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Breast Augmentation With Lift

CONVENIENTLY LOCATED TO SERVE NASHVILLE, BRENTWOOD, AND FRANKLIN

Breast Augmentation with a breast lift is a more complex surgery that requires expertise. Double board-certified plastic surgeon, Dr. Paul Warner Papillion performs hundreds of breast augmentations with breast lifts in Nashville, Brentwood, and Franklin yearly. His technical abilities are key to achieving a safe, great outcome. This is one procedure where you must do your homework in selecting the right surgeon.

Below are the quick facts, Dr. Papillion has answered the key questions you need to know about breast augmentation with a breast lift. Keep reading to learn more!

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Should I choose a Saline or Silicone (gel) breast implant?

This is the first main question when performing a breast augmentation and breast lift.

We use two basic types of implants, a saline breast implant, and a silicone or gel breast implant. They both have a silicone shell; one is filled with saline during surgery, and the other comes prefilled with silicone. Most plastic surgeons, including myself, and patients prefer the gel implant over the saline implant because the gel implants typically have a more natural “breast tissue” like feel and have a lower rate of “rippling” or folding of the shell wall. In thin patients or smaller-breasted patients, the feel and shell wall characteristics are more important because the less breast tissue you have covering the implant, the more you will feel and see the underlying features of the implant. If you start with large breasts and choose a smaller implant, your natural breast tissue will do a good job of masking any implant feel difference or rippling visibility and the differences between implants become less important.

The most common shape and the surface of breast implants used is a smooth round implant. This is the one I prefer and use the most.

When you come in for your consultation, you will be able to hold and feel the difference between breast implants. I will be able to perform an exam and give you my opinion about your breast tissue coverage and help you to decide which implant may be best for you.

What kind of incision or lift pattern do I need?

There are several “incision” types for breast lifts. I perform all of them, in the right scenario. The most important aspect of having a good result is the doctor knowing what incision pattern to use in each case. Poor results occur when doctors choose a pattern that doesn’t match the goals of the surgery. Sometimes they often can offer a “small scar” and it seems appealing, but in the long run, you can risk a poor outcome a few months after surgery. Most incisions heal well, and the scar pattern, in my opinion, is secondary to the breast shape outcome in the final result. In other words, I would rather give you the very best breast shape and appearance with a slightly larger scar, than give you a tiny scar and a poor breast shape and appearance. The overall look of the breast is more important than the length of the scar.

There are 3 main scar patterns: A donut or periareolar scar, a lollipop or periareolar with a vertical component, and an anchor or wise pattern, which is the most common type. All three have their place in surgery, as I do all of them, but the smaller the scar pattern, the more limitations I have to adjust the breast shape and lift. You will need an exam to determine which would work best for you. In general, the more ptosis or sagging you have, the larger the lift pattern you will need.

What is the scar going to look like?

This is the most common question and concern for most patients.

Generally speaking, most people heal very well after a breast augmentation and breast lift. The scars initially have some pink or red pigment, and slowly fade to a white color over a year.

Is it better to place the implant under the muscle or over?

Breast implants can be placed under the muscle or over the muscle. Most plastic surgeons including myself, prefer placing the implant under the muscle. There are two main reasons. One, the muscle offers more coverage at the top and middle side of the implant allowing for a smoother, more natural look. This is extremely important in a very thin patient. When the muscle is just under the skin, you can have a sharp edge to the implant and in some cases be at risk for ‘the round baseball’ look. The other reason is that it’s proven that you have a lower chance to have capsular contracture. Capsular contracture is scar tissue that builds up around the implant that can cause a poor look and discomfort over time.

What size implant is best for me?

Choosing your optimal size:

Your starting body proportions and desired outcome preferences will make the size choice for you. Everyone has a different opinion of what look they want. The most common thing that patients say when asked about size is: I want to look natural. I want to look proportional. The way I like to determine your size is to first talk about your goals, perform an exam to see your dimensions, look at photos you may bring if you have any, and allow you to try on different sizes of implants so that we can get a visual of the look you like best. After combining this information, we have a pretty good idea of what implant size is going to be best for you. I rarely have patients unhappy about a size selection. Looking online at before and after photos that have the size listed can be helpful, but be careful because you need to know the patient’s height and weight, and their starting breast size needs to be similar to yours before you can get an idea of your potential outcome.

What does the day of surgery look like?

Typically starting at midnight the night before your surgery, you will stop eating and drinking all food and liquids. You can brush your teeth the next morning, and take any approved medications with a sip of water, but that is it. You will arrive at the surgery center about 2 hours before your scheduled time. You will be checked in and prepped for surgery. I will see you before surgery, review your procedure, and size, and mark your breasts. After we confirm everything, you will be taken back to surgery. The breast augmentation and breast lift take about 3 hours. After surgery, a nurse will take you to the recovery room where you will fully awake over 30-45 minutes. After this, you will get dressed and head home. You will have a sports bra and dressings covering your incisions and a white band called a bando sitting high on your breasts. The band holds pressure on the top of the implant to help the breast implant settle during the healing phase. The rest of the day is spent with minimal activity and pain control as needed.

What does recovery look like?

In the first few days you can expect swelling and discomfort. How much discomfort you have depends mainly on two things: How large of an implant you chose and how much of a lift you need. Most patients have a reasonable amount of discomfort controlled with the pain medication and a muscle relaxer I give you. You can walk around as much as you like. Activities of daily living, such as eating, showering, and making small meals are perfectly fine to do and encouraged. You do not need to drive while on pain medication. You will see me in the office about 5 days after surgery. At this visit, we check everything and teach you how to massage the breast to help with the implant settling. After this visit, you can typically return to desk-type work activity, driving, and small activities. At 3 weeks post-op, I allow you to get your heart rate and blood pressure up. You can return to lower body workouts, fast walking, progression to jogging, and other more physical activities. Your activities progress, as you feel better. The only restriction I have during the advancement of activities is that you do not do any focused chest workouts. No pushups, No Planks. At 3 months, you can return to planks, and pushups, and have no restrictions.

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Breast Augmentation and breast lift Nashville

These were some of the most common questions discussed during breast augmentation with lift consultation. A personalized consultation is best for hearing and learning about breast augmentation and breast lift a first hand. Dr. Papillion is truly amazing at his job and you won’t be disappointed in your decision to see him. Schedule your consultation today! We can’t wait to meet you!