As with all surgeries, experience with the technique is important because, according to the manufacturer, while the threads can be easily adjusted or removed during the procedure, removing them later can be difficult. Although Refine is a nearly scarless procedure—something women want—barbed sutures used in recent years for facelifts have been problematic, causing pain and sometimes asymmetric results, and have been abandoned, so some surgeons are taking a wait-and-see approach.
Also, the promise is an all-natural method of discreet breast reshaping for those with an aversion to silicone. The procedure of injecting a woman with her own fat was banned in 1987 because of unpredictable results and the formation of calcification cysts in the breasts that caused false positives in cancer screenings. But with advances in mammography technology, that ban was lifted in 2009 and the practice has resumed. Today, most doctors say that fat injections alone are not enough to lift the breast, but the results when fat is used in conjunction with a surgical lift are impressive. “It can fill out the upper chest and create better cleavage,” says Ahn.
Some surgeons start their patients with an off-label use of Brava, an FDA-approved vacuum device for breast augmentation, to increase blood supply and create a space for fat that has been suctioned from the back, hips or the thighs. This is painstaking work: Injecting the fat in the right places to create natural-looking contours takes up to an hour and a half (at a cost of about $900, not including surgeon fees, with a national average of $4,200, plus operating room and anesthesia fees ). Risks, although small, include calcification cysts (which doctors now consider harmless) and tumor. Another factor: Added breast volume can fluctuate with weight gain and loss.
There are, of course, many women who still undergo a traditional breast lift without mesh or injections. Missy, a 34-year-old full-time mother, is one. “I had breastfed two children. I felt deflated and maternal,” she says. “I hated bra shopping. I was always looking for the perfect push-up bra.” She was relieved when her doctor, Michael Law, a plastic surgeon in Raleigh, North Carolina, told her she had enough breast tissue for a surgical lift that would not require an implant or additional fat.
Fifteen months after the surgery – a two-hour procedure under monitored sedation (although general anesthesia is often used) – Missy says she no longer needs an underwire bra. At size 34C, she is one cup smaller than before surgery. Her scars are fading after six pulsed dye laser treatments and six months of daily silicone gel use. And more than a year after surgery, he’s also out of the danger zone for early recurrence. The biggest reward of Missy’s breast lift, however, is the way she feels about herself. “I can wear sundresses without a bra again,” she says. “I feel more feminine, more comfortable in clothes, swimwear and my naked body.”
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