Ideal Age?

[DianaR]

Most women would want this surgery after 40 or 50, when effects of gravity are noticeable.

How old can a woman be and still have a good outcome with this surgery?

[Mr James McDiarmid]

Diana,
The demand for mastopexy goes right across the age spectrum.

Younger patients tend to present with either unilateral or bilateral tubular breast. This is an inherited condition and is present from teenage years onwards.

With older patients drooping of the breast is down to pregnancy/lactation induced changes bodyweight fluctuations and the long term effects of gravity.

My patients are from 20-70, chronological age being a secondary consideration compared to physiological age i:e overall fitness is far more important than age in years.

Most importantly - smoking is a bad idea with this surgery!

[jhellie_baby]

thank you for sharing about it Mr James, some would have the surgery for the physiologic transformation. about the smoking habit is that something to do with the anesthesia effect if you are a smoker.?

[Mr James McDiarmid]

Smoking is really a bigger problem for healing (although it also increases anaesthetic risk). In plastic surgery we get more predictable results in non-smokers since the healing wound has more oxygen getting to it. Smoking increases the chances of necrosis.

[bangaram12]

i think the ideal age is after 39

[AnaarCheeks]

Droopy breasts are certainly not a problem that afflicts the over 40 crowd only. My breasts are not large (a small c) yet they have been drooping since they grew in!

[AmandaT]

Smoking is really a bigger problem for healing (although it also increases anaesthetic risk). In plastic surgery we get more predictable results in non-smokers since the healing wound has more oxygen getting to it. Smoking increases the chances of necrosis.

How many patients do you turn away because they are smokers? Haven't smokers had successful procedures in the past?

[Mr James McDiarmid]

How many patients do you turn away because they are smokers? Haven't smokers had successful procedures in the past?

Amanda, WRT facelift, breast reduction, mastopexy and abdominoplasty I always turn away 100% of active smokers with no exceptions.

Why? The answer is risk management. Simply put, it is just not worth doing these surgeries in the context of this level of risk. These are elective, lifestyle choice procedures and I would rather not do the surgery if there is a significant chance we might be looking at healing problems, dressings and a few weeks/months of misery. Postoperative DVT/pulmonary embolism is also far more likely in smokers and this can be fatal.

What do facelift, mastopexy, breast reduction and abdominoplasty have in common as procedures?
They all involve significant degrees of skin undermining and test the blood supply and oxygenation of the skin to the limit.

I have nothing against smokers (as long as they don't blow smoke in my face!) The fact is though that smokers do not heal as well as non-smokers.
Sure, smokers may have managed to heal (often slowly) after minimalist versions of these procedures in the past, many have not though and we have all seen their pictures on "cosmetic surgery disasters" on the TV.

I am luckily in the position (even in the midst of a financial crisis) to be able to choose the patients I am happy to operate on rather than accepting all-comers. Being selective helps me sleep at night not worrying about my patients, it maintains my reputation, it also means that patients will have longer lasting benefits following surgery.

[Mr James McDiarmid]

"i think the ideal age is after 39"

I just noticed this post by Bangaram.
Sadly this statement typifies the production line mentality of the clinic that our erstwhile poster Bangaram works for.
Putting the language barrier aside, the above is an utterly ridiculous statement and like most of the inappropriate postings Bangaram has made underline the vast cultural and ethical chasm which exists between those of us who pursue what we feel to be ethical practice in the UK and some of our more commercial (in this case european) counterparts.

I would be prepared to bet that if a patient went to the clinic Bangaram works for they would not be turned away if they were a heavy smoker and surgery was unsafe, indeed the only reason they would be unlikely to have surgery is if their credit card was declined. I wonder how much commission Bangaram (who is not a doctor) gets paid for suggesting surgery? I also wonder how many patients treated at the facility who pay Bangaram have required NHS or private treatment for complications on their return to the UK?

Thankfully Bangaram appears to have been excluded from the forum.

Rant over!

Caveat Emptor

[Squish]

Clearly you know more about Bangaram than the rest of us from their public profile! Also about what they do and who they work for! Do tell............ Surely it's unfair that professionals with an interest are masquerading behind a name?

[Mr James McDiarmid]

Hi Squish,

Bangaram popped up a couple of weeks ago having made 51 posts on the forum in the space of 1 night.
Many of the posts were simple cut and paste jobs from a website offering surgery in Prague. She forgot to remove some of the wording from the brochure in one of her cut and pastes and this gave the game away.

I have nothing against overseas surgeons or patients who make an educated decision to go abroad for surgery, However, I get very annoyed by non-specialist patient advisers like Bangaram who are based in the UK and make their living by encouraging patients to go abroad for surgery. They are commission based and have a financial incentive for shipping work abroad.

Sadly these individuals have no idea about the advisability of surgery, possible quality issues and the seriousness of the undertaking they are facilitating - Bangaram's postings were clear testament to this. I would like these individuals to be made as legally accountable as the overseas surgeons when the surgery goes wrong or requires revision. At present there is no legal accountability for the surgeons or advisers and many of us see patients returning from overseas with problems that they are unable to easily have corrected.

Many web forums are infiltrated by individuals claiming to be impartial but having a hidden agenda. Bangaram was one of these.

Bangaram was rumbled very quickly (by another forum surgeon - not by me in this case).

I don't think she will be coming back.