Seattle Plastic Surgeon, Dr. Lisa Lynn Sowder finds breast lift and augmentation to be a difficult operation of opposing forces.
I saw a patient yesterday who needs a breast lift and wants an augmentation. If I just do an augmentation, she will have weirdly shaped and still saggy breasts and if I just do a lift, she won’t be as large as she desires. She needs both operations and I was obligated to explain to her how tricky it is to do both an augmentation and a lift at the same time.
This challenge is one of opposing forces. Placing a breast implant makes the breast tight and we want the tissues to loosen up and stretch some. Doing a lift makes the breast tight and we want it to stay tight. The weight and pressure of the implant can make a lift loosen up. And, to make it even more tricky, every patient reacts a little differently to the forces of the implant and gravity, depending on her breast and skin elasticity and whether or not she spends any time in the International Space Station (no gravity there!).
My revision rate for patients undergoing and augmentation and simultaneous lift is pretty high, about 20%. In most cases the revision involves re-tightening the lift and this can sometimes be done under just a local anesthetic but some patients need major revision, sometimes using $trattice or another acellular dermal matrix which acts like an internal bra. Every patient is different.
I must confess that I have no control over a patient’s breast and skin elasticity and certainly have no control over gravity (I wish!) And I must confess that I do not have a crystal ball to predict which patients will do great and which ones will need a revision.
If anyone out there has a crystal ball for sale (one that really works), let me know. I’d love to buy one!
Thanks for reading, Dr. Lisa Lynn Sowder
@lisalynnsowder
