Breast lift with breast augmentation, part 2

This plastic surgery video will demonstrate part two of a breast life, with breast augmentation. She has already undergone the breast augmentation, and she has been seated on the operating table, and sat up to ninety degrees, and had marks placed on her. The staples have been removed, and now she's having the redundant skin taken off.

The white that you see in the bottom of the wound under the scape, is the dermis, and that's the strength layer of the skin, and all of her sutures will be placed in this strength layer of both the areola side, as well as the skin side. This will allow there to be good suturing, and the wounds to heal very well.

Please note that her nipple is still attached to her gland. One of the common things that I hear during my consultations, is that the women think that their nipples actually cut off and put on the back operating table while the lift is being performed, and that's not the case.

So you'll see that I use that strength layer to make my stitches. And now the nipple areola complex is being elevated tot the higher position than it was before the surgery. And what I will do is, almost like a clock, I'll go from twelve o'clock, to the six o'clock position, and then I'll go to the three o'clock, and then the nine o'clock position, and close the wound. And again, the marks that I've made are reference marks to help me reapproximate the wound.

Ultimately, I will make adjustments as the wound is closed to give her the best closure as possible. This closure will be in two layers. The deep layer will be the major strength layer. The second layer will give tissue edge approximation. For the sake of time, we are demonstrating this using time-lapse photography.

But each one of these stitches is placed individually. After those tissues have been placed, a second layer is placed, to bring that areola to skin edge wound, into perfect approximation. And so this will actually be a running stitch, and it will be placed in such a fashion as to, again, give the wound perfect skin edge approximation.

As a plastic surgeon, we like to see our wounds heal with as minimal scars as possible. This type of running suture will dissolve, so this patient will have no sutures that have to come out. She'll also have no railroad marks or polka dots on either side of her wound, from stitches that stayed in too long. All of her stitches will dissolve on their own. And you can see that once you tighten that stitch, how nicely the wound edges come together. And again, this will be shown in a somewhat time-lapse fashion, just to allow you to appreciate what's involved, but yet not to have to have you watch this entire process.

This operation, a breast lift and augmentation, will typically take about an hour and a half, to two and a half hours, depending on the size of the patient. So at this point, she's had her wounds closed, and she's having supportive tape put on, to splint the wound and give her a better chance to having a nice thin scar.

What you see here is the before and after pictures of the patient on the operating table, in the seated position. She's had a very nice improvement both in volume and nipple positions. And she goes on to have a wonderful result.