Breast Enhancements

Breast Augmentation

We get thousands of visitors wondering about the possibilities that breast augmentation offers. We provide a general overview of the surgery here, "before and after" breast lift photo galleries, and additional information to answer some of the questions most commonly asked.

Many different physical issues are addressed through augmentation mammoplasty, surgical augmentation of the breasts to refine their shape and size. Dilemmas include:

Small breasts out of proportion with hips and body frame
Lopsided breasts that do not match
Loss of firmness or fullness after breastfeeding
Change of shape or tone of the breasts following weight loss
Injury or cancer surgery
Naturally occurring breast development abnormalities

Whether your dissatisfaction in your breast size or shape is something new or a lifelong issue, the surgeons at Premier Plastic Surgery understand how intertwined body shape and self-confidence can be. We take those feelings into account and tailor a solution customized for each client who seeks help in our office. No two patients are alike.

Those desiring breast enlargement have several breast implant options. We offer the latest in surgical technique, as well as high-end saline and silicone implants, which come in various sizes and shapes. We use the highly successful "gummy bear implant," which is the most-studied silicone implant available on the market. In the short video blog above, Dr. Brad Storm talks about the "form stable" Allergan 410 implant and how it compares to the traditional round-shell silicone implant.

Before & After

Breast Lift

Why are breast lifts so popular? Simply put, gravity happens. Babies nurse, weight fluctuates, birthdays roll around, and heredity takes its toll. Women have more resources available: good information, qualified doctors, solid finances, and perhaps most importantly, the confidence to initiate change.

Our population is aging, but not necessarily our mindset. Our love affair with youthfulness is as strong as ever, and if that means having a little cosmetic work done, American women are increasingly willing to take that step.

While a good bra may remedy breast sagging while clothed, it doesn't solve the "getting naked" dilemma. Whether married for 25 years or trying to maneuver the dating scene, every woman wants to look great in a bathing suit. While some women are blessed with good genes, others experience everything from age spots to wrinkles and love handles that seemingly appear overnight. Add significant breast drooping ("ptosis"), and your self-image can take a hit. Right?

Well, we can help you with that. Very often, undergoing "mastopexy" - or a breast lift - is just the ticket. Sometimes, pairing your breast lift with fat injections or implants will give a prettier result. Surgical techniques are varied and much improved since the birth of plastic surgery. In our practice, we stay on top of those technical advances through ongoing education.

Before & After

Breast Reduction

Breast reduction surgery, also known as reduction mammaplasty, removes excess breast fat, glandular tissue and skin to achieve a proportioned breast size for your body. Breast reduction surgery can also help to alleviate the physical discomfort associated with large breasts. Breast reduction surgery may be a good option for you if you experience any of the following:

You are bothered by the feeling that your breasts are too large
Your breasts limit your physical activity
You experience back, neck and shoulder pain caused by the weight of your breasts
You have regular indentations from bra straps that support heavy, pendulous breasts
You have skin irritation beneath the breast crease
Your breasts hang low and have stretched skin
Your nipples rest below the breast crease when your breasts are unsupported
You have enlarged areolas caused by stretched skin

For information on Male Breast Reduction see Gynecomastia.

Before & After

Breast Reconstruction

A breast cancer diagnosis is very frightening. At the time of the diagnosis, it seems that there are so many decisions you need to make all once. All this comes at a time when you’re still reeling from the shock of the diagnosis. Many women consider breast reconstructive options at this point.

At the time of a breast cancer diagnosis, it seems that there are so many decisions you need to make all at once. All this comes at a time when you are still reeling from the shock of the diagnosis of breast cancer. At Premier Plastic Surgery, we understand this and we try to help you make the best choice with good, straight forward information and answers to your questions.

We have pre and post op photos and may even have patients that you can talk to. We coordinate with your general surgeon, medical and radiation oncologist, and personal doctor. Many times, we may be able to coordinate with your general surgeon to perform your reconstruction at the time of your mastectomy operation. We bring a combined 60 plus years of experience with breast reconstruction.

FAQ's

We know you have questions and that's why we are here to answer them for you. If these FAQ don't completely answer all of your questions feel free to contact us by our form or a personal phone call. We will be happy to meet with you and go over all of your questions with a free consultation.

How is a breast lift done?

During a breast lift, the surgeon will raise and reshape the breasts by surgically removing excess skin and rearranging tissue. If needed, he will redefine the size and shape of the areolas and lift them to give them a more youthful appearance. It's not uncommon for the nipple area to enlarge or to drop vertically over time. Drooping glandular tissue may be repositioned or you own fat from elsewhere on the body may be used to contour your breasts in the right places. Simultaneous placement of implants is an option too for patients who desire more volume. The end result will be firmer and higher breasts that resemble a more youthful and shapely you. Once you are fully recovered, you will be psyched to show off that new sporty tank top or flirty sundress you've been dying to wear. At Premier Plastic Surgery, we strive to be professional, discrete and approachable. We highly value the face-to-face time spent during consultations. We take a thorough medical history and make it our goal to understand exactly where you are coming from. We customize every surgery to meet your expectations. Breast lifts are performed under general anesthesia. It's outpatient surgery and takes roughly an hour and a half, plus time in the recovery suite. Each surgery varies, based on the patient. Visit our photo galleries to see the dramatic improvement breast lifts can make in appearance.

What about scars associated with a breast lift?

Incision patterns typically are one of the three kinds:

Around the areola (nipple area)
Around the areola and vertically from the areaola to the breast crease below
Occasionally around the areaola, sown to the breast crease and horizontally along the crease

Skin elasticity and thickness, nipple size, breast volume, degree of breast drooping, and body frame play into the approach your surgeon will take during surgery. Sutures and surgical tape are used to close the skin and to promote minimal scarring. Drainage tubes sometimes are used to assist healing. Long-acting analgesics are given to help in the early stages of recovery. Patients are sent home with after-care guidelines and follow-up appointments.

What are reasons for a breast lift surgery?

Also known as mastopexy, a breast lift raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new appearance of the breast. Often the size and shape of the areola has changed and enlarged over time, and a breast lift can address this problem as well. The most common reasons women choose to have a breast lift are due to the following:

Pregnancy
Breast feeding
Changes in weight
Aging
Gravity
Heredity

How is a breast lift surgery constructed?

Breast lift surgery is an outpatient procedure performed under a general anesthetic. The incisions for the surgery vary based on your breast size and shape, the size and position of your areolas, the degree of breast sagging and the skin quality and elasticity. The incision sites will be discussed during your consult but there are three common incision patterns.

Around the areola
Around the areola and vertically down from the areola to the breast crease
Around the areola, vertically down from the breast crease and horizontally along the breast crease.

Once the incisions are made the underlying breast tissue is lifted and reshaped to improve the contour and firmness of the breast, the nipple and areola are repositioned to a natural height and if need the areolas are reduced in size, and excess breast skin is removed. After your breasts are reshaped the remaining skin is tightened as the incisions are closed. Sutures are layered deep within to create and support the newly shaped breasts. Sutures or surgical tape is then used to close the skin. The breast lift surgery generally takes one and a half hours to two hours. Long-acting local anesthetic agents are used to help in the early recovery. With breast lift surgery restrictive surgical bras are seldom used and drain tubes are sometimes used.

How is the recovery for the breast lift surgery?

The evening following breast lift surgery patients generally remain at bed rest, perhaps getting up for meals and trips to the bathroom. Ice should be applied to the chest as much as possible in the first 48 hours after surgery to help reduce swelling and discoloration. Despite your careful efforts to follow these instructions you will have swelling in your breasts, chest and possibly your abdomen and trunk. The swelling and discoloration will resolve slowly. Most of your discomfort can be controlled with medication and this should be taken before the pain becomes severe. You will have guaze dressing in place and perhaps a drain. If you have a drain you will receive post-operative instructions for this. This drain is usually removed within a few days of your surgery. Loose fitting clothing is the most comfortable and wearing a bra is discouraged for the first week after surgery. Once given the ok to wear a bra, underwires must be avoided. You can increase your activity the second day after breast lift surgery. Mild exercise such as walking and climbing stairs is encouraged; however, heavy lifting activities should be curtailed for the first two weeks. The surgical sites require minimal care. Usually dissolving sutures are used; however, if removable sutures are used they will be removed in approximately one week. Your first post-operative visit for breast lift surgery is within five to seven days and your doctor will advise you on scar massaging and the usage of a bra. Your discomfort will improve rapidly over the first two weeks after breast lift surgery. Aerobic exercises can begin at this time provided heavy lifting is not involved. At four weeks after your breast lift surgery any lifting activity including heavier exercises with the upper extremity would be acceptable. Your surgeon will advise you on wearing a bra. Scar massage is encouraged at about two weeks after surgery until the scars are soft and faded. The final results of your breast lift will appear over the next few months as breast shape and position continue to settle. Incision lines are permanent, but will continue to fade over time. You should expect to see your doctor for another visit in 3 weeks and again in 3 months after your breast lift surgery. You will return to your plastic surgeon's office for follow-up care at designated intervals to evaluate your progress.

About breast augmentation surgery

Breast augmentation surgery is an out patient procedure performed under a general anesthetic. The incision is small, about 1 1/2 inches and is usually made in one of three locations: underneath the breast just above the crease; around the lower edge of the areola; or in the underarm area. The technique and location of the incision depends on your wishes and your doctor's preference. After the incision is made, a pocket is created into which an implant is inserted. The breast augmentation surgery generally takes one to one and a half hours. Long-acting local anesthetic agents are used to help in the early recovery. Small strips of tape are applied to the incision site. With breast augmentation surgery restrictive surgical bras are seldom used and generally, drain tubes are not used.

What is the recovery after a breast augmentation?

The evening following breast augmentation surgery patients generally remain at bed rest. Ice should be helpful at this stage. Most of the discomfort that you may feel can be controlled with medication. Showering is encouraged in 24 to 48 hours. You can increase your activity the second day after breast augmentation surgery. Mild exercise such as walking and climbing stairs is encouraged; however, heavy lifting activities should be curtailed for the first two weeks. The surgical sites require minimal care. Usually dissolving sutures are used; however, if removable sutures are used they will be removed in approximately one week. Your first post-operative visit for breast augmentation surgery is within five to seven days. Bruising is usually minor and goes away within one to two weeks. Minor bruising is common and there is always some swelling. Often, with breast augmentation surgery the upper portion of the breasts are full and rounded and there may be some asymmetry in the two sides. This resolves in 3 to 4 weeks and you should see the breasts settle into place. Your discomfort will improve rapidly over the first two weeks after breast augmentation surgery. Aerobic exercises can begin at this time provided heavy lifting is not involved. At four weeks after your breast augmentation any lifting activity including heavier exercises with the upper extremity would be acceptable. Your surgeon will advise you on wearing a bra. Massage of the implants is encouraged to create a softer breast and to avoid formation of scar tissue around the implant. The fullness on the upper portion of the breast continues to improve over subsequent weeks to create a more natural, relaxed appearance of the breast. Scar massage is encouraged at about two weeks after surgery until the scars are soft and faded.

About breast reduction surgery

Breast reduction surgery is an out patient procedure performed under a general anesthetic. The incisions for the surgery vary based on your breast size and shape, the size and position of your areolas, the degree of breast sagging, the skin quality and elasticity, and the amount of reduction desired. The incision sites will be discussed during your consult but there are three common incision patterns :

A circular incision around the areola
A keyhole or racquet-shaped pattern with an incision around the areola and vertically down to the breast crease
An inverted T or anchor-shaped incision pattern

After the incision is made, the nipple is repositioned and if necessary the areola is reduced by removing excess skin at the perimeter. The nipple remains attached to its original blood and nerve supply. Surgical removal of excess fat, glandular tissue and skin will take place. Liposuction is often used to remove excess fat in conjunction with excision techniques. Once underlying breast tissue is reduced the breast is lifted and reshaped. For extremely large, low hanging breasts, the nipple and areola may need to be removed and transplanted to a higher position on the breast. This is known as a free nipple graft. Once the breasts have been reshaped the incisions are brought together. Sutures are layered deep within the breast tissue to create and support the newly shaped breasts. Sutures or surgical tape is then used to close the skin. The breast reduction surgery generally takes one and a half hours to three hours. Long-acting local anesthetic agents are used to help in the early recovery. With breast reduction surgery restrictive surgical bras are seldom used and drain tubes are often used.

Recovery after a breast reduction

The evening following breast reduction surgery patients generally remain at bed rest, perhaps getting up for meals and trips to the bathroom. Ice should be applied to the chest as much as possible in the first 48 hours after surgery to help reduce swelling and discoloration. Despite your careful efforts to follow these instructions you will have swelling in your breasts, chest and possibly your abdomen and trunk. The swelling and discoloration will resolve slowly. Most of your discomfort can be controlled with medication and this should be taken before the pain becomes severe. You will have guaze dressing in place and perhaps a drain. If you have a drain you will receive post-operative instructions for this. This drain is usually removed within a few days of your surgery and is used to collect any excess blood or fluid. Loose fitting clothing is the most comfortable and wearing a bra is discouraged for the first week after surgery. Once given the ok to wear a bra, underwires must be avoided. You can increase your activity the second day after breast reduction surgery. Mild exercise such as walking and climbing stairs is encouraged; however, heavy lifting activities should be curtailed for the first two weeks. The surgical sites require minimal care. Usually dissolving sutures are used; however, if removable sutures are used they will be removed in approximately one week. Your first post-operative visit for breast reduction surgery is within five to seven days and your doctor will advise you on scar massaging and the usage of a bra. Your discomfort will improve rapidly over the first two weeks after breast reduction surgery. Aerobic exercises can begin at this time provided heavy lifting is not involved. At four weeks after your breast reduction surgery any lifting activity including heavier exercises with the upper extremity would be acceptable. Your surgeon will advise you on wearing a bra. Scar massage is encouraged at about two weeks after surgery until the scars are soft and faded. The final results of your breast reduction will appear over the next few months as breast shape and position continue to settle. Incision lines are permanent, but will continue to fade over time. You should expect to see your doctor for another visit in 3 weeks and again in 3 months after your breast reduction surgery.

About breast reconstruction surgery

Breast Reconstruction Surgery itself can be accomplished in three basic ways. One option is to use your own tissue to reconstruct the breast. Another option is to use man-made device that will allow expansion of your own tissue to make a space for a permanent implant that will be placed at a later date. Other, less common options may include a combination of your own tissue and a permanent implant. Timing is another important decision. Some patients may have their reconstruction at the time of their mastectomy. Others may need to wait. To determine the right option for you, we must consider many issues.

About the recovery of breast reconstruction surgery

Most breast reconstruction operations require at least an overnight stay in the hospital. Some of the more extensive procedures require 3 to 5 days in the hospital. During the early recovery, there will be drain tubes in place to take away any fluid buildup in the spaces that were created during reconstruction. Pain is managed with a combination of intravenous medications as well as oral medications and sometimes pumps that deliver local anesthetic agents to the surgery site. For patients that use their own tissue for the reconstruction there may be more extensive weight limitations required for successful healing of the origins of these tissues used for the breast reconstruction. All of these issues will be explained at the initial evaluation visit. Many of the breast reconstruction operations require several months to reach their maximum point of improvement. During this period attention will be paid to maximizing the improvement of the scarring and obtaining the appropriate shape and contour. There is seldom any limitation of activity after 6 to 8 weeks from surgery and sometimes patients can return to fairly normal activities as early as two weeks after the operation. This depends on the method of reconstruction chosen. Again, late recovery processes are discussed at the initial evaluation. Individual expectations will be outlined based on method of reconstruction, work requirements, and outside physical interests.

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