Eva Sheie (00:04):
Welcome to the podcast where before meets after. Submit your questions for our experts at wherebeforemeetsafter.com. I'm your host, Eva Sheie.

Dr. Gallus (00:15):
I'm Kat Gallus. I'm a plastic surgeon in San Diego, California.

Eva Sheie (00:20):
How do we know if we need a lift or if we can get away with not having a lift?

Dr. Gallus (00:26):
So that's a great question and it's a super popular one. I think if your nipple position is low, you're going to need a lift. It's almost like an urban legend that putting in a larger implant is somehow going to bring your nipple up, and so I don't know why that would be the case. I've heard it described as a child on the swing, and so if you increase the pocket, then the nipple will swing up as a child on the swing will, but it's usually not very effective. Does that make sense? Like you're on the swing and then the swing comes up.

Eva Sheie (01:01):
I suppose that if the swing defies the laws of gravity, maybe this is a reasonable theory.

Dr. Gallus (01:07):
But I met a lot of women that have had breast implant surgery where they wanted a lift and they were convinced to instead go with a larger implant, and now they present with a large implant and saggy breasts that they still have and they're not happy with it. And I think that stems from probably about 10 to 15 years ago, there was a lot of controversy about doing a breast augmentation and a lift at the same time. I remember there was a published article saying, beware of the combined mastopexy aug. And I think when, you're not kidding, it's in PRS, people were concerned about tissue necrosis and nipple death and all these horrible complications that could happen and how they were competing interests. When I was in training, I worked with a very reputable, he's still practicing today, plastic surgeon who refused to do them at the same time.

Dr. Gallus (02:03):
You would do the lift and then you would come back and get the augmentation. That was like one category of surgeons. They believe strongly that they shouldn't be done together because you're doing two competing things, you're increasing the pocket and you're also tightening the pocket. And there's some logic behind that. I also think when you have non-core surgeons doing procedures, so the general surgeon who's dabbling in plastic surgery or whatnot, if you are unfortunate enough to go to one of those, the ENT guy who's set himself up as a plastic surgeon doing body, when you go to those surgeons, they're not comfortable rearranging the breast tissue and putting an implant in. So they are a hundred percent going to steer you away from that and often don't want to do a lift at all. And so then you end up with larger implants because they're trying to keep you as a patient.

Eva Sheie (02:54):
Yeah, that's one way to do it.

Dr. Gallus (02:57):
Right. Because they're also not there to revise it later, right? When five years from now the 500 cc implant that was put in is falling down your chest and your breasts aren't lifted, then that's not who you go back to have that corrected. So I feel like that's a huge component of it. Because board certified plastic surgeons are comfortable doing a mastopexy and an augmentation at the same time.

Eva Sheie (03:20):
I would hope so.

Dr. Gallus (03:21):
Pretty good at it. Yes.

Eva Sheie (03:23):
Is the breast lift with augmentation the most popular thing that you see? Is that a fair statement?

Dr. Gallus (03:31):
I don't know, I think at least in Southern California, at least where I am, it's pretty common, but just doing a breast lift is common and I have a fair amount of women who come in for breast reductions. That's actually increasing in popularity, and I thought it was anecdotal or just me, but ASPS has some interesting statistics to back that up for this last year.

Eva Sheie (03:53):
Where can we find you on Instagram?

Dr. Gallus (03:55):
I am at Restore SD, as in San Diego, plastic surgery.

Eva Sheie (04:00):
Sounds great. Thank you.

Dr. Gallus (04:01):
Thanks.

Eva Sheie (04:07):
On this podcast, we bring you directly to the doctors who are where before meets after. Links to our guest's website and contact info are in your show notes. Follow us on Instagram @wherebeforemeetsafter. If you're a board certified plastic surgeon and would like to be a guest or a sponsor of the show, go to wherebeforemeetsafter.com for more information. Where Before Meets After is a production of The Axis, the podcast agency for Aesthetics, theaxis.io.