Wednesday, August 19, 2015

Plastic Surgery...Let's Talk About Boobs.

Hey yall.

So while I typically blog about motherhood, feminism, and spirituality, occasionally I find a way for my day-job ((plastic surgery nurse)) to sneak in.

((For example, here is a post from a few years ago, on the Merge Between Feminism and Beauty))

I get asked A LOT of questions from people about my job.

"Is Botox dangerous?" 
"Do people actually transfer fat to their boobs?"
"What should I have done to get rid of this?"
"Is saline or silicone better?"

I have a big idea in the works for addressing all the questions, but until then, I thought this post might peak some interest.

So, let's talk about boobs.

I see them all day long. I photograph them, measure them, assess them, palpate them, and then help surgically modify them.

*For a while, I felt really strange about the latter.

But, over time, I've realized most of our patients have wanted this particular body modification for years, and after their surgery, they feel confident, empowered, and have a stronger connection to their identity.

It's a bit of a stretch, but many of our patients can relate to Caitlyn Jenner when she said she identified as being a woman, and her whole life felt like she was in the wrong body. Many large-breasted women are dancers, gymnasts, cheerleaders, athletes, or just free-spirited hippies who want to go braless in a sundress but felt like their body type has held them back. Most of society is pretty accepting of the woman who chooses to have a breast reduction. But the other side of that coin is the woman who feels like her chest makes her "look like a little boy" and while she wears feminine clothes and enjoys embracing her femininity in all other aspects, feels as though her lack of breast tissue doesn't fit with how she sees herself. 

Of course, I find the psychological + sociological aspects of surgery fascinating. But I'm going to try to keep it simple with this post and just explain what the procedures are.

  • A breast reduction is essentially the same surgery as a breast lift. The incisions are around the areola, vertically down the breast, and horizontally in the crease. Many people refer to this as an "anchor" incision. 
  • If the intention is to decrease the size, it's called "reduction mammaplasty." If the intention is to lift the nipple position, it's called a "mastopexy." 
  • Either way, when the nipple position comes up, some breast tissue is lost. While every person is different, most people go down a few cup sizes with this surgery. Some people only want to lift the nipple, not lose breast tissue. When that's the case, a small implant can be placed at the same time.
  • Many people who do a mastopexy with a breast augmentation ((breast lift with an implant)) wear the same bra size after surgery as they did pre-operatively. They just fill out their bras differently; they have more upper pole fullness.
  • By far, the most common way to increase breast size is with an implant. 
  • Regardless of saline//silicone, we almost ALWAYS put the implants under the muscle. Implants above//over the muscle can make interpreting mammograms more difficult. It's easier to interpret a mammogram on a patient with implants under//below the muscle because it pushes breast tissue up and makes it more visible. And as an added bonus, it looks a lot better, too. There's a natural slope from the upper chest as opposed to looking "stuck on."
  • The most common incision is in the inframammary crease (("IMC")). If a woman has a breast augmentation, she will likely have a future implant exchange, and the IMC is required for these surgeries, so it makes sense to start there. The armpit (("axillary")) incision is commonly requested, but most women don't realize that these scars show more often than the IMC incisions ((tank tops, bathing suits, sleeveless dresses, etc...)). They also have a slightly higher risk of infection.
    • Saline Implants
      • Are essentially an FDA-approved, expensive water balloon
      • Come with a 10 year warranty
      • Less expensive
    • Silicone Implants
      • Also FDA-approved, feel like breast tissue
      • Come with a lifetime warranty
      • Shows less "rippling" than saline implants, typically a better choice for thinner patients for this reason
        Rippling can still occur with silicone implants, but is far more common with saline. Going under the muscle for implant-placement also helps decrease rippling.
  • Fat Transfer
    • If a patient is opposed to implants, but still wants to make her breasts larger, she can have fat transferred from one area of her body to the breasts ((another common request is to the booty)).
    • Fat transfer is a very safe procedure, but not as reliable as an implant. A lot of times, patients are happy immediately after, but after the swelling subsides, and some of the fat dissipates, the results aren't as impressive. If a subtle change is all that the patient wants, it's a great option. 
This is all just the tip of the iceberg! It's kind of fun to blog about something different, and share some of my expertise with yall.

If you have specific questions, feel free to click on the "contact" link at the top of this page.



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