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Scar sparing breast uplifts ?
Posted on June 24th, 2009 6 comments
Scar sparing breast uplifts are currently receiving a lot of attention in scientific Plastic surgical literature.Generally, uplift procedures are advised once a certain degree of btreast ptosis (sagginess) has developed. Once the level of the nipple is located below the level of the submammary crease , literature reviews generally recommend some kind of uplifting procedure, with or without use of breast implants. Whether a breast augmentation is to be advised together with the breast uplift, will depend on the amount of available breast tissue and patient desires.
Whether or not to stage breast augmentation and breast uplift into two proedures remains a matter of controversial topic, and surgeons opinions about this vary.
Whilst it is true that rates of revisional surgery for breast uplifts is significantly higher than for both procedures individually, it is also true that a staged procedure naturally bears a 100%revision rate.
Case 1

Patient with significant volume loss following multiple pregnancies
Progressive ptosis(sagginess) with nipples below the inframammary fold
Patient asked for uplift and volume fill
Operation performed was subglandular liftCombination with vertical scar mastopexy
Result 10 months post op
Good projection
Sufficient size
In spite of the undoubtedly significant percentage of revisional surgeries for breast augmentation with uplift, patient satisfaction is still very high. Most touch up surgeries will aim to correct nipple position and/or scars.
Opinions among surgeons regarding which technique to use generally vary considerably, but the technique with the least scarring is not necessarily the one that makes the patients most happy.
Especially among Caucasian patients much is to be said for rather considering more scarring to trade in for a favourable shape, since fair skinned patients tend to scar favourably and the scars tend to fade over time to a degree that they are of much less concern to patients.
Bear in mind that this is a long term observatzion, scars after breast uplift may be quite red initially before gradually fading. The process of scar fading after breast uplift is not entirely in the surgeons hands, lots wil depend on personal factors also.
Within reason, one can also explain if the patient is willing to accept more scarring there is less chance of recurrence of ptosis (sagginess). Nevertheless, very shortly after a breast uplift, and regardless of the technique used, it is not unusual for the scars to be quite red and swollen, especially when absorbable suture material, which I personally recommend, is being used. Given time, these scars, nearly without exception, tend to fade significantly and do not normally concern patients then.
To promote softening and fading of these scars after breast uplift (mastomexy) we tend to use silicone stripes, which promote softening of the scars more rapidly. But as alway, time is the best healer.
Read more about breast uplifts here
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Dry, wet and superwet “soft-touch”liposuction….the differences
Posted on June 3rd, 2009 7 commentsWhen performing liposuction, as a first step the surgeon will inject a solution consisting of saline, a local anestetic, adrenaline and bicarbonate into the area to be treated.
The amount of fluid in relation to the amount of fat extracted determines into what category the liposuction falls. Should less fluid be injected than fat extracted, then it qualifies as dry, if the other way round, it is superwet.
Case samples of liposuction liposuction
Patient requested removal of diet resistant fat deposits on outer thighs, flanks and buttocksProcedure selected was soft touch liposuction under local anetsteic and sedation
Result after removal of 2200cc of fat in sof touch techniqueGood skin retraction
Overall pleasant change of body contour
Result 5 months post OP
Case 2
Patient with good skin qualityNo skin ptosis
Reqeusts body contour correction in lower abdomen and flanks

Result after removal of 1700cc of fat
Soft touch technique
Good skin retraction
Result 3 months post op.
The advantage of superwet soft touch technique normally is that there is less pain and bleeding, although oozing of residual injection fluid commonly occurs postoperatively. This is often mistaken for bleeding after the liposuction, but its occurrence is normal and should normally cease within about two days.
Read more about liposuction here



Dr. Alexander Aslani is director and head of the department of Plastic, Aesthetic and Reconstructive surgery of Hospital Quiron Malaga, Spain.
The department is the only one of its kind offering reconstructive microsurgery within the private healthcare sector in Andalucia, and apart from its offices in Hospital Quiron, also offers consultations in private practice in Cirumed Clinic Marbella.
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