by Terrye Tebbetts
A patient referred her friend to us recently and her first statement/question to me was, “I am interested in having some breast work done. I think I would like a lift and reduction; however, I like the look of an implant. Currently I am a 38 d/dd. Is the idea of having reduction and BA an oxymoron?” This is a classic example of needing to balance what you want – your expectations as a result of having surgery – with what your body will realistically allow you to have.
Often, it is hard for women to even ask this type of question because they know they don’t like what they have, but how in the world do you fix it and what will it look like after? It is really easy for us to help patients through this decision making process since Dr. Tebbetts makes all decisions about a breast operation based on measurements of the patient’s body and applies those measurements to the High Five System. Whether we are augmenting, lifting or reducing a breast, it all comes back to the numbers.
Remember, when you augment a breast and want the end result to look natural and like it belongs on the body, you simplly fill the empty space. Ahhh, but you MUST fill the empty space. If you put too little, it looks like a rock in a sock. If you put too much it looks like you are headed to the stripper pole. Sometimes, I have to tell patients they can’t be as big as they would like to be, and sometimes I have to tell them it needs to be a little larger than what they had in mind. But remember, that number is coming from the measurements of their own breasts – not just my opinion or Dr. Tebbetts’ opinion.
Now, a breast reduction or mastopexy (lift), seeks purely to get the breast anatomy back where it should be. To do automatically what the patient does every morning when she picks up all that breast and nestles it up into her bra cups. You think getting into a pair of skinny jeans is challenging??? Try getting a DD breast nestled up into a bra while trying not to think about how that bra looks like your grandmothers instead of the cute little demi lace cups at Victoria’s Secret! The moves women with large breasts have to go through to lock their breasts in and down are truly amazing. So a breast reduction takes skin and tissue and simply gets the nipple above the inframammary fold. You cannot change how wide a breast is nor can you change the position of the inframammary fold (the crease under the breast) on the chest wall. A breast reduction takes the weight off the breast and allows the patient to have a result that is firm and perky and more balanced. A breast that is easier to dress and manage mammograms and exercise with – it is an extrememly liberating operation for women who really need it! And the breast augmentation recovery can be just as easy as a breast augmentation – a few minor differences – but still out patient and up and moving in 24 hours!
A reduced breast, remember, maintains it’s original width. So the skin envelope is smaller and the weight has been reduced, but the width cannot change. When you measure a breast to augment it with an implant, you must fill the width of the breast. See where I am going with this? You can’t just put a little bit of implant in – you have to fill it – if it were a DD to begin with and we reduced it and got it balanced, what since does it make to fill it all back up again and make it heavy? Another really important thing to remember is – - we can operate on the breast tissue you bring us, but we cannot change the genetic qualities of that same tissue – - it’s the SAME tissue that did not hold it’s weight well to begin with.
So yes, trying to augment a breast that has been reduced is a bit of futile effort in my opinion. If you needed a reduction to begin with, then your body is setting up a scenario that will not allow an implant to succeed.
About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com.