Single procedure breast lift and breast augmentation considered safe

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The Journal of Plastic and Reconstructive Surgery, the official medical publication of the American Society of Plastic Surgeons (ASPS) released a report earlier this year which articulated that breast lift (mastopexy) and breast augmentation in a single procedure is safe.

In the study, ASPS Member Surgeon Dr. Michael Calobrace and his group stated: "With appropriate patient selection and a carefully planned operative approach, our data demonstrates a one-stage procedure can be safely performed with acceptable complication and reoperation rates."

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Data from 2005 to 2009 showed that out of 430 breast lifts performed, 332 of such instances were with patients who underwent breast augmentation at the same time. Dr. Calobrace and his colleagues compared these cases against those who only had breast lift surgery. After assessing the rates of complication and reoperation, they found a 13 percent rate of reoperation on the combined procedure as opposed to 10 percent on breast lift only. In terms of acceptability, the group concluded that the difference is insignificant.

Apart from being cost-effective, the single-stage procedure also requires a one-time recovery period for the patient. This single-stage procedure is not for everyone, though. It is always best to consult first a reputable cosmetic surgeon before deciding to go under the knife.

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SIEF: The new option for breast augmentation?

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Breast augmentation involves using implants for fuller breasts. In this type of procedure, implants such as silicone and saline are used. However, these days, new trends are beginning to replace the practice of using such implants. A new technique being used by some plastic surgeons is SIEF or Simultaneous Implant Exchange with Fat.

SIEF, according to the Journal of American Society of Plastic Surgeons is the method of implant exchange using recipient-site pre-expansion followed by autologous fat transplantation. Generally, this new method is used for patients who want to change their implants and those with recipient-site soft tissue problems. In addition, this method benefits those with excessive upper pole thickness, capsular contracture, implant malposition, and parenchymal thinning.

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Before a SIEF procedure, the patient should undergo baseline three-dimensional breast imaging to analyze and quantify the breast volume. Breast imaging is done to establish a “goal” expansion volume. During the pre-expansion process, the patient is fitted with an external expansion device which creates the “goal” expansion volume. By interpolating between baseline volume and final goal volume, interval goals are derived and compared with the actual weekly measures. The patient, by the third week of the process, should have successfully achieved the goal volume.

After the pre-expansion process, the autologous fat is suctioned from the abdomen, thighs, and flanks via liposuction. The suctioned fats are used as implant exchange for silicone and saline.

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Injection of the fat implant requires two processes: Phase I, which involves injection of the implants over existing implants and Phase II, which involves injection of the supplemental implant after existing implants are removed. During the first stage, a syringe is used to inject the fat implant to the breast while the old implants are still intact. Extra care is observed in injecting the fat to the expanded breast subcutaneous space so as not to injure the existing implant. After the initial stage of the injection process, the implants are removed, resulting to the collapse of the breast. This allows an effective transplantation of the supplemental fat to the breast space.

The advent of the simultaneous implant exchange with fat (SIEF) has opened new avenues for those who want to remove their breast implants. While it is a relatively new method, studies, such as those published in the Journal of American Society of Plastic Surgeons, prove that it is a viable option for those seeking new methods of breast augmentation.

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