What Can I Do About Saggy Breasts?

Deflated, ptotic (saggy) breasts are a common complaint, especially after having children.   So how do we reverse this process?  Like many things in Plastic Surgery, the technique for correction depends on what is causing the problem. Two factors contribute to this complaint:

courtesy of office.com

courtesy of office.com

  1. Loss of volume.  Breasts change size with puberty, pregnancy, and changes in weight.    They may actually be smaller, or they may just appear smaller (see #2 below).
  2. Ptosis.  This describes the actual droopiness of the breasts.  Medically speaking, there are three grades of ptosis.  In grade I ptosis, the nipple is at the level of the inframammary fold (the skin crease below your breast).  In grade II ptosis, the nipple is below the inframammary fold.  In grade III ptosis, the nipple is at the lowest point of the breast.  Severe ptosis can make a breast appear smaller because all of the volume is spread out, and sitting lower on the chest wall than it should be.

It is possible to have only volume loss, only ptosis, or a combination of the two.  If the only problem is lost volume, then a breast implant will correct this by filling out the excess skin.  If ptosis is the issue, then the treatment is a mastopexy.  This involves an incision at least around the nipple.  For more severe ptosis, the incision may be extended down the breast and even along the inframammary fold, similar to the anchor style incision used in breast reduction.  Moving the breast tissue back where it belongs will make the breasts appear fuller.  If volume is still deficient, however, then a breast implant may be needed in addition to the mastopexy.

Mastopexy and breast augmentation is frequently done as a single operation, if the ptosis is fairly minor (e.g. grade I ptosis).  But correction may require two separate stages if the ptosis is very severe (e.g. grade III ptosis).  This is because a mastopexy has the goal of lifting the tissue, but adding an implant at the same time adds weight.  This added weight can compromise the results of the mastopexy, leading to a less optimal result than if the mastopexy is done first and the tissue allowed to fully heal before placing the breast implant.

 

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Will I Have Loose Skin after Losing Weight?

Excess skin is very common after losing a significant amount of weight.  But there are a lot of conflicting opinions out there on what exactly causes the extra skin, and what you can do about it.

courtesy of shutterstock.com

courtesy of shutterstock.com

Today I’m giving you my top 5 facts about weight loss and extra skin:

  1. “Losing weight quickly makes it more likely you’ll have loose skin.”  I’ve seen this stated all over the internet.  Heck- I’ve even said it myself.  And it is true… sort of.  Skin takes quite awhile (i.e. months) to tighten up after weight loss.  So if you lose weight very quickly, you will initially notice more loose skin than if you lose weight slowly.  But at a year out after losing the weight, the amount of excess skin you have will be about the same either way.  The skin just takes some time to rebound.
  2. Skin elasticity varies from person to person.  We’ve all seen those pictures of moms with fabulous abs after having three children.  No loose skin to be seen, and they swear no surgery was involved.  The truth is those individuals are blessed with great genes, and have skin that rebounds well.
  3. Skin elasticity varies with age.  So losing 100 lbs in your twenties is less likely to leave you with extra skin compared to losing the same amount of weight in your fifties.
  4. Surgery is really the only effective way to remove excess skin.  There are some non-invasive treatments out there.  But most of these are geared toward smaller surface area (e.g. along the jawline), and show minimal improvement at best.  Surgery is the only way to treat large amounts of excess skin.  This is often done over the abdomen, the lower back, the upper arms, and the thighs. The scars are pretty significant, especially over the upper arms.  But there really is no other way to get rid of the extra.
  5. Insurance plans may cover removal of excess skin, in some instances.  Extra skin over the abdomen is the only area that is ever covered, and only then if it is causing problems such as rashes or difficulty moving around.  Removal of skin in other areas is virtually never covered by insurance.

Do you have any experience with skin removal surgery?  If so, do you have any words of advice or wisdom to share?

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Are “At-Home” Chemical Peels Safe?

“At-home” kits are popular for everything from gel manicures to chemical peels.  And they are easier than ever to obtain; a search on Amazon reveals numerous options for at-home chemical peels.  But are they a safe option?

search results on Amazon.com for "chemical peel"

search results on Amazon.com for “chemical peel”

Because these kits are intended for home use, there is generally a very wide safety margin, assuming you follow the instructions of the peel.  But the trade-off for increased safety is decreased effectiveness, at least in the example of chemical peels.  Chemical peels work by damaging the outer layer of skin; the deeper the damage, the more dramatic the result.  So although a home chemical peel is likely to be very safe, it will also result in minimal improvement.

shutterstock.com

shutterstock.com

Medical-grade chemical peels are administered in a physician’s office, and thus are stronger and more effective than the over-the-counter version.  In addition, I always recommend a skin care evaluation, which many offices offer for free.  You may be using a chemical peel to treat a problem for which there is a more-effective treatment.  One great example of this is hyperpigmentation; although chemical peels will very gradually improve pigmentation, a BBL laser treatment is much more effective.

 

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.