of complications that you should be aware of.
Dr. Gabbay’s extensive experience with breast augmentation and breast lift surgeries will help you make an informed choice. Whether you decide on breast augmentation or breast lift as the right choice for you, Dr. Gabbay and his staff are devoted to restoring your confidence and enhancing the appearance, size and contour of your breasts, while upholding the highest standards in aesthetic plastic surgery.