Cosmetic breast surgery involves making breasts bigger, smaller, less droopy and overall shapelier, depending on a patient’s goals and current appearance. New implants allow us to get better, more natural results in breast augmentation. Elevating sagging breasts can be done alone or in conjunction with a tummy tuck (abdominoplasty) as part of a “mommy makeover.” Sometimes breasts can be lifted and made bigger in a combination procedure that is technically more difficult, but can really improve the appearance of a woman’s breasts in one operation. Finally, breast reduction surgery, which is often medically necessary and covered by insurance, can involve a combined lift and reduction.
Drs. Chang & Vander KolkLearn more about our procedures for:
Breast Augmentation
Silicone gel implants have come a long way since they were removed from the market for all surgeries with the exception of reconstruction. New technological advances have resulted in a gel that is “cohesive” which means that the gel stays in place and does not ooze out if the outer silastic membrane of an implant ruptures. The cohesive gel is like firm Jell-O or gummy bears, whereas older silicone gel was like hair styling gel, which was like a thick liquid. This makes the implants feel more natural and is much safer for the patient. Saline implants are still available for those patients who want an implant filled with a more natural substance. Saline is physiologically similar to the water and salt combination that makes up our tissues.
Breast implants come in a variety of sizes to match a patient’s desires. Once a patient has decided to undergo the procedure, they have options for placement of the incision (below the breast, around the areola or in the armpit. This decision is made during the consultation with Drs. Chang, Vander Kolk or Collins and entails a detailed examination of the patient’s anatomy and in many cases their history.
Analysis – Hypomastia (small breasts).
Treatment – Breast augmentation.
See Drs. Chang, Vander Kolkand Collins' before and after pictures for breast augmentation.
Breast Lift (Mastopexy)
There are several reasons for the breasts to sag. Gravity, aging, breastfeeding (due to the expansion and later contraction of the breast size) and weight loss. Ptosis, the medical name for sagging or drooping, can be further classified as to the degree or grade. Grade 1 is the nipple just above the infra-mammary fold, grade 2 the nipple is at the infra-mammary fold and grade 3 the nipple is below the infra-mammary fold. The most severe form is when the nipple is below the fold and at the lowest level of the breast.
A breast lift seeks to elevate the nipple, reposition the breast tissue and remove the excess skin. This is done a variety of ways, depending on the patient’s anatomy, but always with an incision around the nipple.
Analysis – Grade 2 ptosis (sagging).
Treatment – Mastopexy.
See Drs. Chang, Vander Kolk and Collins' before and after pictures for breast lifts.
Breast Augmentation & Breast Lift
When a patient who is older or has lost a large amount of weight seeks to have her breasts enlarged, a combination procedure can be considered. While more difficult to control shape, size and symmetry, it does lift the nipple, reshape the breast and fill the upper part of the breast. This latter correction (the superior hollowing or flattening) is not seen with a mastopexy alone.
Analysis – Loss of breast volume with associated ptosis (sagging).
Treatment – Breast augmentation and mastopexy.
Breast Reduction
Most insurance companies require 400 to 1000 grams of breast tissue to be removed in order for coverage to be authorized. When the patient and Dr. Chang, Vander Kolk or Collins determine that the amount to be removed is less than that required by insurance, the procedure essentially becomes a cosmetic operation. Many patients still experience some improvement in shoulder pain or neck pain, which can be associated with large breasts.
Analysis – Mild macromastia (large breasts).
Treatment – Breast reduction (300 grams – 1 cup size).
See Drs. Chang, Vander Kolk and Collins' before and after pictures for breast augmentation.
Please Call for an appointment: 410.332.9700