Drooping of breast tissue after breast augmentation—"ptosis"—can create a very displeasing visual deformity. Most often the deformity is due to ptosis that pre-existed the augmentation. Many patients were told they needed a lift but they did not want the scars. They then received a relatively large implant, and this heavy implant exacerbated the ptosis. Sometimes large implants alone are enough to cause ptosis. In other situations, a high-riding implant can cause an upper bulge, and the natural breast tissue will slide off to the bottom of the implant and the nipple will point down.
This illustration from one of Dr. Teitelbaum’s book chapters demonstrates the difference between three closely related problems: fold malposition, stretch, and rippling.
Some type of breast lift will need to be done if there is too much breast skin or if the nipple is too low. This does involve scars—but if loose skin or a low nipple is the problem then a lift (mastopexy) is the only solution. There are various types of lifts with different lengths and scar locations. Dr. Teitelbaum will discuss the scar options for your situation.
If a pre-existing implant is too high, then the implant and, often, scar tissue are removed surgically. Then, a new implant is placed a bit lower so that it pushes what was the drooping breast tissue outwards and upwards.
Dr. Teitelbaum was a member of the national plastic surgery task force that developed the Covid-19 protocols for plastic surgery offices. He is therefore well-versed in all of the recommendations and his office meets or exceeds all of them. By now you are familiar with all the obvious measures such as reminding patients and staff not to come to the office if they have any symptoms, taking temperatures, maintaining social distancing, having everyone wear masks, placing hand sanitizers everywhere, reducing the number of patients in the office at one time, testing all surgical patients, etc. One unique feature is that Dr. Teitelbaum’s operating room has "laminar flow" – a very advanced system that directs the flow of air from a large diffuser on the ceiling to exhausts near the floor, ensuring that the fresh air flows in one direction. This not only reduces the chance of COVID infections for the patients and staff, but it also reduces the risk of surgical infections.
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