AESTHETIC PLASTIC SURGERY / Breast

Dr. Salibian offers many different types of plastic surgeries including breast augmentation, breast lifts, breast reduction and breast reconstruction. Doctor Salibian can also correct inverted nipples (mammiloplasty), or reconstruct a breast cancer patient’s nipple (areolar reconstruction). Please continue to read more about some of these procedures for the breast area and how they can benefit you.

Breast Augmentation

Breast augmentation can increase size and even restore volume in deflated breasts. You have many options to choose from should you elect this plastic surgery procedure. What type of implant will be best for you? Which incision site will be the best place to hide the scar? Breast implants can be inserted through the nipple, underneath the breast, and in other locations. During your consultation visit with Dr. Salibian, you can discuss the types of placement methods available for breast augmentation.

Breast Lift

As time passes, a woman’s breasts may begin to sag, particularly if she’s had a child. A breast lift tightens the skin around the breast tissue and places the nipple higher on the body. No tissue is removed in this operation except for the excess skin. Many women are pleased with the resulting full appearance. Some women opt to have a breast lift with the use of an implant to increase the size of the breasts or give more projection to the breasts. The final shape of the uplifted breasts will maintain their beautiful appearance for a long time with minimal sagging baring drastic changes in ones weight.

There are several surgical approaches in performing a breast lift. Your best options whether the incision is limited to the nipples or a vertical extension is needed or a formal mastopexy with the anchor shaped incisions are made are best discussed during your detailed consultation with Dr. Salibian. The risks, benefits, alternatives and expectations are all fully covered during your consultation. In addition, a literature packet is given to you to take home and learn more or help clarify some of the points made during your consultation. It also contains helpful instructions, guidelines and recommendations to prepare for the surgery and the recovery period.

Breast Reduction

Women with large, heavy breasts may suffer from back pain, skin irritation, difficulty with sports and certain activities and other annoyances. A breast reduction can help to alleviate pain and other problems. During this operation, Dr. Salibian will remove some of the tissue in the breasts as well as the excess skin, and then elevate the breasts to their new position and shape them into an aesthetically pleasing contour and in proportion with the rest of your body. Dr. Salibian uses technique that is individualized to each patient’s breast size and desires that minimize the length of the scars and maximizes the shape and longevity of the contoured breasts. The details of the location of the incisions, expectations and after care are all discussed during your consultation.

Breast Reconstruction

A specialty of Dr. Salibian’s practice is breast reconstruction. Because he has experience in the complex field of microsurgery, he is able to perform intricate reconstructive surgeries that can optimize the natural feel, shape and symmetry of the reconstructed breast as well as minimize the donor site deformity. There are several options available for reconstructing a breast, such as the autologous method – using your own natural tissue. Although Dr. Salibian can provide more details about breast reconstruction and the choices available to you during your consultation, here is a brief look at some of your options:

• Autologous Reconstruction: This method uses your own fatty tissue and skin without the need for an implant. Dr. Salibian specializes in a surgery called a muscle-sparing free TRAM flap. This operation uses tissue from the belly area, the lower abdominal pouch, to form a new breast and at the same time end up with a flap tummy contour (abdominoplasty – tummy tuck). Unlike most TRAM flap reconstructions, this operation does not remove the whole length of the muscle but only a small portion where the blood supply to the overlying fatty tissue and skin is present and is transferred with the use of microsurgical technique to the chest area and shaped into a breast. This optimizes the circulation of the newly reconstructed breast, allows shaping and contouring to match your opposite breast. At times, because the newly reconstructed breast has a more youthful and up lifted look and feel, many women request the reshaping or an up lift to their opposite breast to match the better looking reconstructed breast. Because the muscle sparing free TRAM flap allows more of your abdominal muscles to stay behind, this in turn minimizes the chances of future abdominal wall muscle weakness or bulging.
• Autologous and Implant Combination: The breast is reconstructed using your own tissue as well as an implant. An example of this would be the latissimus dorsi muscle flap procedure. It uses tissue from your back and an implant to create a new breast.
• Implant Reconstruction: An implant is placed under the muscles of the chest after a mastectomy. No tissue is removed from other parts of the body. This is a staged procedure where in the first stage, usually at the time of the mastectomy, a tissue expander is inserted underneath the chest muscles. In the ensuing several weeks and months, this device is slowly expanded as your body learns to accommodate the expander and during a second stage, this device is replaced with an implant. The final implant can be saline or silicone gel.