Improving augmentation results with a breast lift

By Dr. Glenn M. Davis

For the majority of women, the ultimate appearance goal for breast augmentation surgery is fuller, shapelier breasts with attractive cleavage. However, adding volume alone may not be enough to achieve the desired look, especially in women with drooping breasts. By combining augmentation with a breast lift, an enhanced breast size, shape and position is possible.

Evaluating Breast Sagging
Women whose breasts are already naturally uplifted can increase volume with breast implants while maintaining their existing youthful profiles. However, for women who notice visible sagging in their breasts, a breast lift may be indicated.

The primary deciding factor is how much sagging is present. Breast sagging naturally occurs over time, though women who have been pregnant often notice a greater degree of sagging following their pregnancies, and women who have lost a substantial amount of weight also will commonly see sagging breast tissue.

When you talk with a plastic surgeon about the appearance of your breasts, he or she will "grade" the degree of sagging, which influences the type of procedure that may be recommended. There are three grades of breast sagging.

• Grade I: The central point of the nipple is at the height of the inframammary crease (the fold where the bottom of the breast connects to the chest wall). If you are in this category, a breast augmentation only may provide a satisfying outcome.

• Grade II: If the central point of the nipple falls between 1 - 3 centimeters below the inframammary crease, a lift still may not be necessary. However, if only an augmentation is performed, the implant placement may add volume lower within the breast than is desired.

• Grade III: At a distance of 3 centimeters or more from inframammary crease to nipple, it is generally a good idea to combine breast augmentation with a breast lift. The areola and nipple will typically be resized and recentered during the procedure as well.

In addition to these three grades, there is also the possibility that the breasts will appear droopy even though the nipple remains higher than the inframammary fold. Patients may wish for a combined breast lift and augmentation even if not technically necessary to improve the aesthetic appearance of the breast shape and placement after augmentation.

Combining Procedures
While performing a breast lift and augmentation can be staged in completely separate procedures, there are a number of benefits to scheduling one surgery that incorporates both at the same time. Patients largely prefer the option of a single surgery, as the convenience factor is higher and the overall cost is lower. Both breast augmentation and a breast lift are straightforward procedures, and both have low immediate and long-term complication rates.

While in the past some surgeons believed that combining cosmetic surgery procedures could increase the risk of complications, it is now generally accepted that many common plastic surgery combinations such as breast augmentation/lift and tummy tuck/liposuction have very similar complication rates and revision rates compared to performing the procedures separately.

That said, surgeons still need to pay careful attention to the technical considerations that need to be addressed in order to achieve an optimal outcome. For instance, beginning a combined augmentation/lift with the augmentation piece allows for more accurate evaluation of the amount of skin and tissue that will be necessary to cover the additional volume before proceeding to lifting, shaping and excision.

The ideal final results of combined breast augmentation and breast lift surgery are firmer, higher breasts that have more volume as well. As with any cosmetic procedure, surgical skill and experience are integral to achieving this superior augmentation outcome for women with drooping breasts.

- information provided by www.smartbeautyguide.com

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TCA Peels (Information provided by Skinacea.com)

TCA peels, trichloroacetic acid peels, are medium strength chemical peels that rejuvenate and repair your skin. They improve skin discoloration, reduce fine lines, and even out skin texture. They also cause your skin to physically peel, so they will require around a week of downtime. However, the results are usually well worth the wait! 

This section explains what happens during the various stages of the TCA peeling process and what you can expect from a TCA peel, whether you get one professionally done or give yourself one at-home.

What do TCA peels do?

TCA peels are medium depth peels, ranging from 8% to 30% strengths. Though their concentrations might not be as high as other chemical peels, TCA peels are considered much deeper peels than lactic acid and glycolic acid peels. For instance, a 75% glycolic acid peel never made me peel, but a 12.5% TCA peel had my skin peeling for days.

TCA peels brighten and even out your skin tone by reducing the appearance of hyperpigmentation (dark spots, acne marks, sun spots, freckles) and skin discoloration. They revitalize dull-looking skin, helping skin look soft and smooth. Because of their deep exfoliating effects, TCA peels can clean out congested pores to refine the surface of your skin. Unfortunately, they don't work as well for acne scars or moles, but they can minimize the appearance of skin tags. TCA peels are also great for erasing fine wrinkles and treating sun damage.

TCA peels can be used on the face, neck, or back of the hands. They can also be used all over the face or just as a spot peel. One TCA peel will give better results than one glycolic acid peel, but more than one TCA peel is still necessary for the best results. Results generally last around 6 months, but they can last even longer when supplemented with glycolic or lactic acid peels every two weeks.

What to expect from a TCA peel

TCA peels are serious peels with about 7-10 days worth of downtime. If you are considering getting one done, definitely schedule some time off of work and clear your calendar because you don’t want to get any sun exposure after the peel and you’ll probably look too red and flaky to be presentable.

So, how do you prepare your skin for a TCA peel? How much will it hurt? And how long will the peeling last? These questions and more will be answered in the following breakdown of what the 10 day course of a TCA peel (from pre-peel to recovery) are like:

• Pre-peel:

  Before you get the TCA peel, there are a few things you should do to prepare your skin for it. Some dermatologists recommend using retinoids or an AHA serum for two weeks prior to the peel to prime the skin for a more even and penetrating peel. However, this is optional. 
  
  Three days before the actual peel though, you must stop the use of all exfoliants (manual or chemical) and especially avoid using any harsh products (such as hair removal or grainy scrubs) on the day of the peel and for the duration of the peel.
  
  48 hours before you get a full peel, you must do a patch test on the area where you will get the peel. If you are getting a peel on your face, patch test your face. If you are getting a peel on your hands, patch test your hands. Spot testing the TCA peel solution is extremely important for a safe peel because it will help you understand how your skin responds to the acid and make you aware of any averse reactions before getting a full-face peel.
  
  It's also wise to get yourself some time off work. If you can't get 10 days off, try to get the days off when your skin will start to peel the most, most likely 3-4 days after the day of the peel. Have a good moisturizer, petroleum jelly (Vaseline), antibiotic cream (usually provided by the dermatologist or Bacitracin or Neosporin), and anti-itch cream (Lanacaine or Cortaid) on hand. If you plan on going out during any of the 10 days, make sure you have a good sunscreen and a big floppy hat to wear too.