How you feel about your breasts goes straight to the heart of how you feel about yourself as a woman.

No matter your age, your breasts are central to defining femininity and how vibrantly youthful you feel.   Dr. Alyson Wells brings a woman's insight and sensibilities, along with her comprehensive training, skill and experience to this essential category of plastic surgery, whether cosmetic or restorative.

Age, genetics, pregnancy, weight changes, sun exposure, gravity, hormone fluctuations, surgical procedures for disease – each can cause the size and shape of the breast to change.

Consider what changes your breasts have undergone.

     Laxity of the skin – like facial skin, the breast loses elasticity
     Drooping, sagging, or downward displacement – suspensory
         ligaments weaken and stretch with gravity
     Loss of fullness, especially in the upper portion of the breast
     Loss of volume of the breasts globally, not just the upper
         portion of the breasts
     Descent of the nipple toward the bottom of the breast
     Persistent enlargement of the breasts following pregnancy or
         weight gain
     Partial or total loss of breast tissue to disease

At Valley Plastic Surgery, we take a holistic approach to tailor the breast procedure(s) that best address your specific situation.  If you are considering improvement in the breast area, you may benefit from one of these procedures:  breast augmentation, breast lift, or breast reduction. 

Breast Augmentation (Augmentation Mammoplasty)
Breast implants offer a cosmetically-pleasing appearance, achieving a fuller, shapelier breast.  The goal of breast augmentation at Valley Plastic Surgery is a natural roundness and fullness.  Augmentation helps increase or balance the size of the breast, restores breast volume, and optimizes proportions between the upper and lower body.

Types of Implants
Breast implants are either saline (salt water) or silicone.  It will be important for you and Dr. Wells to assess your goals, physique, and needs to determine the best choice for you.  For the advantages of each, see Saline vs Silicone.

Placement of Implants
Breast implants can be placed in either of two locations, either submuscular or subglandular.  In submuscular placement, the implant is placed in a pocket partially or completely beneath the pectoralis muscle, against the chest wall.  It is preferable in most patients to place the implants in the submuscular location.
In subglandular placement, the breast implant is placed in a pocket formed beneath the breast tissue, but above the pectoralis muscle.  This location is less commonly used, but may be appropriate in some circumstances.

Implants placed beneath the pectoralis muscle give a softer, more natural appearance than most implants placed above the muscle.  Placing the implant beneath the muscle also reduces the risk of scar tissue building up around the implant.

Implants are most commonly placed via one of the two following incisions:  the periareolar (junction of the lower areola and skin of the breast, following the curvature of the areola) or the inframammary (following the crease underneath the breast).  There are advantages to both, based upon the individual patient.  Your own body type, amount of existing breast tissue, whether saline or silicone implants are used, and the look you desire will help us assess which is best for you.

Breast Lift (Mastopexy)
A Breast Lift is a good solution for women who have experienced the effects of gravity, time, breastfeeding, and/or weight loss.  The goal of a breast lift is to basically keep the same breast volume, but achieve a firmer, more uplifted and youthful appearance with more roundness and fullness.  The nipple, which has descended toward the bottom extent of the breast, is elevated to a more cosmetically-appealing level on the breast.

Incisions
A breast lift removes excess skin from the breasts to make them tighter and rounder, along with elevating the nipple and areola to address the sagging, loose and/or heavy appearance of the breast.
Depending on the amount of sagging, different incisions can be used for the procedure.  Generally, the more lifting that is required, the more extensive the incision (and therefore the scar).  See Breast Lift (Mastopexy) Incisions for more details on types of incisions.

Breast Lift with Augmentation
It is important to recognize that Breast Augmentation cannot correct significantly sagging or drooping breasts.  In these instances, a breast lift may be necessary in conjunction with breast implants for the best cosmetic result.  Because loose, excess skin is removed and the remaining skin tightened after the breast implants are placed, the result is a total rejuvenation for a fuller, firmer, perkier appearance.  Implants placed at the time of mastopexy are useful for achieving fullness at the top of the breasts and in the cleavage area.

Breast Reduction (Reduction Mammoplasty)
Breast Reduction, a procedure that removes excess breast fat, glandular tissue and skin, is the best solution for women with large breasts, who would like less heaviness of the chest, better proportion and relief from symptoms that can be associated with large breasts.

Breast reduction is a good option for you if:
      You are physically healthy
      You have realistic expectations
      You don’t smoke
      You are bothered by the feeling that your breasts are too large
      Your breasts limit your physical activity
      You experience back, neck and shoulder pain caused by the
          weight of  your breasts
      You have indentations or grooving on shoulders from bra
         straps  supporting heavy, pendulous breasts
      You have skin irritation beneath the breast crease
      Your breasts hang low and have stretched skin
      Your nipples rest below the breast crease when your breasts
          are  unsupported
      You have enlarged areolae caused by stretched skin

Incisions
The incisions used are just like two of those used for breast lifts (see Breast Lift & Breast Reduction Incisions—Vertical and Inverted T) and they are typically very cosmetically acceptable.  The incisions should not be visible in a bathing suit or other more revealing clothing.

In some circumstances (but not all), insurance may cover the cost of a breast reduction.

At Valley Plastic Surgery, we welcome all your questions.  It is natural to feel some anxiety, whether excitement for the anticipated outcome or preoperative stress.  Dr. Wells understands the gamut of emotions experienced and welcomes the opportunity to answer your questions fully and help alleviate any concerns.