Dr. Monacelli has extensive experience in cosmetic and reconstructive procedures of the breast. He has been in practice in Ithaca, NY for over 20+ years, and during that time, many of the cosmetic and major reconstructive surgeries that he has done, have been on the breast.
Breast augmentation is one of the most common major cosmetic procedures that Dr. Monacelli performs. Breast augmentation can be a tremendous confidence builder in many women who either never developed full breasts, or have had decrease in size of their breasts following pregnancy or weight loss. Breast augmentation can safely fill out the breasts and allow these women to wear clothing that they may not otherwise feel comfortable wearing. Dr. Monacelli’s philosophy on breast augmentation stresses natural looking results. An overdone or artificial look is never the goal.
Also known as augmentation mammaplasty, breast augmentation involves using implants to fulfill your desire for fuller breasts or to restore breast volume lost after weight reduction or pregnancy.
Enhancing your appearance with breast augmentation
If you are dissatisfied with your breast size, augmentation surgery is a choice to consider. Breast augmentation can:
Implants also may be used to reconstruct a breast after mastectomy or injury.
Both saline and silicone breast implants are used in Dr. Monacelli’s practice when appropriate. Most women are candidates for either type of implant, and Dr. Monacelli counsels his patients to help them choose the implant that is the best for their unique situation.
Saline Implants
Saline implants have been readily available for many years and have a very long history of safety and effectiveness. Saline implants do have an increased tendency to wrinkle compared to silicone gel implants. However, saline implants continue to give consistently good results in many patients, particularly patients that have adequate breast tissue and body fat present to cover the implant and thus minimize the chance for noticeable wrinkling. Saline implants are easier to handle, should they rupture. The saline is absorbed by the body and the implant deflates, making the detection of leakage much easier than with silicone implants.
Silicone Gel Implants
Silicone gel implants while controversial in the past, have made a very strong comeback. Their advantages over saline implants are that they generally feel softer and more like breast tissue than saline, and they tend to ripple or wrinkle less than saline does. These advantages become more important in very thin patients, where the implants are more likely to be felt. When they leak, however, the silicone is not absorbed like saline is, and thus the breast do not deflate. For this reason an MRI scan may be necessary to see if silicone implants have leaked.
Dr. Monacelli will review all of the implant options with you and help you make the best decision for your unique situation.
Silicone implants often require a larger incision and therefore are more commonly placed through an inframammary incision.
After the incision is made, a breast implant is inserted into a pocket either:
The method for inserting and positioning implants depends on the type of implant, degree of enlargement desired, your body type, and your surgeon’s recommendations.
Go back to the category list of cosmetic surgery procedures.
A woman’s breasts often change over time, losing their youthful shape and firmness. These changes and loss of skin elasticity can result from:
Also known as mastopexy, a breast lift raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour. Breast lifts are often done as an isolated procedure, but also as a frequent adjunct to breast augmentation surgeries.
Sometimes the areola becomes enlarged over time, and a breast lift will reduce this as well. A breast lift can rejuvenate your figure with a breast profile that is youthful and uplifted.
There are multiple techniques available for performing a breast lift, all of which result in some degree of scarring. A major goal has been to reduce the size and number of surgical incisions used in mastopexy surgeries, and thus reduce the extent of scarring. Dr. Monacelli will carefully evaluate each patient and make recommendations based on his extensive experience performing these surgeries. In Dr. Monacelli’s opinion, it is only the patients with severe ptosis of the breasts that require the traditional “inverted T” scars with a circular scar around the areola, a vertical scar below the areola, and a long curved horizontal scar in the inframammary fold at the bottom edge of the breast.
Some patients only needing a small lift can have a procedure done solely through a periareolar incision, a circular incision all the way around the areola. This leaves only a circular scar around the edge of the areola, and typically leaves the least noticeable scar. The most common procedure, however, used in patients who need moderate to large amounts of lifting, is done through a combined periareolar incision and a vertical incision below the areola, on the lower half of the breast. In Dr. Monacelli’s experience the vertical scar generally heals well in most patients, and the improvement in breast shape and position is greatly enhanced with this procedure.
There are three common incision patterns:
Excessively large breasts can result in significant physical and emotional issues. Many women suffer from chronic neck, back and shoulder pain from overly large breasts. The emotional discomfort and self-consciousness that can be associated with large breasts can be just as troubling.
Breast reduction, also known as reduction mammaplasty, is a procedure to remove excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts.
Breast reduction always involves a breast lift. The incision patterns are basically identical; see the Breast Lift section above for more details on the incisions used. However, in addition to skin tightening and lifting the nipple and breast tissue, significant weight is removed from the breasts to make them lighter and smaller.
Breast reduction patients are some of our happiest patients because they frequently feel immediate relief in their neck, back and shoulders, and they find it easier to be more active, and can fit into clothing better.
Gynecomastia is common condition in adolescent and adult men, where the breasts are excessively large. This can result in significant social discomfort, as well physical complaints related to tenderness in the breasts. It is frequently treated by liposuction to remove fatty tissue from the breasts as well as direct surgical excision of breast tissue. In occasional cases, a second surgery may be needed to remove excess skin and tighten the breasts.
View additional breast reconstructive plastic surgery procedures. Learn more about the several plastic surgery techniques used to achieve breast reconstruction.