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Breast Surgery Miami – Video Transcription

Dr. Karlinsky:

Hi guys, Dr. Karlinsky here. I’m a cosmetic surgeon. I practice in Miami, Florida. This is part of my preoperative videos for my patients who are already booked for surgery or contemplating surgery. This particular video is about a breast lift, reduction, or breast lift with augmentation. I encompass all of these three procedures in one video because the information is very, very similar with minor differences.

So if you are somebody who is scheduled or considering to undergo a breast reduction, a breast lift with no reduction, or a breast lift with augmentation, as I mentioned in my pre-op clearances video, you will need to have mammography and, or ultrasound if you’re 35 or above. Or even if you’re under 35 and you have breast cancer history in your family, I would like for you to get those tests to ensure that everything is fine and you can proceed with an aesthetic operation.

Now, the difference between a breast reduction and a breast lift, simply is that with a breast reduction while we are lifting the breast, we’re also making it smaller versus with a breast lift that encompasses essentially the same incisions, we’re only removing some of the excess skin and elevating the breast on a chest wall without reducing the actual glandular tissue, the actual breast.

So with a breast lift, whatever size you are now, you’re going to maintain that size. With a breast reduction, of course, your breasts will become much smaller. Now, sometimes somebody doesn’t need a very large reduction, sometimes they need a very large reduction. And that again depends on the individual patient.

When it comes to a breast lift with implants, a lot of times my patients confuse why they should get an implant. And I always explain that the only reason why you should consider doing a breast lift with an implant is if you’ve had significant weight loss and now have no tissue left over, then an implant becomes really helpful because it gives you more volume. Or if you’re doing a breast lift, you didn’t have significant weight loss, but while you do need a breast lift because your breasts are ptotic or droopy, you also want them to be bigger.

Remember that with a breast lift augmentation, the biggest limitation on the size of the implant has to do with the fact that I’m also removing skin to lift the breast. And I always have to remind my patients that I cannot guarantee you what size implant will actually fit into that new envelope. We typically use a sizer in the operating room that I inflate with air and then try to close the skin envelope to ensure that it’s not too tight.

And I always urge my patients not to go too big on the implant if you’re doing a lift, because typically when somebody gets a lift, it means that the skin is fairly stretched out, it’s very thin. The bigger implant that you put, the more likely the breast is really to bottom out or to descend down, which is not uncommon. I hear from my patients, “I wish they stayed up where they were right after surgery,” because remember, the skin over time has lost its elasticity or maybe it’s been very stretched out. So less is always more in my book.

I also remind my patients when it comes to a breast augmentation with a lift, the potential risks for complications are higher. We know that potential need for revision surgery is also higher, so I do want you to keep it in mind.

And ultimately, if you’re happy with the size of your breast and you just really want them to be lifted because you have a hard time putting on maybe certain bathing suits or you feel like you cannot wear a dress that doesn’t have straps, or a backless dress because your breasts are just not … the nipple and the areolar complex is sort of pointing in the wrong direction, then just the lift alone is going to accomplish that for you with minimal potential risks.

Remember that all of these procedures will leave you with scars on your breasts. Typically, I use what’s called a Wise pattern lift. It’s like an anchor type of incision. So you would have a scar around the areola, down the middle, and underneath the breast. These scars typically heal very nicely, but as I’ve mentioned in many other videos, remember that poor scarring is always one of the potential risks.

And so in your mind, you have to be prepared that you will have visible scars. And if you can honestly say to yourself, I would rather have visible scars on my breasts, but have them more lifted, perky, fuller, then you are ready, mentally prepared to have this procedure done. If you cannot say that to yourself, if you say, “No, no, no, I cannot see scars on my breasts, that would drive me insane,” hold off on doing a breast lift, or a reduction, or a lift augmentation.

Now, just like any other operation, you will need to do your preoperative tests as I have mentioned in prior videos. And as always, I urge my patients to use the number that’s available on my Instagram, @drkarlinsky, to send me a WhatsApp message. If you’re from out of town and I’m not able to see you way ahead of surgery, send me a picture, no face, and I will be able to confirm to you if you need really a breast reduction, or whether it’s a breast lift, or a breast lift augmentation. And this will make it much easier for you to really plan for the correct procedure.

Just like with any operation, I always tell my patients after surgery, you’re going to have all the incisions closed with absorbable sutures. All the incisions will be closed with sticky tape that’s called Steri-Strips, which stays in for about seven days or so, and then you’re able to simply peel it off. If you happen to already have gone home, if you’re from out of town, you’re able to do it yourself. Certainly, I always prefer my patients stay for a week after surgery. We’ll be able to do it for you on day seven after your operation.

When you wake up after surgery, you’re going to be in the recovery room. We use a soft postsurgical bra that you can keep on if you like, you can take it off. You can use anything that’s soft like a camisole that has a built-in liner, or you can use a bralette. Anything that gives you support and is comfortable is perfectly okay to use.

I do not put any restrictions on my patients after their breast operation, like reduction, lift, or lift augmentation. Whatever you wear, remember, it has to be comfortable. Remember, you’re going to have incisions underneath your breast, so you don’t want to wear anything that has underwire because it will push into the incision and it doesn’t feel very good.

Now, my only restrictions, like any surgery, no heavy lifting, no running for about two weeks after the operation, and then get back to normal life. Listen to your body. If you’re doing something and it feels okay, it’s probably okay to do. If you’re doing something, it doesn’t feel good, it hurts you, it pulls, and you feel that you’re not ready yet, please don’t push it because the potential for delayed hematomas or bleeding after surgery is always there.
Now, in terms of risks and complications, when it comes to your breast surgery, remember, like any operation, potential for infection, bleeding, poor scarring, wound separations, these things always exist. The two scariest potential risks that are associated with breast reductions, lifts, and lift augs is potential to lose sensation in your nipple-areolar complex and potential for necrosis of the nipple-areolar complex, which is the actual death of the nipple and the areola.

These are very rare complications. In 15 years, I’ve only seen two patients in my career to whom this happened. And it is a very devastating complication, but it does exist and that risk goes higher when you’re talking about doing a lift with an implant.

Now, these risks are still very low if you think about how many procedures you do and how often you see that, but I still have to inform my patients that these risks exist, and of course, risks associated with anesthesia, blood clots, pneumonia, any kind of reactions.

So please remember, I always remind my patients, this is real surgery and that is why all of my patients have my private cell phone number. I and my team are always on standby. If, God forbid, there are any questions or concerns, you always have a way of getting in touch with me.

Now, you can shower the day after surgery. Please remember, somebody has to be there with you to pick you up after the operation, stay with you for a minimum of 48 hours until you feel strong enough to be on your own. One of the things that I have not mentioned before, but driving-wise, remember, you can only start driving when you feel that the pain is very minimal and you have full mobility of your hands and that you’re no longer taking narcotic medications. So sometimes that comes up as a question.
Remember, especially when it comes to breast surgery, because you are going to have limited mobility, it just hurts after a breast operation, just keep that in mind in terms of your driving capability. Other than that, the other instructions are really the same like any other operation, you shower the day after surgery, you get back to normal life, just no heavy lifting, no running.

Now, from the standpoint of being able to wear regular bras, after about two weeks or so, if you feel comfortable, I have no restrictions as I had mentioned before. You can wear anything that feels okay. I think that is the most important information you need to know for a breast reduction, lift, and augmentation. Actually, one more thing I forgot to mention to you.

A lot of times patients come in and they’ll show me a picture of a young woman who had a breast augmentation and they’re looking to get a breast lift or a breast reduction. Remember, these are two very different things, and I always remind my patients to have a realistic expectation. Your breast is not going to look as if you just put an implant in there. It may look that way in the beginning, but it will always settle. It will settle and still give you that kind of flatness on the top and a little bit more roundness on the bottom, what’s called bottoming out effect. It would always look more of a natural kind of breast.

Remember that your nipple-areolar complex will always be in the correct position, pointing forward. So if you wanted to wear something that should be worn without a bra, you’ll be able to do so, but you may not necessarily always have that upper pole fullness that a lot of my patients look for. I just want you to keep that in mind and have a realistic expectation about the operation.

But as always, if I can give you more information, if there’s still some questions in your mind, please feel free to reach out, and I and my team will answer to you as soon as we can. Thanks for watching.