Typically in Dr. Chun’s practice, Mastopexy is often performed in conjunction with the implant and capsule removal surgery. The implant removal surgery reduces the breast volume and therefore creates excess loose skin in most patients. This causes post-removal cosmetic deformities in some patients.
Mastopexy prevents this by removing the excess skin, creating a tighter skin/soft tissue envelope, and reshaping the breast using tissue rearrangement. It also reduces/repositions the areola but the nipple is never detached! This is known as the anchor mastopexy with a circular scar around the areola, a vertical scar from the areola to the breast crease, and a horizontal scar along the breast crease.
In general, the amount of excess skin after the implant removal surgery determines the scar length. Greater the excess skin, longer the scars.
30’s patient with 10 years old silicone 325 cc implants placed submuscularly.
Removing excess skin and tightening the soft tissue envelope restored her pre breast augmentation appearance.
30’s patient with 15 years old silicone 330 cc implants placed submuscularly.
Removing excess skin and tightening the soft tissue envelope restored her pre breast augmentation appearance.
Late 30’s patient with 16 years old silicone 275 cc implants placed submuscularly and a previous anchor mastopexy.
The history of a previous mastopexy implied lesser ability of the skin to contract, which would have caused cosmetic problems after the implant removal surgery. Adding mastopexy eliminated this possibility and gave her a very reasonable appearance.
50’s patient with 9 years old silicone 420 cc implants placed submuscularly and a previous “donut” mastopexy.
The history of a previous mastopexy implied lesser ability of the skin to contract, which would have caused cosmetic problems after the implant removal surgery. Adding mastopexy eliminated this possibility. Unfortunately, she has very little breast tissue which resulted in small breasts.
30’s patient with 17 years old silicone 325 cc implants placed subglandularly.
She already had ptosis with a high implant position causing undesirable cosmetic appearance. Adding mastopexy improved her post-operative cosmetic result.
Late 60’s patient with 16 years old silicone 250 cc implants placed submuscularly.
She already had ptosis with a high implant position causing undesirable cosmetic appearance. Adding mastopexy improved her post-operative cosmetic result.
60’s patient with 32 years old ruptured silicone implants.
Previously had a mastopexy due to sagging.
Preexisting ptosis and abnormally high implant position created a severe cosmetic deformity. Bilaterally ruptured silicone implants were removed en-bloc. Adding mastopexy improved her cosmetic outcome.
Late 40’s patient with 10 years old silicone 457 cc implants placed submuscularly and a previous “donut” mastopexy.
She still had sagging breasts even after the previous mastopexy. Implant removal with mastopexy improved her cosmetic appearance.
Mid 40’s patient with 10 years old silicone 450 cc implants placed submuscularly. This was her third set of implants due to recurrent capsular contractures.
She already had sagging breasts so adding mastopexy significantly improved her breast shape after en-bloc total capsulectomy and implant removal.
60’s patient with 34 years old ruptured silicone implants placed subglandularly.
She already had significant ptosis and implants that were too high, resulting in poor cosmetic appearance. Both ruptured implants were removed en-bloc. Adding mastopexy significantly improved her cosmetic outcome.
Late 60’s patient with 12 years old silicone 397 cc implants placed subglandularly.
Preexisting ptosis and implants that are positioned too high caused poor preoperative cosmetic appearance. Left ruptured implant was removed en-bloc. Adding mastopexy significantly improved her cosmetic outcome.
Late 50’s patient with 30 years old silicone implants placed submuscularly.
She already had significant ptosis. Removing implants and mastopexy improved her cosmetic appearance. Notice how much higher the left areola is relative to the tip of the left breast tattoo, as a result of the mastopexy.
Late 30’s patient with 11 years old silicone 260 cc implants placed subglandularly.
Pre-existing ptosis with asymmetry. Adding mastopexy improved her cosmetic outcome. Unlike the previous case where the high implant position is causing mostly upper breast skin stretch, in this case, the lower breast skin is being stretched. This patient would have had significant cosmetic deformities(caving in, loose skin folds and increased sagging) without the mastopexy.
60’s patient with 30 years old ruptured silicone implants placed submuscularly.
This patient had ruptured silicone implants, breast shape deformity from extremely high implant position, and significant ptosis preoperatively. Both ruptured silicone implants were removed. Adding mastopexy noticeably enhanced her cosmetic result.
Late 40’s patient with 23 years old saline 400 cc implants placed subglandularly.
She already had significant ptosis and adding mastopexy improved her cosmetic outcome. This case shows why a mastopexy is not a “lift”.
Mastopexy will remove excess skin and tighten the breast shape but can not change the underlying skin quality, as evidenced by looser breast shape seen here. Tighter post-operative breast shape seen above are usually from younger patients with tighter skin. These types of patients
Mid 60’s patient with 45 years old saline implants placed subglandulary.
This patient presented with older, loose skin combined with ptosis but there is a lot of natural breast tissue. Mastopexy tightened the skin envelope and improved the cosmetic outcome by reducing the preexisting ptosis.
60’s patient with 8 years old silicone implants.
She previously had a left mastectomy for breast cancer and then underwent a TRAM(stomach tissue) flap reconstruction. She also had a subsequent revision where silicone implants were placed. Since she already had a significant amount of right breast tissue and the TRAM flap added tissue to the left breast, removing implants and performing mastopexy/reconstruction enabled her to keep her good cosmetic appearance.
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