Is breast augmentation combined with uplift a safe procedure ?

Breast augmentation mastopexy,which means a breast uplift combined with  breast augmentation with implants is probably, apart perhaps from rhinoplasty, the most demanding procedure in aesthetic surgery.

“There is a lot of misunderstanding around this operation,and whilst it may be extremely rewarding, patients need to understand the complexity of the operation to adequately appreciate the results “, says Dr. Alexander Aslani, who is head of department of Plastic surgery, Hospital Quiron, Malaga.
He has extensive experience with breast augmentation with mastopexy, because it is one the most frequently demanded operations within cosmetic surgery in Spain.

Indication for a breast uplift is breast ptosis (sagginess) of the breast, most commonly following weight loss and pregnancy.

This results in an empty skin envelope with no appropriate filling. The concept of the operation is to tackle the problem from two sides: firstly to tighten the skin envelope and secondly to fill it appropriately with a breast implant.
“The change can be very impressive and patient satisfaction is very high, however, depending on the degree of sagginess, a certain amount of scarring will be necessary,” says Dr.Aslani.”I normally advise patients that shape of the breast is much more important to patients than scarring in the long run, but scarring will be involved.
To what degree does very much depend on your skin type, the fairer the skin the better the result.”
There are still surgeons promoting a two-stage approach, which means doing the mastopexy in one go and then the implant placement in the next.
“The advantage of this is that the tissue reaction is more predictable” so Dr. Aslani.”On the other hand patients always need two operations. In my experience, although I completely agree that the overall revision and complication rate of combined breast implants and uplift is significantly higher than in a plain breast augmentation , it is safe and preferable to do the operation in one go.
There is a higher incidence of infection, wound healing problems, scar revision, that is true, but this is clearly outweighed by the benefit arising to the patient from a one-stage procedure.

My experience is that given that patients are aware of the complexity of such a breast augmentation and breast uplift procudure, they are usually very happy with the fairly impressive change achievable.

There is however a certain chance that both surgeon and patient agree on performing a touch-up procedure like a scar revision, often around the nipple, after about a year has passed.Whilst these are mainly minor procedures that can be done under local anesthetic, scientific literature reports incidence of such requests being as high as 15%.
Especially for UK residents coming to Spain for cosmetic surgery this has to be discussed and born in mind.
The most common misunderstanding within this procedure is the expected change of breast size.
“Uplift and implants combined do not necessarily increase cup size, but rather a preexisting cup-size is filled by proper breast volume than just by an empty skin envelope. It is about changing the shape of breast, not primarily about increasing the size. There must be a good understanding between patient and surgeon beforehand, I always say the patients with breast augmentation with uplift need to be selected very carefully.Especially patients rather wishing bigger breasts need to be advised that there is unfortunately no way to get around gravity in the long term.”
The change in breast shape is quite dramatic and patient satisfaction with the operation generally very high.
However, patient understanding regarding the procedure must be kept very clear.
Whilst scarring, implant positioning and staging were and will remain a controversial topic among Plastic surgeons for a while, the combination of breast implants with breast uplift can,on the other hand, be one of the most rewarding surgeries of all.

Dr.Alexander Amir  Aslani, MD, EBOPRAS

Hospital:
Director and Chief Surgeon
Department of Plastic, Aesthetic and Reconstructive Surgery
Hospital Quiron Malaga
Avda.Imperio Argentina, 1
E-29004 Malaga
Spain
www.quiron.es

Private practice:
Cirumed Clinic
Avda.Ramon y Cajal 7-4°
E-29601 Marbella/Malaga
Spain
Phone:+34 607 307 515
info@cirumed.es
www.cirumed.es

Breast enlargement-what implant to take ?

“There is no easy answer to this question, because not every breast is the same”, says Dr.Alexander Aslani, who is head Consultant Plastic Surgeon of the Cirumed Clinic Marbella and Consultant Plastic Surgeon in London´s Highgate Hospital.

“It depends very much on the breast and , more importantly, on patients preference. Different patients prefer different looks, and this has to be taken into account when planning the procedure.
Generally, The question is where fullness is required….if it is on the upper pole, a round implant may be the better option, especially if the implant is positioned behind the breast muscle, choice of breast implant,but this depends very much on the case.I prefer to show patients pictures with relevant examples, and then we make a choice together .Breast surgery is not just a “boob job” but a very individual and every breast is different and therefore requires different solutions,” says Dr Aslani.

Round implants or anatomical ? Again this this depends, says Dr.Aslani. People perceive that breast enlargement with anatomical implants as more natural.

“Anaomical implants behind the muscle can occasionally look a bit flat on top, if the breast is fairly flat on top in the first place and the muscle rather strong,” so Dr.Alexander.Aslani.

Generally breast augmentation is one of the operations with he highest degree of patient satisfaction, which tends to give patients an enormous boost in self confidence.

Materials used are, without exception, cohesive silicone-gel filled implants.

Breast augmentation/breast enlargment in Cirumed Clinic Marbella continues to be one of the most popular procedures for patients from abroad seeking cosmetic surgery in Spain, the backbone of medical tourism in Marbella.

There is a couple of other procedures breast enlargement can safely be combined with, says Aslani, depending on the nature of the request.

A frequently asked question is….can Breast enlargement be done as a day case ? Yes, it can says Dr.Aslani, but he suggest for patients not to enter without a “plan B” to possibly stay overnight.

How long do breast implants last ?

“At present, we don’t know”, says Dr.Alexander Aslani.”We presume that patients can enjoy the effects of a breast enlargement for as long as there are no problems. Should problems occur, action might naturally have to be taken and the breast implants exchanged”.

Dr.Alexander Aslani, Cirumed Clinic Marbella, Marbella, Malaga, Spain, www.cirumed.es, www.alexanderaslani.com