Breast Lift (Mastopexy)

Breast implants are a great idea for somebody who wants to increase their size, but what if you are happy with your breast size and just want to restore a youthful appearance by making them perkier? A mastopexy (or more commonly known as a breast lift) may be the right choice for you. This procedure can even be done in combination with implants if you are looking for an increase in size as well as better shape and placement of your breasts.

A full breast lift is where the doctor makes a cut in the crease below the breast, a cut around the areola (nipple) and then an incision from the areola to the cut in the crease—this is known as an anchor incision and as you can see below, it resembles an anchor.

Once the incisions are made, the excess tissue will be removed and the breast will be moved up; often, the areola will be reduced in size too.

This procedure will result in different scarring than a typical breast augmentation would. The scar around the areola will often not be noticeable, since it will be hidden in the color of the nipple. The scar at the bottom of the breast, located in the crease, will also be fairly hidden since the breast will often lay over that area. As a quick side note, these two incisions are also used in breast augmentation since they do not leave extremely noticeable scarring, so I wouldn’t worry too much over the marks they will leave. The last scar, and the one you do want to concern yourself with, is from the incision connecting the areolar cut to the cut in the crease. This straight line from nipple to the base of the breast will  fade over time but will probably not ever be perfect.

A modified breast lift will result in scarring that is much less noticeable—however, since this procedure uses fewer incisions (which mean less scarring) it is not able to alter the breast shape as well. For this reason, this type of procedure is often done in combination with breast implants. The popular incisons for this are either the donut lift or the crescent lift.

The donut lift (or Benelli lift) removes a ring of skin around the nipple and then sutures it back together thus removing tissue from the breast.

The crescent lift will have an incision around the top of the nipple and basically move the nipple up on the breast after removing the tissue above it, thus lifting the breast.

Here are some examples of what a breast lift can do:

Both of these women had a crescent incision breast lift as well as implants inserted. As you can see, a breast lift can make a tremendous difference.

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Liposuction

Working out can do wonders for your body. It can help you tone up and lose weight, but often you reach a point where no matter how hard you try you can’t get that last stubborn few pounds off. This is where liposuction comes in. Liposuction is the process of removing fat from your body; it can be useful in simply taking unwanted fat off, or it can be used to help sculpt and shape your body. Liposuction is ONLY the right choice for you if you are looking to get rid of a small amount of fat, and if you have already tried diet and exercise. Any larger amounts and you will want to look in to some kind of “tuck” procedure (like a tummy tuck), which I will talk about later.

This procedure is done by removing fat using a tube and suction device (called an aspirator). There are different options for how this is done regarding fluid injection and how the tube portion works. Wet liposuction uses a small amount of fluid (a smaller volume than the amount of fat you want to remove) that will contain a local anesthetic (like lidocane), a salt solution to make it match body fluid tonicity, and adrenaline which will help contract blood vessels and reduce bleeding. The fluid will help loosen the adipose (fat) cells, and to minimized bruising. The fat is then suctioned out. Super wet liposuction uses roughly the same volume of fluid as quantity of fat that you want to remove. This is popular for procedures that are removing LOTS of fat. Laser assisted liposuction utilizes thermal and laser energy and it is even thought to increase skin tightening.  The benefits of this method over traditional methods is still somewhat contested though, so if you are going this route make sure your surgeon is very experienced. Tumescent liposuction involves the injection of large volumes of a solution (which is made up of an anesthetic and vasoconstrictor) straight into the fat you want to remove. This can be a very dangerous method if you are having a large volume of fat removed.

Those all deal with the fluid portion, but the actual method of removing the fat is related to the canula that will get the fat out of the body. There is a wide variety of options for this as well: suction assisted is the industry standard—a tube is inserted that is attached to a vacuum device and as your doctor moves it around, it breaks up and suctions out the fat cells. Ultrasound assisted uses a special tool that transmits ultrasonic vibrations in the body that emulsify (liquidate) the fat which makes it easier to suction out. This process requires the use of suction assisted afterwards to remove all of the emulsified fat. Power assisted does the same thing as suction assisted but it has a mechanical device that eliminates the need for the surgeon to move it around as much since it will move on its own.

Your recovery from this will be about a week or two before you can go back to work and normal light activities. You are going to need to wear a compression garment for up to one month. Your doctor will prescribe you pain medication and you will see your final settled results by 6 months. Prior to that, there will be considerable bruising (which will subside within a few weeks) and swelling (that will go down over the first two months). Depending on where you have this done, expect to have limited motion since you will definitely be sore.

Here are some great before and after pictures so you can see just how effective this procedure is: 

These images are all excellent examples of not only how much fat can be removed, but the benefits you can have from shaping. In some cases, the doctor can even shaped the fat removal to make your muscles look more defined (I've even seen cases where patients come out looking like they have 6-pack abs).

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Lip Augmentation

Full, luscious lips are thought of as a sign of youth. If you are looking to take a few years off your appearance, perhaps some lip enhancement can help you. This is a delicate procedure because, as I have mentioned before, even small changes to your face can change your appearance a great deal. However, lip enhancement is a GREAT choice for those who are unsure of what they want. This can be a temporary or permanent procedure and thus it allows you to figure out what you want. Over time, a very large variety of substances have been used. Some work better than others, and today there are a few main fillers that you can choose from.

One important thing to know is that you should not get lip injections done within 6 months of taking the acne medication Accutane. You should also not get the injections if you plan on starting to take Accutane within 6 months. This medication has been shown to increase certain scarring, and you definitely do not want that! Also, discuss any active diseases that you have (like diabetes) because these can affect how your injections come out.

Lip augmentation can be surgical (using implants) or nonsurgical (using injections).

Lip implants can include: dermis grafts (skin grafts), fascia grafts (fascia is a type of connective tissue in the body), tendon grafts, AlloDerm, and Gore-Tex.

                Alloderm is a dermis graft that comes from human cadavers—it does not last very long, and is fairly expensive so I would advise you to look at the other options before deciding on this one.

                Gore-Tex implants are nice because they are permanent but they are reversible. So if something goes wrong, you are able to fix it. They are made from expanded polytetrafluoroethylene, aka ePTFE. This material is not toxic and will support tissue incorporation so it will definitely seem natural.

The incisions for this surgery are made right on the corners of your lips. Lips are highly vascular and have a fantastic blood supply so they will heal very quickly! This image shows you where the cuts are made:

Lip injections include: human/porcine/bovine collagen, and restylane.

                Most of the available injections are TEMPORARY. Collagen will last for about 3 or 4 months. Before you get collagen injections, make sure that you have a skin allergy test! Permanent injectable materials are rare, but you can  look in to Artecoll or Aquamid for example.

Restylane is a very popular choice today; it is used for lip injections as well as for filling in fine lines on the face. The recovery time is VERY fast (about 2 days) and you will need to have injections done again about every 6 months.

Here is a very nice example of a lip augmentation. You want to make sure to be modest with the size increase and to keep the lips proportional, otherwise you risk looking unnatural and duck-like, or worse.

People chose either injections or implants for a variety of reasons. Injections are known to give lips a more pouty appearance than implants do, so if that is what you are looking for injections might be the better choice for you. Another major thing to think about is how long you want this to last. If you are just flirting with the idea of having fuller lips, be sure to go with something that will wear off in a few months.

It is extremely important to find somebody with LOTS of experience doing this procedure, especially if you are having something permanent done. Everybody has seen what a bad lip augmentation looks like, and if you haven’t take a look at Lisa Rinna’s lips—she was pretty much the poster girl for lip augmentation gone wrong.

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