Undecided

sg3920 · 11-09-2009, 10:45 AM

Hello Dr. Sorokin,

I'm currently undecided between 2 doctors. I had a full anchor breast lift with saline implants placed over the muscle 11 yrs ago. I had a child 6 yrs ago and my breast have now sagged again. I have seen a few doctors and they all suggested re-doing the mastopexy to give my breast the perkiness I want and to correct my scars which are still pretty visible. Also, to place larger silicone implants behind the muscle since I would like to go slightly bigger.

My question is that 2 of the doctors advised me that they can re-do the lift without the need of fully re-opening that large incision at the bottom of my breast, just by opening it about 3 inches. There is one doctor that says he has to fully re-open that incision to be able to take off all the old scar tissue from around the scar. Any of this makes sense? your thoughts would be greatly appreciated. Thanks

DrSorokin · 11-09-2009, 08:38 PM

You need to be very careful with redo mastopexy/implant exchanges. You should get a copy of the original operative report so the new surgeon is 100% of the blood supply to the nipple. It is somewhat odd to have a full anchor mastopexy and implants above the muscle done in the same setting. This could often compromise the blood supply to the nipple. Revision needs to respect the original blood supply. As far as having to reopen the entire incision, this needs to be assessed on an individual basis. If a little more incision needs to be reopened in order to get you a better result in the long run you already have the scars so does it matter? Go with the surgeon that you feel can get you the best results, give you the best patient care, and that you feel comfortable with.

sg3920 · 11-10-2009, 10:31 AM

Dr. Sorokin,

Thank you for your response. It's interesting that you mentioned the blood supply issue, because I did have that complication from that surgery. I lost part of my left aureola which is one of the main reasons I want to get the breast re-done. The surgeons I have seen have told me they can take most of the scarring away when they performe the lift again but that I'm always going to have a little bit of discolorement on that small area on my left nipple. One of them told me I can later have it tattooed if it still bothers me. One more question, one of the surgeons only uses "twilight" or IV sedation for his procedures. Do you consider that my procedure is rather too complicated to be done under this type of anesthesia? do you think that I should defintely go with general anesthesia? thank you so much for your time.

DrSorokin · 11-10-2009, 07:28 PM

Sedation should truly be fine. This choice is patient/doctor preference. Good luck!

11-09-2009, 10:45 AM	#1
sg3920 Join Date: Sep 2009 Location: Miramar, Florida Posts: 48 Thanks: 1 Thanked 6 Times in 6 Posts	Undecided Hello Dr. Sorokin, I'm currently undecided between 2 doctors. I had a full anchor breast lift with saline implants placed over the muscle 11 yrs ago. I had a child 6 yrs ago and my breast have now sagged again. I have seen a few doctors and they all suggested re-doing the mastopexy to give my breast the perkiness I want and to correct my scars which are still pretty visible. Also, to place larger silicone implants behind the muscle since I would like to go slightly bigger. My question is that 2 of the doctors advised me that they can re-do the lift without the need of fully re-opening that large incision at the bottom of my breast, just by opening it about 3 inches. There is one doctor that says he has to fully re-open that incision to be able to take off all the old scar tissue from around the scar. Any of this makes sense? your thoughts would be greatly appreciated. Thanks

11-09-2009, 08:38 PM	#2
DrSorokin Certified by the ABPS Join Date: Sep 2007 Location: Marlton New Jersey Posts: 612 Thanks: 6 Thanked 470 Times in 288 Posts	You need to be very careful with redo mastopexy/implant exchanges. You should get a copy of the original operative report so the new surgeon is 100% of the blood supply to the nipple. It is somewhat odd to have a full anchor mastopexy and implants above the muscle done in the same setting. This could often compromise the blood supply to the nipple. Revision needs to respect the original blood supply. As far as having to reopen the entire incision, this needs to be assessed on an individual basis. If a little more incision needs to be reopened in order to get you a better result in the long run you already have the scars so does it matter? Go with the surgeon that you feel can get you the best results, give you the best patient care, and that you feel comfortable with. __________________ www.delawarevalleybreasts.com www.delawarevalleyplasticsurgery.com esorokin@delawarevalleyplasticsurgery.com www.njplasticsurgeryblog.com The above message is not intended as or to imply medical advice as this cannot be given in a forum such as this without an appropriate history and physical and doctor/patient relationship. If you cannot accept this policy, please ignore my messages.

11-10-2009, 07:28 PM	#4
DrSorokin Certified by the ABPS Join Date: Sep 2007 Location: Marlton New Jersey Posts: 612 Thanks: 6 Thanked 470 Times in 288 Posts	Sedation should truly be fine. This choice is patient/doctor preference. Good luck! __________________ www.delawarevalleybreasts.com www.delawarevalleyplasticsurgery.com esorokin@delawarevalleyplasticsurgery.com www.njplasticsurgeryblog.com The above message is not intended as or to imply medical advice as this cannot be given in a forum such as this without an appropriate history and physical and doctor/patient relationship. If you cannot accept this policy, please ignore my messages.

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11-10-2009, 10:31 AM	#3
sg3920 Join Date: Sep 2009 Location: Miramar, Florida Posts: 48 Thanks: 1 Thanked 6 Times in 6 Posts	Dr. Sorokin, Thank you for your response. It's interesting that you mentioned the blood supply issue, because I did have that complication from that surgery. I lost part of my left aureola which is one of the main reasons I want to get the breast re-done. The surgeons I have seen have told me they can take most of the scarring away when they performe the lift again but that I'm always going to have a little bit of discolorement on that small area on my left nipple. One of them told me I can later have it tattooed if it still bothers me. One more question, one of the surgeons only uses "twilight" or IV sedation for his procedures. Do you consider that my procedure is rather too complicated to be done under this type of anesthesia? do you think that I should defintely go with general anesthesia? thank you so much for your time.