A Complete Guide to Breast Surgery: Augmentation + Lift

Whether you are a mother whose breasts have lost their fullness and perkiness due to breastfeeding, or a woman who simply wants to feel more confident about her body, there is hope for improvement.

Regardless of your circumstances, finding an experienced surgeon, by the American Society of Plastic Surgeons (ASPS) can discuss your options to give you youthful, shapely breasts.

Whether you need a breast augmentation, breast lift, silicone implants, or saline implants, at Austin-Weston the Center for Cosmetic Surgery, the three plastic surgeons along with our dedicated staff are here to help you through the process based on what's best for you, your body, and your financial boundaries.

Continue reading for more information on breast surgery, and the considerations associated with each option.

Breast Augmentation or Lift? That Is the Question...

The decision whether to improve the shape or appearance of your breasts is an important first step in determining whether a lift, augmentation, or both are best for you; the decision is a personal one, dependent on your goals and your desired look. Breast lifts and augmentations can be performed separately or combined, depending on the patient's individual needs. While augmentation alone may be suitable for some patients, for others it may require an augmentation and lift to achieve the desired results. With over 30 years of combined experience in cosmetic surgery, the surgeons at Austin-Weston are committed to the safety and best possible outcome for each patient. During your consultation, your surgeon will work with you and provide suggestions to create a custom treatment plan that meets your goals while addressing your unique needs. A breast lift, also called mastopexy, focuses on reshaping the breast by removing excess skin and repositioning the breast to a more natural position. Breast augmentation involves the insertion of either a silicone or saline implant to increase the volume of the breast. Augmentation not only increases the size of the breasts but also reshapes the contour providing a fuller, shapelier look.

The 'Breast Lift' Test You Can Do at Home

It can be disappointing if you go to a consultation looking to have a breast augmentation and realizing that a breast lift will need to be combined to achieve the shape and perkiness desired.

Here's a test you can do yourself to determine if an augmentation will suffice, or a combination of augmentation and lift is necessary...

Standing in front of a mirror, look at your nipples in relation to the natural crease beneath your breasts. If your nipples are lower than your breast crease before surgery, adding implants without removing excess skin will only increase sagging, which will continue to get worse due to gravity over time. If this is the case, a lift will probably be needed as well.

Am I A Candidate for Breast Augmentation?

When determining if you're a candidate for breast surgery, a variety of factors need to be taken into consideration:

1. Personal Goals
2. Your Overall Health
3. Financial Commitment

First, your goals and reasons for surgery.

Do you have a desire for larger breasts? Perhaps you have noticed sagging. Or, maybe one breast is noticeably smaller than the other. These and any number of other issues may prompt a woman to explore surgical options.

Next, are you in good overall health?

While some health problems won't preclude you from a breast lift or breast augmentation surgery, your consultation appointment is the time to discuss any issues with your surgeon before moving forward. It is important to be honest and thorough when completing these forms, as the information you provide helps prevent complications. When asked about medications, be sure to include any vitamins or herbal supplements, as these can affect your blood pressure and clotting ability. Honesty regarding tobacco and alcohol use is also critical, as this can have a profound impact on recovery and incision healing. Be sure to bring a list of your health concerns, previous health issues, and medications to your consultation. Your family health history will also be discussed.

Lastly, the financial reality of surgery should be considered.

During your consultation appointment, the surgeon and staff will be at your disposal to review the financial aspect and commitment related to your specific needs and procedures of choice. After discussing your options with the surgeon, you will receive a detailed price quote for the procedure and your specific needs. Confirm how long the price quote is valid and when it expires. Most surgeons allow a few months, so you have plenty of time to consider your options. Take this time to discuss payment and financing options and if you're confident in your decision to move forward, pay the deposit for your surgery.

Taking the Next Step: Your Consultation

The next step in your breast augmentation journey is a complimentary consultation with a plastic surgeon, during which you will discuss your goals, expectations, and the surgeon will offer their recommendations for achieving your desired results.

Breast augmentation patients will have the opportunity to try on different sizes of implants to see how they look and feel. Comfort with the fit and overall experience should be the top priority.

During the consultation, you will address the goals of a breast lift, augmentation, or both. Should you choose augmentation, the next step is discussing the size and shape, placement, and implant options – such as silicone or saline.

The surgeon will address your overall health, desired goals, and possible risks or complications that might be associated with the surgery. If you have questions, bring a list of with you to your consultation so you can address any remaining doubts you might have with the doctor and get them out of the way before taking the leap.

At Austin-Weston the Center for Cosmetic Surgery, your satisfaction is our main concern and we want every patient to feel comfortable with the decision to go under the knife. With over 30 years of combined experience, our surgeons are experts at providing each patient with a treatment approach that will lead to a positive surgical experience and natural results.

Considering a Breast Lift?

A breast lift is primarily beneficial for women who simply want to reshape their breasts without increasing the overall size. Many women choose a lift because they are happy with their current size, but not the current shape and position of their breasts. Over time, breast tissue and the skin over the breasts can become loose, causing the breasts to sag and appear poorly shaped and poorly positioned.

A procedure to correct these problems will take anywhere from one to three hours of surgery, in which the extra skin tissue will be removed for reshaping the breasts. Resulting in perky, youthful-looking breasts, and a fuller bust without dramatically increasing the size.

Considering a Breast Augmentation?

While breast lift surgery is primarily focused on repositioning and reshaping, augmentation surgery involves the use of an implant to increase the volume and is typically a quick surgery, about one hour. The procedure begins with a small incision and the creation of a small pocket to hold each implant. After the implants have been placed and adjusted for ideal fit, the incisions are then closed.

Implant Options: Saline vs. Silicone

Silicone and saline implants are both safe and provide a natural look. The type of implant that fits your needs will depend on your goals for size, shape, and feel. During your consultation, you will have the opportunity to try on and feel both types of implants. Both silicone and saline implants are FDA approved and safe.

• Saline Implants: Do not come pre-filled. The implants will be filled and adjusted after they have been inserted and placed. Saline implants are ideal for women wishing to improve symmetry. Saline implants are filled with a saltwater solution, like natural body fluids. Saline has a slightly firmer feel than silicone.
• Silicone Implants: Come prefilled and are designed to provide a natural feel. They are filled with silicone gel, which retains uniformity throughout the implant for a feeling that resembles natural breast tissue.

Incision Location: Armpit vs. Breast Fold

If you've started to do your research on breast augmentation and implants, you will already be familiar with some of the terminology involved in this procedure. One of the most common questions we hear from patients is regarding the incision – armpit incisions or breast fold incisions.

• Armpit Incisions (Transaxillary): Transaxillary incisions are made in the armpit and are about one to two inches in length. Because of their position, these incisions are discreet. The incision is created using small instruments to make a pocket under the muscle tissue in the breast. Then, the implant is inserted, and if a saline implant is being used, it will be filled to the desired size.
• Breast Fold Incisions (Inframammary): Inframammary incisions are made in the fold on the underside of the breast. Both incision locations allow breastfeeding mothers to continue nursing. Although both options are safe, transaxillary incisions are most commonly used in order to avoid scarring on or near the breasts since the incision it's located in the armpit, resulting in virtually undetectable scars.

Implant Placement: Above vs. Below the Muscle

Another frequently asked question involves implant placement – above the muscle or below the muscle.

• Above the Muscle: Placement of implants above the muscle, called sub-glandular, may result in implants that are less natural looking and easily felt through the skin. There is also a slightly higher risk of capsular contracture and difficulties with mammography. For these reasons, placement of implants above the muscle is often not a viable option but it used in situations depending on the patient's body, their individual needs, and desired goals with surgery.
• Below the Muscle: Under the muscle is typically the most common option for several reasons. Below-muscle placement means that your implants will be less palpable. You will be less likely to feel them, and the final look will be more natural. The risk of capsular contracture, a possible complication, is reduced. An additional benefit of below-muscle placement is easier breast imaging with mammography, an important health screening for women as they get older.

Surgery Day

On the day of your procedure, be sure to follow any pre-operative instructions provided, including dietary and medication requirements, such as not eating prior to surgery and either stopping or starting medications as indicated. Be sure to have someone available to drive you to and from your procedure, as you will receive general anesthesia, which will leave you groggy and unable to drive after surgery.

Your surgery will last anywhere from one to several hours depending on the specifics of your procedure. Before beginning the procedure, your surgeon will mark each breast to provide guidelines for incisions and to confirm your choices.

When performing the procedure, your surgeon will follow the decisions made during your consultation and pre-surgery appointments using this as their guide for the procedure. Whether you have chosen a lift, augmentation, or combination, your surgeon should make the appropriate incisions and adjustments, including placing implants if they are part of your surgery.

Once the surgery is complete, recovery begins. Be sure that you fully understand the recovery process and instructions prior to the day of surgery.

Surgery Recovery

Typically, breast augmentation and lift procedures are done on an outpatient basis, allowing you to return home the same day as your procedure. The recovery time will vary depending on the patient and their individual situation but typically takes 2-4 weeks to recover. Most women find that they need four days off from work to recuperate. It is ideal to arrange your schedule so that you won't need to do any strenuous activity in the first few weeks after surgery, including lifting children or heavy groceries, going to the gym, or doing extensive yard or housework.

Regardless of which procedure you choose — a lift, augmentation, or both — expect to refrain from lifting any more than 10 pounds during the first week after surgery, and no more than 25 pounds in the second week of recovery.

During your consultation and after your procedure, the surgeon and staff will discuss specific recovery needs with you and answer any remaining questions you might have.

The 3 R's: Risk, Replacement, and Revision

As with any procedure, breast augmentations and lifts do have some risks.

1. Risk: During your consultation, you will receive information about risks in general, but also about risks specific to you. Although complications are rare, they include infection, bleeding, scarring, loss of sensation, firmness of the breast, and leakage or rupture of an implant. Your level of risk will depend on your overall health, whether you smoke, follow-up care, and other factors.
2. Replacement: Most women find that they never need to have their implants replaced. However, although rare, there is a possibility of the need for replacement. Your surgeon will discuss these possibilities during your consultation. Complications that could result in the need for replacement or re-operation include leakage of fluid from an implant. During your consultation, be sure to ask about any specific concerns regarding the risks of your augmentation.
3. Revision (or Re-Operation): Another component to consider is the breast implant warranty. Warranties add value to your breast augmentation package by protecting you from additional costs down the road. Some warranties are free with the purchase of implants.

The surgeons at Austin-Weston stand behind their work. What that means for our patients is that your primary breast augmentation surgery will be under warranty your results for three years following your surgery – no charge for any revision that is surgically or medically indicated for capsular contracture or implant malposition. This includes any implant malposition or capsular contracture coverage at no cost, as well as any changes you may want to the implant size if you decide to go a little larger or smaller at the cost of the implant only. Patient must have a post-op appointment at the 12-month mark as well as 24 months post surgery.

Even if you want to change the size of your implants, your fee will only include our wholesale cost of the implants plus the standard Operating Room and Anesthesia charge with no surgeon's fee. This will significantly reduce your cost. We are unaware of any other practice in the country that offers such a warranty. We hope this peace of mind will help you choose an Austin-Weston surgeon for your breast augmentation!

Selecting a well-qualified, plastic surgeon and asking the right questions will increase your chances of getting the most favorable return on investment, which is exactly what plastic surgery is: an investment in 'you'. To schedule a complimentary consultation, call 703.893.6168 or contact us today for more information regarding breast surgery and the various procedure options.

Recommended Resources:

• Payment and Financing Options
• Before & After Gallery: Breast Surgery
• Schedule a Complimentary Consultation