The Surgeon Minute

Guiding Patients with Breast Surgery

Guiding Patients with Breast Surgery

One of the more difficult aspects of a breast surgery consultation is that oftentimes a patient will come in complaining about the look and/or feel of her breasts without really knowing exactly what it is that’s wrong.

This shows how critical the conversation with the appropriate physician should be. It’s the job of the surgeon to guide the patient towards the ideal breast augmentation procedure, but not to make the decision for her. This may be something as simple as an the appropriate size and shape of implant or something more complicated such as a breast lift or a lift with an implant.

Dr. Charles Messa of Weston, FL discusses the ways in which he works with the patient to help them come to what they truly want and make the correct decisions.

Breast Surgery Options

When a patient comes to have a consultation with a breast surgeon, the most important thing for the physician to ascertain is exactly what bothers her.

  • Does she have a specific goal as to the size of her breasts?
  • To their fullness?
  • Does she want more cleavage?

Answering these questions helps surgeons determine which procedure will deliver the best results. An implant will add fullness, but it can not lift a nipple that has drooped below the crease of the breast.

When patients ask, “Do I need a lift?” what they really want to know is do they need something in addition to the implant to make the breast look more youthful. A perky breast is a young looking breast. It’s important to consider where the patient’s nipple and areola are positioned in relation to the crease or fold beneath her breast.

Breast below the fold.

If the nipple is at the fold then an implant alone will probably be enough to rejuvenate the look of the breast. Then the only question is determining the appropriate size, shape and placement of implant for that patient’s anatomy and goals.

However, if the nipple is below the crease, then the patient has what’s called moderate to severe ptosis and a breast lift will be needed correct it. Bottom line, an implant alone can increase your size and give you more cleavage, “but if you don’t do something to address the loose breast skin then you will end up having an implant that sits too high up on your chest,” says Dr. Messa.

Breast lift before and after.

Breast Lift Options

There are a number of breast lift options and the right one is really going to depend on the degree of your sagging. If you only have a mild degree of breast droopiness then a physician will likely do a Benelli or periareolar lift where the incision is limited to the nipple and areola itself. However, most breast lift patients need more of a lift, so surgeons may perform a Lollipop lift in which the incisions go both around nipple and vertically down the center of the breast.

If a patient has enough breast volume on her own – typically a C or D cup – surgeons will advise her to get a breast lift only. But if she is small breasted and desires more cleavage, then they might recommend a breast lift with an implant.

The upside of a breast lift is youthful looking, perky breasts. The downside is scars. In general, if Dr. Messa feels that the patient needs a lift to achieve her goals, but doesn’t want one because of the scarring, then he recommends that she not do anything at all. “If you’re not going to be comfortable doing the appropriate procedure in terms of implant size and lift then you’re better off being happy with how you are,” he explains.

Breast augmentation revision before and after.

Breasts can be very unique and will differ based on the rest of a patient’s body. “Breasts are as individual as patients’ faces,” says Messa. During the consultation, he listens to the patient goals, examines her physique, and then explains exactly what is causing her dissatisfaction as well as the best procedure for correcting it.

Whatever the answer, board certified plastic surgeons – and specifically experienced breast surgeons – want patients to be in the know during the whole process. Surgery should never be performed on a whim, and thus the consultation process as well as relationship patients build with their surgeons is of extreme important. Dr. Messa says he wants to meet a patient’s expectations safely so that they’re satisfied with the results. “Our goal is to make people happy.”

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