When it comes to breast lifts the most common questions I get each day concern the probability, risk, and/or how we can avoid scarring. While I would like to be able to offer patients a 'scarless' breast lift, the reality is that breast lifts will always require incisions and to get a great cosmetic result the type or placement of incisions is not dependent upon what I would prefer to do but rather it is dependent upon how much breast sag or ptosis a patient exhibits, the patients balance between skin and breast tissue and where this laxity in skin and tissue exists.
Usually, medically necessary surgery dictates where incisions must be made, and it’s sometimes difficult to place those incisions where visibility is reduced. In addition, because medical surgery is performed to improve your health—or possibly even save your life—the surgeon’s focus will be on the primary purpose of the procedure rather than the cosmetic aspects. This may mean closing the incision in one layer, or using staples, which themselves cause scars in addition to the incision.
Unfortunately, scarring is a reality of any breast lift surgery. The amount of scarring and positioning of the incision, however, can be personalized and tailored to the patient’s condition. Generally, a patient who needs a more pronounced lift may need a full anchor scar, while a patient with milder sagging can get away with a single vertical scar. A board certified plastic surgeon will guide you toward the correct type of breast lift for your condition, but it is important to understand that this scarring is the tradeoff that results from having perkier, more youthful breasts.
Good skin tone is essential to a good outcome, since the skin needs to snap back into the body’s new contours once the fat is removed. “If a patient has good skin elasticity, they’re going to have a really good result,” says New York plastic surgeon Dr. John Mesa. “But if the patient has bad elasticity, like a woman who’s had multiple pregnancies and the skin on her belly is too stretched, the skin isn’t going to shrink—and you’ll be left with sagging” (unless lipo is paired with a tummy tuck).
You may notice an improved body contour immediately (for instance, if you have your saddlebags suctioned), but your results will be disguised initially by swelling. Swelling should improve dramatically after six weeks and continue to go down over the next six months. If you think you’ll need more lipo to get the result you want, wait at least six months for the swelling to subside, then evaluate the situation with your surgeon. Just keep in mind that you’ll continue healing and seeing better results for up to a year.
Although the removed fat cells are unlikely to grow back, body fat has been shown to return to preliposuction levels within a year after the surgery, particularly returning to the abdominal area. Researchers believe the body compensates for the rapid fat loss by putting on more fat. In a trial of 34 women published in the September 2012 edition of the journal “Obesity,” the cosmetic benefits of liposuction were lost after one year. A later study, however, suggested that recurrence of belly fat can be avoided by exercise.
Office liposuction under tumescent local anesthesia costs from about 4-7500, and more extensive procedures need to be done in the operating room under general anesthesia. Depending on the time the cost can go up to 15,000. Multiple areas are discounted in the sense that when done in the operating room under general, the additional areas are charged by the total time, not per area, which is a savings.
Gaining in popularity is something called the vertical lift, which involves a scar around the areola and then straight down the breast, eliminating the underneath scar. Proponents think that the shape is good, that the breast maintains a lot of projection over time without bottoming out, and that the underneath scar is avoided. I believe that many of these breasts look overly projecting to my taste, and that bottoming out can be minimized with the inverted T style pattern. I also feel that the underneath scar is rarely seen, and that the scars that are seen - around the areola and going straight down, seem relatively more visible with this technique since it requires some bunching up of the skin during closure. Understand that some of the best surgeons in the world argue with one another about this issue at meetings all the time!