Breast lift in Paris
Women's surgery at Henri Mondor Hospital
Breast lift in Paris
Plastic, Reconstructive & Aesthetic Surgery in Paris Est Créteil
Loss of breast volume is common with age, following pregnancy, weight fluctuations and the menopause.
It is most often accompanied by ptosis, leading in extreme cases to bare breasts, with distension of the skin and areolas pointing downwards. This hypotrophy-ptosis is usually poorly accepted psychologically, as it is experienced not only as a marker of age, but also as an attack on femininitý, resulting in a loss of self-confidence and unease, sometimes serious, which can go as far as a real complex.
When there is still enough gland, the ideal is to carry out an isolated ptosis cure.
Lipofilling
Breast lifting in Paris
The aim of the operation is to restore the areola and nipple to their correct position, to concentrate and lift the gland and to remove excess skin. Unfortunately, a scar is necessary. If the ptosis is significant, the scar has the shape of an inverted T with three components: periareolar around the areola between the brown and white skin, vertical between the lower pole of the areola and the submammary fold, horizontal hidden in the submammary fold.
The length of the horizontal scar is proportional to the degree of breast ptosis. If breast ptosis is moderate, the horizontal scar can be reduced to a minimum. Finally, in rare cases, a single scar around the areola may be sufficient. It is often advisable to accept slightly longer scars that are nevertheless of good quality, as they will better guarantee an attractive curve.
Breast lift in Paris
Pr Hersant Plastic, Aesthetic & Reconstructive Surgery
Breast lift: what are the risks?
As with any surgical operation, there are risks that should not be overestimated or ignored. Most of them are not specific: risks associated with anaesthesia, infections, skin necrosis, particularly favoured by smoking, hypertrophic scars and haematoma. The two most specific are loss of nipple sensitivity and asymmetry. Sensitivity usually returns within 6 to 18 months, but may persist. Asymmetry requires surgical correction, but never before one year.
When ptosis is associated with̀ insufficient volume of the gland, it can be corrected by a prosthesis or an injection of fat from the patient herself.
Breast implants
The breast implants currently in use consist of an envelope and a filler.
The shell is always made of a silicone elastomer. The filler contained within the shell may be silicone gel or physiological serum.
The implant is said to be pre-filled when the filler has been incorporated at the factory. The surgeon orders the volume appropriate to the case. The vast majority of implants fitted worldwide are pre-filled with silicone gel. Significant technical progress has been made.
Silicone gel has become very cohesive to limit perspiration through the envelope, a source of shells. The strength of the envelopes has increased, reducing the risk of rupture. The wall can be smooth or more or less textured, i.e. rough.
Macro-textured prostheses:
These are now prohibited. They are associated with a rare cancer affecting lymph nodes and organs: anaplastic large cell lymphoma. The prosthesis can be round or more or less contoured for a more natural look.
In the run-up to surgery, smoking is always inadvisable, but even more so when it comes to fitting prosthetic material. Depending on the case, the prosthesis may be placed just behind the gland or under the muscle.
Depending on the case, a drain may be placed to evacuate the blood accumulated around the prosthesis. Finally, a modelling dressing is applied.
It is generally accepted that breast implants have an average lifespan of 10 years. Replacement should be discussed at this point. In all cases, an annual clinical check-up is recommended.
Risks :
Those mentioned above for the cure of isolated ptosis with the addition of specific risks linked to the prosthesis. Infection of the prosthesis cannot be treated with antibiotics.
It leads to the removal of the prosthesis. A new prosthesis can only be placed after a few months. Ruptures of the prosthesis envelope naturally require replacement.
Secondary malpositioning or displacement will lead to an indication for surgical correction. The rotation of the prosthesis may affect the aesthetic result in the case of a contoured implant. Late periprosthetic effusion will require investigations to rule out the possibility of cancer.
Lipofilling
Increasingly, fat injections are being used to restore gland volume. This technique is popular with patients who do not want foreign bodies.
What’s more, it allows any localised excess fat to be treated at the same time: hips, abdomen, saddlebags, knees. This technique was originally developed for reconstructive surgery. A mammo-echographic assessment must be carried out by a specialist radiologist before the operation and again after one year.
Modern techniques make it possible to obtain fat deposits that are more evenly distributed and therefore more natural. The technique requires sufficient donor sites.
Patients who are too thin :
Cannot benefit from this technique. The fat is harvested in a non-traumatic way through small incisions hidden in folds. Micro-cannulas are used, allowing micro-particles of fat to be grafted along numerous independent paths through the recipient tissue to achieve a homogenous result.
As this is a graft of living cells, the tissue changes as the patient’s weight fluctuates.
The result can be assessed 3 to 6 months after the operation. Sometimes a second fat transfer session is necessary. The specific complications of this operation are cytosteatonecrosis: these are firmer areas that correspond to oily cysts.
These areas eventually soften over time. If this is not the case, further investigations are necessary.
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