Who Are Not Ideal Candidates for Immediate Breast Reconstruction Surgery?

KEY TAKEAWAYS:

  1. Large breasts and sagging nipple areolar complexes or breasts may make a patient unsuitable for immediate breast reconstruction surgery.
  2. In such cases, skin-sparing mastectomies and staged implant-based reconstruction may be necessary.
  3. Politis Plastic Surgery in Tampa, FL, led by Dr. Effie Politis, offers expert care and personalized treatment plans for breast reconstruction patients.

Introduction

Breast reconstruction surgery can be a transformative procedure for many women who have undergone mastectomy. However, not all patients are suitable candidates for immediate reconstruction. Dr. Effie Politis, a renowned plastic surgeon in Tampa, FL, discusses the factors that may lead to a patient being deemed unsuitable for immediate breast reconstruction surgery. Understanding these factors can help patients and their surgeons make informed decisions about their reconstruction options.

Skin-Sparing Mastectomies and Large Breasts

One of the main reasons a patient may not be an ideal candidate for immediate breast reconstruction surgery is if they have large breasts. In such cases, a skin-sparing mastectomy may be necessary. A skin-sparing mastectomy involves the removal of the breast tissue while preserving as much of the breast skin as possible. This approach can help create a more natural-looking reconstructed breast. However, patients with larger breasts may require additional procedures to reduce the skin envelope, which can make immediate reconstruction more challenging.

Sagging Nipple Areolar Complexes or Breasts

Another factor that can impact a patient’s suitability for immediate breast reconstruction is the presence of sagging or ptotic nipple areolar complexes or breasts. Ptosis refers to the drooping or sagging of the breast tissue, which can occur due to factors such as aging, weight fluctuations, and pregnancy. In cases where the patient’s breasts are significantly ptotic, immediate reconstruction may not be possible, as the surgeon may need to address the sagging skin and tissue first

Implant-Based Reconstruction in Stages

Although some patients may not be ideal candidates for immediate breast reconstruction, Dr. Effie Politis emphasizes that they can still undergo implant-based reconstruction. However, this type of reconstruction will need to be performed in stages. This staged approach allows the surgeon to address the specific challenges posed by large or sagging breasts and ensure optimal results for the patient.

Politis Plastic Surgery: Your Partner in Breast Reconstruction

If you are considering breast reconstruction surgery, trust the expertise and compassionate care of Dr. Effie Politis and her team at Politis Plastic Surgery in Tampa, FL. With years of experience in reconstructive and cosmetic surgery, Dr. Politis will work closely with you to create a personalized treatment plan that addresses your unique needs and goals. Whether you are a candidate for immediate breast reconstruction or require a staged approach, Politis Plastic Surgery will be there every step of the way to ensure you achieve the best possible outcome.

TRANSCRIPTION:

Hi, my name is Dr. Effie Politis with Politis Plastic Surgery.

The patients who are not candidates and sometimes require skin sparing mastectomies are ones again with larger breasts where you have to really reduce that skin envelope or tautic

which means sagging nipple areolar complexes or breasts and we still are able to offer

them implant-based reconstruction, it’s just done in stages.

REFERENCES:

Breast Augmentation Featuring Dr. Effie Pappas Politis

 

Breast augmentation, also called augmentation mammoplasty, is surgery to increase breast size. The ultimate goal of the procedure is to help you look and feel your best. 

Many women feel that their breasts are too small or have concerns that one breast is smaller than the other which can lead to less confidence. Also, you may struggle with how to dress or with the type of bra to help you with the asymmetry.  

But through augmentation, you can adjust for uneven breasts, whether after pregnancy or following significant weight loss. Most women feel good about their breasts after surgery and regain confidence and self-esteem.

Making the decision

Breast augmentation involves placing breast implants under your breast tissue or chest muscles to enlarge your breasts.  But it is not something your doctor or someone else can decide for you.  It is a personal decision made by you and for you.  

Nevertheless, if you’re considering the procedure, you should speak with a plastic surgeon to help you understand what the surgery involves, including the benefits, possible risks, complications, and follow-up care. Your surgeon will also help you find out if the procedure is the right decision for you in terms of your overall health.

At Politis Plastic Surgery, we make sure our patients have thoroughly considered the procedure before they schedule their operation. So when you book your consultation with us, we use the session to review your goals, expectations, and what we can achieve together. 

During the consult, we also review your medical history and educate you on the FDA approved breast implants available in the market today. At the end of the session, we’ll make the decision whether the procedure is appropriate for you, discuss the techniques we will use, and give your instructions on how to prepare for the surgery.

Types of implants used

In today’s market there are a variety of breast implants available for breast augmentation. We encourage you to use your initial consultation to discuss your implant options with your plastic surgeon. 

Generally, the implants differ in terms of surface, filler material, shape, and how they are inserted.

  1. Filler material

Generally you have the choice of implants filled with cohesive silicone gel or with saline (salt water solution) both of which have an outer silicone shell. 

If you are 22 years or younger, your surgeon is likely to recommend saline implants. These implants are inserted empty, and then filled with sterile salt water once they are in place.

  1. Implant surface

You also have a choice between smooth and textured implants. Textured breasts implants have bumps on their surfaces, which are aimed at reducing the risk of contracture—a complication that may develop after augmentation. 

But if you want a softer, more natural feel, then implants with smooth rather than bumpy surfaces are ideal. Speak with your plastic surgeon about contracture and other complications as you make your implant choice.

  1. Shape

There are two shape options for breast implants: round and tear drop. Round implants are very popular as they conform best to the natural shape of the breast and provide a bustier and fuller look or what’s is called a responsive look.

Tear drop implants, also called anatomic or contoured implants, are a great option for women with parts of their breasts removed during prior surgery, such as reconstruction or mastectomy. 

Also, if you have a significant amount of your breast tissue descended, then a tear drop implant can provide the volume to elevate and mount your breast back to the chest wall. 

Likewise, your surgeon may recommend tear drop implants if you’re undergoing revision surgery due to rippling or malposition or to give shape to your breasts if you have so little breast tissue.

  1. Placement

Breast implants can be placed either behind your breast tissue (sub-glandular) or behind the chest muscles (sub-muscular). 

Roughly 75-percent of augmentation is usually done in the sub-muscular plane as it reduces the chance of scar tissue contracture and allows for easier mammography after the surgery. 

Plus, sub-muscular placement usually offers better results if you are thin or are hoping to drastically enlarge your breasts. 

Alternatively, sub-glandular placement gives great results for breasts that are sagging.

Quick, outpatient procedure

At Politis Plastic Surgery, we perform breast augmentation as an outpatient procedure. So in virtually every case you can expect to go home the same day. And to ensure the procedure is safe and successful, we have assembled a team of experienced nurses as well as board-certified anesthesiologists to provide you the best experience possible.

While there are lots of myths about recovery from breast augmentation, at Politis Plastic Surgery, we provide you with specific post-operation pain relief.  As well, there are blocks performed by board-certified anesthesiologists, which ensure less anesthetic drugs during the procedure and better pain relief after the procedure.

Our patients typically go home satisfied the same afternoon and resume showers and activities the next day. For more information on breast augmentation and other plastic surgery procedures, visit the site “Politis Plastic Surgery.”

What is breast lift surgery?

A breast lift is a surgical procedure performed to raise and firm the breasts. Also called mastopexy, the procedure involves removing excess skin, tightening surrounding tissue, and creating and reshaping new breast contours.

Breasts tend to lose their shape and firmness, reduce in size, or sag over the years due to pregnancy, breastfeeding, and the effect of gravity on them. As a result, the breasts become unattractive and may cause a dip in a woman’s self-confidence.

Through mastopexy, such breasts can be raised, reshaped, and contoured to look more attractive. And if the breasts have lost their volume, implants may be inserted alongside a breast lift to increase both size and firmness.

In women with breast ptosis — nipples that sit below the inframammary fold or point downwards—the procedure restores the nipples to a position higher on the breasts. And for women with enlarged areola, the darker skin around the nipple, the surgery can reduce the size of the areola.

Who needs a breast lift?

Generally, women go for a breast lift surgery after pregnancy and breastfeeding, which usually leave them with stretched skin and reduced breast volume.  But it is also effective in getting rid of the adverse effects of aging on the breasts.

The procedure helps to change the alignment of the breast and nipple, eliminate breast sagging, and correct breast ptosis. Plus, it reshapes the breasts, changes the size or shape of the areola, and raises the nipple position relative to the rest of the breast.

Mastopexy is ideal for you if you have:

  1. Sagging, soft, out-of-shape breasts
  2. Flatter, elongated or pendulous breasts
  3. Nipples and areolas that point downwards
  4. Stretched breast skin and enlarged areolas
  5. One breast that is lower than the other
  6. Breasts that when unsupported have their nipples fall below the breast crease

But to undergo the procedure, you should also have:

  1. Fully developed breasts
  2. Good overall health
  3. Realistic expectations
  4. No future plans of pregnancy, which can reverse the results of the procedure

Besides, you should know that:

  1. A breast lift surgery will not radically change your breast size or perfectly round out the upper part of your breasts.  So if you desire much fuller or smaller breasts, then you should instead go for breast augmentation or breast reduction surgery.
  2. Pregnancy and breastfeeding after mastopexy will stretch the skin and reverse the results of the procedure. Hence, you should wait until breast development, child birth, and breastfeeding have stopped before you undergo the surgery.
  3. The size and shape of your breasts before mastopexy with influence both the procedure and the outcome. In fact, while breasts of any size can be lifted, you may not achieve long-lasting results if you have heavier breasts.

How is a breast lift surgery done?

The procedure begins with anesthesia. A specialist anesthetist administers a general anesthetic to keep you completely asleep as the surgery is performed. This helps to make the breast lift surgery painless.

Your plastic surgery will then make the appropriate incisions into your breasts to allow for resizing and reshaping. Incisions can be made around the areola, then vertically down to the breast crease, and further vertically down from the breast crease and horizontally along the breast.

Through the incisions, your plastic surgeon outlines the areas from which to remove excess breast skin and defines a new location for the nipple. The surgeon then uses the incisions to remove excess skin and to move the areola and nipple to a higher position.

Also, the skin around the areola is brought down. Then the breasts are reshaped. Usually, stitches are located around the areola, vertically extending downwards from the nipple area, and along the breast’s lower crease.

When a breast implant is to be inserted, together with the breast lift, it is placed in a pocket directly below the breast tissue, or much deeper under the chest wall muscle.

Finally, your surgeon closes the incisions. Some incision lines are buried in the natural breast contours while others are visible on the breast surface. Though incision lines are permanent, they fade and significantly improve with time. 

Your surgeon will layer out sutures deep within the breast tissue to create and support the newly contoured breasts. The skin is closed using skin adhesives, surgical tape, or sutures.

Remarkable, delightful results

Though the results of a mastopexy are not immediately visible due to bruising and swelling, the size, shape, position, and firmness of the breasts will change right away. Then, the overall results will improve as healing occurs, with lasting, pleasant results taking up to 6 months to be realized.

At Politis Plastic Surgery, we offer a breast lift surgery to women, who are unhappy with their drooping, soft breasts. Our procedure is preceded with an open, candid consultation session that helps to explain the benefits, risks and alternatives to the procedure, define the goals of the treatment, and outline how to prepare for the surgery.

If you are looking for breast lift surgery in Tampa, FL, call us today to schedule your consultation with Dr. Effie Politis. For more information on breast lift, breast augmentation, breast reduction, and other plastic surgery procedures, visit the site “Politis Plastic Surgery.”

Can you fix breast asymmetry?

Key takeaways

  • Breast asymmetry refers to when one breast is visibly different in shape or size from the other. It can cause self-consciousness and discomfort.
  • The main ways to correct breast asymmetry are through breast augmentation, breast lift, breast reduction, or a combination of any of these procedures. The chosen procedure depends on the type and severity of the asymmetry.
  • At Politis Plastic Surgery, they help women feel more comfortable and confident by fixing severe and modest breast asymmetry, using a combination of procedures to achieve optimal results. They recommend speaking with an experienced, board-certified plastic surgeon to determine the best course of action for the individual.

You’ve noticed it. Your breasts aren’t similar in shape or size. One is bigger than the other. And you don’t like it. In fact, you are increasingly self-conscious and uncomfortable about it.

Well the truth is no two breasts can match perfectly. There are usually slight differences in size and shape, with one breast often being marginally larger than the other. Fortunately, the difference is usually small enough to overlook.

But when the asymmetry is more severe, embarrassing you, or making you self-conscious, you may need to undergo a procedure to correct the visibly uneven breasts. At Politis Plastic Surgery, we help women feel more comfortable and confident by fixing severe and modest breast asymmetry.

How is breast asymmetry corrected ?

Asymmetry is corrected through breast augmentation, breast lift, breast reduction, or a combination of any of these procedures. The choice of procedure depends on the type and severity of the asymmetry.

Though the chosen procedure may be performed on only one breast, this is quite rare and done with more subtle degrees of asymmetry. In most cases, both breasts require surgery, particularly to address the amount of skin and location of the nipples.

(a) Breast augmentation

When one of your breasts is visibly smaller than the other, a surgeon will often recommend augmenting the smaller breast using saline or silicone implants.

During the procedure, the surgeon may opt to place breast implants in one or both breasts, depending on the severity of the asymmetry and your desired results.  It is common to have the breast implant placed in the smaller breast to increase its size.

(b) Breast lift

For breast asymmetry that occurs as excessive sagging on one breast, a breast lift (mastopexy) may be the best option. Your surgeon will remove the sagging and excess skin from one breast and tighten it to give it a more symmetric shape and to support a firmer contour complimenting the other breast.  The breast lift procedure is completed through several incision techniques but the choice of technique depends on your specific body.

(c) Breast reduction

When you desire to match your larger breast to your smaller one, your plastic surgeon may recommend breast reduction surgery. Excess breast tissue, skin, and fat are removed from the larger breast via excision or liposuction to reduce it to the size of the smaller breast, creating a contour closer in shape and size to the other breast. Breast reduction usually includes a breast lift, so the procedure may be done on both breasts even if there is only reduction on one side.

(d) Blending of procedures

Simply inserting implants under sagging skin may not give the lift you desire. And placing implants without removing excess, stretched skin may only result in larger, sagging breasts.

Likewise, when only a size boost is needed, in addition to firmer breasts, a breast lift alone may give disappointing results. A breast lift tends to work well for breasts that are fairly even in size and only unevenly shaped but often fails if the breasts are widely different in size.

So in many cases if your breast asymmetry is due to shrinkage, wide variation in size or massive difference in shape, your plastic surgeon will opt for a combination of breast lift, reduction, and augmentation to achieve optimal results. In fact, a breast lift combined with breast augmentation can work beautifully together to correct sagging, increase breast size, and yield shapelier, fuller breasts.

Are you unhappy with your asymmetric breasts? Would you like to fix the asymmetry but aren’t sure about the right procedure? Contact Politis Plastic Surgery today to speak with an experienced, board-certified plastic surgeon who fixes breast asymmetry on a regular basis.

Dr. Effie Politis will give you candid honest recommendations on whether a breast lift, breast augmentation, or a combination of procedures will give you the best results for breast asymmetry. She will also customize the procedure to meet your unique aesthetic goals ensuring you consider different looks and options before you make a decision. For more information on fixing breast asymmetry and other cosmetic issues, visit the site “Politis Plastic Surgery”.

References:

Working with Dr. Effie Politis

I love Dr. Politis, I think she’s amazing, I think she truly cares about her patients and wants to do the right thing and the best thing for them, and sometimes the answer to that is that we don’t do surgery on you. We’re not out to take money it’s not, you know, we want to survive but we’re not going to take somebody’s money if we don’t think we can provide them with the outcome that they’re looking for or if we don’t feel like that’s the safest thing for them medically. I always tell people she’s a mom who happens to be a surgeon because I do feel like she puts her family, you know, as a high level of importance in her life. And I respect her for that as part of why I enjoy working with her because I’ve worked with physicians in the past that maybe didn’t put their family first and I think that we all should put our families first that’s what family’s for. I love working with her I feel like we understand each other there’s mutual respect she is comfortable with what I tell her and i’m very comfortable with the responses I get back from her so I feel like we, you know, work really well in that respect

Saline vs Silicone Breast Implants

Hey everyone, it’s Dr. Effie Politis and I just want to compare and contrast saline versus silicone implants, as we know women often undergo breast enhancement surgery to get a breast volume and shape that is more proportional to their body.

So, let’s start out with saline implants: We all know that saline is a fluid that is placed in a silicone shell. It is an “uncontrolled” type fluid, so it doesn’t have a lot of structural support. So it often causes rippling and wrinkling and it stretches out women’s lower-poles.

The advantage of a saline is that if you have a rupture or a tear, your breast will deflate and you can just look in a mirror and see that almost immediately in your body [it] just resorbs the fluid.

Silicone implants that are now in the market are medical grade and they are very cohesive, so they have a nice gel-to-shell ratio and they really help your breast tissue respond nicely. I do enjoy the feel of a silicone implant on my patients because it almost acts as one with their breast tissue. It also provides better structural support in the long term.

However, the issue with silicone implants is that we don’t often recognize a tear. This is why you have to be aware of your body. You have to follow-up with your plastic surgeon at regular surveillance intervals. If you do feel like there is a compromise, most women complain of some breast pain [or] perhaps some scarring around the implant, and we have some imaging modalities to diagnose this, please call our office or DM me on social media if you have any issues with your implants as I am a plastic surgeon with an expertise on breast surgery. Thanks so much.