Plastic surgeon
David Stoker, M.D. explains to
Jodi Thiessen how he achieves a
breast lift without extensive incisions.
Cosmetic procedures are constantly evolving. Education, information, and surgeons’ passing on their findings of which techniques work and which
don’t allow the patient to benefit directly.
Plastic surgeon Dr. David Stoker has adapted a
minimal incision breast lift, which can also be used for breast
reduction, that results in perky, natural shaped breasts.
“The incisions are similar to the Le Jour technique but
technically speaking the pedicle is different,” says Dr. Stoker. “The idea is that the nipple stays attached and is rotated with
the breast tissue into a more superior location. It can look
almost as if the patient has had an augmentation. This is
because the breast tissue is secured into the appropriate
anatomical locations.”
The incision is around the nipple and vertically down in a
lollypop shape. This is almost a fifty percent reduction in scarring
from the original technique, which is in the shape of an anchor.
Because of the movement of breast tissue into a more perky
position, a lot of patients are very impressed with how much
projection they receive. “When the tissue is not spread out over a
large area as with a droopy breast, when it is in a compact region,
it will project a lot farther,” says Dr. Stoker. “It can give a perkier
shape than the traditional anchor incision technique.”
Dr. Stoker combines The Laser Bra with these minimal
incisions to obtain the best possible result. The Laser Bra is a
technique where an internal bra is created with the patient’s own
tissue to give long–lasting lift results. A CO2 laser is used to deepithelialize
the patient’s own skin, which makes it stronger.
Plastic surgeon and developer of The Laser Bra®,
Dr. Grant Stevens explains: “With this technique, the skin
otherwise discarded in a breast lift is treated in such a way with
the laser that a bra is fashioned and secured to the chest wall.
This “bra” holds the breast tissue up and in place. It is entirely
internal and is done with the patient’s own tissue so there are no
added problems with infection or rejection.”
There are two main reasons Dr. Stoker has included this
technique with his minimal incision lift. “It minimizes the blood
loss from the procedure and it also allows me to use the
patient’s own tissues – the strong dermal tissues – to suspend
the breast tissue in a higher location to give a longer lasting lift.”
There is no limitation to the amount of lift that can be gained
using this procedure. In comparison to traditional breast lift
surgery, the length of the operation and anesthesia time are
decreased. “Because there are fewer incisions, the discomfort
level is probably less as well,” says Dr. Stoker.
This technique is not for breast lifting alone; it can also be
successfully used for breast reductions. Through the same lollypop
incision breast tissue can be removed and replaced to create
smaller, perkier breasts. Dr. Stoker explains: “We tend to remove the
breast tissue from the lower portion and side of the breast because
that’s usually what bothers the patients the most, what’s hanging
down and what’s protruding under their arms. The breast tissue in
the inner aspect and top of the breast is maintained. Then a pocket
is created in the upper portion of the breast and the lower breast
tissue is rotated up into it, resulting in more fullness up top.”
The minimal incision technique creates excellent projection
and shape. As part of a reduction the patient also gets a lift.
“Most women who have a breast reduction still want to maintain
cleavage,” says Dr. Stoker. “Most want to stay perky and it’s the
perkiness that’s not easy to achieve with the anchor type
incisions. The anchor scar technique is more likely to result in a
flatness and more likely to bottom out.”
To ensure the final result appears natural Dr. Stoker
overcompensates at first, which means the breast has a lot of
fullness at the top. Over the ensuing months the tissues relax
into a natural shape.
The glandular tissue and ducts for the most part remain intact
so most patients do maintain sensation of the nipples and most
probably maintain the ability to breast-feed.
While the incisions are minimal Dr. Stoker also uses
techniques to ensure that the resulting scars fade over time.
“When suturing, most of the tension is put on the deep tissues
so the superficial tissues are almost kissing. The skin can then
be closed with minimal tension. Wearing a supportive bra is
helpful in decreasing tension on the incisions as well. The main
idea is to decrease the tendency for the scar to widen.”
Patients can expect a dramatic improvement after a minimal
incision lift because it is successful at lifting or reducing the
breast tissue and results in a very natural appearance. While it
uses minimal incisions, it is not scar free, but with careful
technique in time the scars may fade to thin lines.