A: A breast reduction with lift procedure is tailored to your exact needs. You may be a candidate if your breasts are fully developed, you are experiencing physical or emotional discomfort caused by overly large breasts, are in good health, and have realistic expectations for the results of your surgery. A consultation with your doctor will help you determine the exact procedure you need.
In general, silicone-gel-filled implants are smoother, softer and feel more like natural breast tissue than their saline-filled counterparts. Silicone implants feel like a semisolid gel, while saline implants are often likened to water balloons. Silicone-gel implants are also less likely to wrinkle and ripple than saline breast implants. Wrinkling is actually considered one of the major disadvantages of saline implants. The thinner the woman and the less breast tissue she has, the more likely the saline implant's crinkles and wrinkles will be felt and even seen.
Does the nipple/areola sit below the crease underneath my breast? One trait cosmetic surgeons frequently look for when evaluating a breast lift candidate is the position of the nipple/areola in relation to the inframammary fold, or crease beneath the breast. Try this test: slide a plain sheet of paper underneath your breast (no bra) so it sits against the breast crease. When looking in the mirror, do your nipples sit below the top edge of the paper? If so, this is a good indication that you have enough sagging to warrant a breast lift. 

If you’re considering breast lift surgery, choosing a cosmetic surgeon is the most important decision you’ll make. When you visit potential surgeons, ask how frequently he/she performs breast lift surgery and how many total procedures that surgeon has performed. View before and after photos, not just on a surgeon’s website but also during your consultation, paying close attention to the results of patients whose breasts before surgery look similar to yours—this will help you get a feel for a cosmetic surgeon’s aesthetic style.
Prepectoral or subcutaneous: in a breast reconstruction following a skin-sparing or skin- and nipple-sparing mastectomy, the implant is placed above the pectoralis major muscle without dissecting it so that the implant fills directly the volume of the mammary gland that has been removed. To avoid the issue of capsular contracture, the implant is often covered frontally or completely with a mesh in biomaterial, either biological or synthetic.
Cosmetic surgeons may use the “crescent lift” technique for women who have a very small amount of sagging to correct. This involves a small incision running halfway around the top half of the edge of the areola. Usually, a crescent lift is only done when a patient is also having breast augmentation, and even in these cases the crescent incision type is less frequently used. 

There are a few alternatives to breast augmentation with implants. Fat grafting breast augmentation involves harvesting fat via liposuction from another area of your body and injecting it into your breasts. Fat grafting is typically used to improve the appearance of your breasts after surgery to treat breast cancer, to correct a congenital breast deformity or to even out any imperfections occurring after breast augmentation with implants, such as wrinkles or ripples. The long-term effects of fat grafting to a normal breast are not fully understood, and the degree of augmentation possible via grafting is only modest at best. For these reasons, fat grafting for cosmetic breast augmentation is still considered experimental by many plastic surgeons.
Fat Transfer for a Natural Breast Augmentation will use the fat from another area on your body to create a modestly larger breast size. This can be used at the same time as fat grafting to reshape the breasts, as well as a breast lift. Many women choose to go with the fat transfer because they are not introducing any foreign substance to their body.
The woman wanting a lift is usually slightly different. She had breasts she was happy with before, she had loving kids who she may or may not have breastfed, exercised and had a good life. They come wanting to restore the youthful breast they once they had(or better), they hate that it is slightly more deflated than before and it's slightly more south then they'd like. The formal name of this operation is "Mastopexy" and that's why you hear terms like "Mastopexy augmentation" because often in order to restore the youthfulness of the breast you not only need to reposition the nipple/areolar complex "up" with a mastopexy, you also need to provide some additional volume with an implant, hence augmentation as well. The discussion with implant also is entirely different discussion all together, but this highlights the primary difference in the reduction and a lift.
Anyone who wants more than a very modest size change will require multiple injection sessions to work up the results – and even then, there is only so much healthy tissue that can be harvested and injected, says Ganchi. (Bony areas typically won’t work as donor sites.) The patient must also have a healthy blood supply to support the healing of living tissue afterwards. 
Before I left his office, Dr. Kolker took me through some before-and-after shots of some of his rhinoplasty patients. Many of them had noses similar to mine, and their "after" pictures were much like the ones Dr. Kolker had generated for me. He told me that of all the nose jobs he'd done in his career, only one time did he have to go back and operate again, and that was because the patient wanted a more drastic change. That clinched it for me: I knew I was in good hands and that my result would be subtle and not overly "done."

Dr. Kolker then laid out his surgical plan for me: He'd perform an open rhinoplasty, explaining that the difference between an open and closed procedure amounts to a small incision on the underside of the columella (that skinny strip of skin between the nostrils), which can be seen only from below and fades rapidly. Both procedures require incisions inside the nose, but an open rhinoplasty adds that small columellar incision.


Since the mid-1990s, the fifth generation of silicone-gel breast implant is made of a high-strength, highly cohesive silicone gel that mostly eliminates the occurrences of filler leakage (“silicone gel bleed”) and of the migration of the silicone filler from the implant pocket to elsewhere in the woman's body. These implants are commonly referred to as "gummy bear breast implants" for their firm, pliant consistency, which is similar to gummy candies. The studies Experience with Anatomical Soft Cohesive Silicone gel Prosthesis in Cosmetic and Reconstructive Breast Implant Surgery (2004) and Cohesive Silicone gel Breast Implants in Aesthetic and Reconstructive Breast Surgery (2005) reported low incidence-rates of capsular contracture and of device-shell rupture; and greater rates of improved medical-safety and technical-efficacy than that of early generation breast implant devices.[94][95][96]
Case 33: For this young woman, the nose felt boxy and unrefined in comparison to her more defined facial features. Goals of rhinoplasty included lifting and definition of the tip along with subtle hump reduction to create a more sleek and streamlined nasal contour. Achievement of these goals creates a nose that harmonizes rather than dominating other features.

We strongly recommend you choose an implant type with your surgeon, who will be able to match the right type to accomplish your desired results. All available implants are considered good, safe choices. However, this article will explain the pros and cons of each of the three main types of breast implants so you can get an idea of what might be the best fit for you.

Transaxillary: an incision made to the axilla (armpit), from which the dissection tunnels medially, to emplace the implants, either bluntly or with an endoscope (illuminated video microcamera), without producing visible scars on the breast proper; yet, it is likelier to produce inferior asymmetry of the implant-device position. Therefore, surgical revision of transaxillary emplaced breast implants usually requires either an IMF incision or a periareolar incision.
When the patient is unsatisfied with the outcome of the augmentation mammoplasty; or when technical or medical complications occur; or because of the breast implants’ limited product life, it is likely she might require replacing the breast implants. Common revision surgery indications include major and minor medical complications, capsular contracture, shell rupture, and device deflation.[44] Revision incidence rates were greater for breast reconstruction patients, because of the post-mastectomy changes to the soft-tissues and to the skin envelope of the breast, and to the anatomical borders of the breast, especially in women who received adjuvant external radiation therapy.[44] Moreover, besides breast reconstruction, breast cancer patients usually undergo revision surgery of the nipple-areola complex (NAC), and symmetry procedures upon the opposite breast, to create a bust of natural appearance, size, form, and feel. Carefully matching the type and size of the breast implants to the patient's pectoral soft-tissue characteristics reduces the incidence of revision surgery. Appropriate tissue matching, implant selection, and proper implantation technique, the re-operation rate was 3 percent at the 7-year-mark, compared with the re-operation rate of 20 per cent at the 3-year-mark, as reported by the U.S. Food and Drug Administration.[64][65] 

If your breast implants rupture, or you develop capsular contracture (two of the top reasons for revision surgery according to the FDA), you will need surgery to correct the issue. You can choose to remove your breast implants with or without replacement. This surgery will be similar in cost to your primary breast augmentation, or could be higher depending on the complexity. Again, health insurance companies do not usually cover costs associated with breast implants, even if you have a medical reason to remove them. As stated above, warranties may or may not cover costs as well.
Firstly about surgical technique. Breast lift and reduction employ similar surgical technique, it's just that with reduction you're removing more breast tissue (because the biggest aim of a reduction is.... to reduce the size of the breast). Does breast lift remove SOME breast tissue, the answer is yes, but the AIM of the lift is more to restore the youthfulness of the breast. Both women, one wanting a reduction vs a lift need their nipple/areolar complex repositioned "up". Only the woman wanting a reduction need the volume addressed.
During your initial consultation, you will have the opportunity to discuss what you want to achieve. Your surgeon will evaluate you as a candidate for fat grafting and clarify what fat grafting can do for you. Once the surgeon understands your goals, he or she may suggest additional or related procedures. It is important to be completely honest during the consultation. Bring several photos of yourself at an earlier age; they may serve as a good point of reference for discussing your goals. It’s a good idea to be fully prepared to answer these questions:

For women who experience breast sagging, I would recommend a breast lift; not breast reduction surgery. Breast reduction can provide a more modest breast size by removing tissue and skin from the breasts; however, a breast lift is needed to achieve a perkier, higher-positioned breast contour. It’s very common for patients to combine their breast reduction surgery with a breast lift to achieve more comprehensive breast enhancement results.

I awoke from surgery feeling just as overwhelmed and then crying happy tears. I blame the drugs...in part, anyway. I was in the recovery room with a splint on my nose. I had to go to the bathroom, and I remember feeling sort of drunk as I walked down the hall (again, drugs). When I got to the restroom, I thought, Should I look in the mirror? I did, very quickly, and what a relief! I could see the tip of my nose, and it already looked different. I figured if the splint was any indication of my new shape, I'd be thrilled, as it resembled a very smooth ski slope.
This category includes costs such as prescriptions for antibiotics and pain relievers and support garments that are worn after your procedure. Overall, miscellaneous costs are low. Your prescription costs will depend on how many your surgeon prescribes and how much of the cost your insurance covers. At minimum, you'll have prescriptions for pain medication and antibiotics. Some surgeons may also prescribe medications for:

Subfascial: the breast implant is emplaced beneath the fascia of the pectoralis major muscle; the subfascial position is a variant of the subglandular position for the breast implant.[77] The technical advantages of the subfascial implant-pocket technique are debated; proponent surgeons report that the layer of fascial tissue provides greater implant coverage and better sustains its position.[78]

Case 39: The facial plastic surgeons at PROFILES Beverly Hills tailor every Rhinoplasty to achieve just what you are looking for. Sometimes, the most subtle of changes take just as much effort as the most dramatic ones. This pretty model didn’t want to drastically change her look. Her Los Angeles Finesse Rhinoplasty gave her the refinement she wanted, especially on her front and three-quarter views. Along with fat transfer to the lower eye area, her overall look was softened to make her that much more camera ready.
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