About Breast Surgery

Dr. Paul Zwiebel can help you have the beautiful breast profile you have always wanted.

Breasts can naturally begin to sag or droop due to weight loss, weight gain, the natural aging process, and childbirth. At his plastic surgery center in Littleton, Colorado, board certified plastic surgeon Dr. Paul Zwiebel may be able to help patients who are experiencing this loss of elasticity in their breasts. In Denver, breast lift plastic surgery lifts the breasts for a more attractive shape. The procedure takes one or more hours to complete and can be performed in conjunction with breast enhancement.

During the breast support procedure, Dr. Zwiebel will make incisions around the areola (the dark pigment surrounding the nipple), down from the bottom center of the areola to the crease, and then horizontally in the fold of the breast. Excess skin below the breast will be trimmed away and removed, then pulled down around the nipple to create lift. Remaining tissue and the nipples will be repositioned to create an elevated, more youthful breast contour.

In Littleton and Denver, breast lift patients from the Colorado region, experience minimal side effects. Some complications can include temporary bruising, swelling, loss of feeling in the breasts or nipples, and scarring. We would like to emphasize that a breast treatment is a surgical procedure and, as such, carries with it some risk. Dr. Zwiebel encourages all patients to learn as much about the process before undergoing a breast treatment. In Denver, breast lift patients should gather as much information as possible. At his plastic surgery center in Littleton, board certified plastic surgeon Dr. Paul Zwiebel, encourages each patient to share their concerns and questions with him and his friendly staff at all times.

Breast Surgery Denver Before & After Photos

Breast Reduction

Dr. Paul Zwiebel can help you have just the size breasts you have always desired.

Women with overly large breasts can suffer from a myriad of negative physical and psychological conditions. Extremely large and heavy breasts often cause back problems, shoulder problems, and can prevent women from participating in physical activities. They can also be a source of embarrassment, especially if they are disproportionate to the woman’s body. At his plastic surgery center in Littleton, Colorado, board certified plastic surgeon Dr. Paul Zwiebel is fortunate to be able to offer a solution to the problem of overly large breasts to his patients in Denver: breast reduction plastic surgery. This procedure is designed to reduce the size of the patient’s breasts and to increase overall body symmetry.

Dr. Zwiebel begins the breast reduction procedure with an incision, which is made around the areola (the dark circle of skin surrounding the nipple) and below the natural curve of the breast. Next, excess fat, glandular tissue, and skin are removed, and the remaining skin is tightened around the newly contoured breast.

In Denver, breast reduction can be a medically necessary procedure, and, therefore, may be covered by your medical insurance carrier. However, we are not an in-network provider for any insurance company. If you would like to submit your operation costs through your insurance plan, you will need to speak to your insurance company and ask what your out-of-network benefits are for breast reduction. Also, it is important to note that many policies do not cover breast reduction as a covered benefit. In addition, for policies that do cover breast reduction, we will have to prove that your case is “medically necessary” according to the pre-set standards dictated by your insurance policy. For example, you will have to show that your breasts are causing pain, that your weight is proportionate, that you have tried non-surgical means of resolving back and neck pain, and the insurance company may require a certain amount to be removed per breast. It will be to your advantage to call your insurance provider and speak with a representative. We understand that insurance coverage can be very confusing, and we invite you to contact Dr. Zwiebel’s office in Littleton with any specific questions.

We would like to emphasize that in the city of Denver, breast reduction is a surgical procedure and, as such, carries with it some risk. We encourage all patients to learn as much about the process before undergoing breast reduction. As a board certified plastic surgeon, Dr. Zwiebel encourages his patients to gather as much information as possible. Dr. Zwiebel and his friendly staff in Littleton are always ready to answer any questions or concerns you may have at any time.

Breast Reduction Denver Before & After Photos

Contact our Littleton plastic surgery center at (303) 586-3931 to request information and schedule a personal consultation

Breast Revision

At the Zwiebel Center for Plastic Surgery, we understand that at woman’s decision to undergo breast revision surgery is highly personal and private. We will treat you in a respectful manner, and with utmost professionalism. We fully respect your privacy and will be very discreet during your confidential consultation with Dr. Zwiebel. First, we will listen to your concerns related to the appearance of your breasts that you feel are important and would like to change. We want to understand your expectations and help determine if they can be realistically achieved. Your questions and concerns will be addressed and your information will be treated with complete confidentiality.

It will be very helpful in the evaluation and planning of your revision surgery if you are able to provide information about your previous surgery, including records and operative reports obtained from your prior surgeon.

Dr. Zwiebel will advise you if you are a good candidate for breast revision surgery and determine what technique’s are best for your unique situation. Dr. Zwiebel will educate you about the procedure and what to expect during your recovery.

Breast Revision Denver Before & After Photos

Breast Revision Procedures

All women can experience a change in their breasts with pregnancy, breast feeding, hormone changes and time. Fluctuations in body weight can cause changes in breast size and drooping. These changes can produce problems of excessive breast size, inadequate breast volume, laxity, drooping, and unsatisfactory shape. For women who have had breast implants, such changes over time can also have a significant effect on breast aesthetics.

During your personal consultation, Dr. Zwiebel will first listen to your concerns and questions, perform a careful evaluation, and thoroughly discuss alternatives based on your unique situation and desires. Surgical options may include breast reduction, breast lift (mastopexy), removing, repositioning or changing implants, or modifying the space around implants.

Breast Implant Deflation (Saline Implants)

Breast implants cannot be expected to last forever. If a saline-filled implant breaks, the deflation of the breast is obvious as the implant contents (salt water solution) are harmlessly absorbed by the body. Implant deflation can occur as a result of trauma or capsule contracture, but more commonly it seems to occur with no apparent cause. Surgery will be required to remove or replace the implant.

It is preferable to replace the implant within a week or two, before the implant pocket begins to scar down and contract. Treatment may be as simple as removing the deflated implant and replacing with the same size. This is an out-patient procedure, commonly done with just a local anesthetic through the existing breast implant scar. Recovery is quick, with immediate resumption of almost all normal activities. If you prefer to be asleep during the replacement, intravenous sedation can be used for your comfort in the safety of our fully-accredited sin-office surgical suite.

Because most breast implants come with a warranty from the manufacturer, the implant manufacturer may replace the implant and may contribute to the cost of the procedure fees.

If you choose to change your implant size, or if you have a capsular contracture, rippling or other issues, we can discuss the options to improve the aesthetics of your breasts. For example, if you have had drooping or lost volume after pregnancy, you may consider a breast lift to improve the firmness, shape and position of your breasts.

Breast Implant Leak (Silicone Implants)

It can be hard to know if your silicone implant has a leak, unless a mammogram, ultrasound or breast scan implant shows it is defective. We often discover a leak during surgery for capsule contracture around an implant that is older (more than 10 years old).

To be sure all the silicone leak is removed, surgery will usually require removal of the implant and the capsule (the lining the body creates around the implant). This procedure is an out-patient procedure, performed with intra-venous sedation: you will be completely asleep during the operation, but wake up quickly at the conclusion of the operation. We use long-acting local anesthetics and a special anesthetic pump, for your continued comfort, post-op.

As with saline implant replacement, manufacturer warranty may help with costs of a replacement operation. There are also many opportunities for improving breast aesthetics, if desired: not replacing the implants, changing implant size, breast lift or other procedure to improve shape and feel.

Increasing Breast Size

Replacing implants to increase breast size can be a relatively simple procedure, but may require increasing the size of the implant pocket, the space in which the breast implant is positioned. To help you make a good choice, Dr. Zwiebel will carefully measure your frame and assess your breast anatomy and tissue characteristics (Dimensional Planning) to determine what size and shape implants may fit your body without increasing potential risks of complications. If you are considering larger implants, it is very helpful to have the information about your current implants so that an intelligent decision can be made about the change you would like to make. This surgery can be relatively simple or require more tissue release (capsulotomy) to make room for the larger implants.

Decreasing Breast Size

If you desire to remove or replace your breast implants, Dr. Zwiebel will listen carefully to learn your desired outcome, perform a careful analysis of the dimensions and tissue characteristics of your breast and chest, to then be able to discuss options available to you. If you choose to decrease the size of your implants, it may not be as simple as placing a new implant. The capsule that surrounds the implant may need to be tightened with internal suturing (capsulorrhaphy) and the skin may need to be tightened or lifted.

Capsule Contracture (“Hardening of Implants”)

When breast implants feel too firm or hard, or appear unnatural, it is often a result of tightening or shrinking of the pocket around the implant. After breast implant surgery, the body naturally creates a smooth lining around the implant; this lining is called a capsule.Capsule Contracture occurs if the capsule thickens and tightens around the implant. Causes of capsule contracture include infection, trauma or bleeding around the implant. Sometimes, there is no apparent cause of the capsule contracture. If it is severe, it can cause discomfort or changes in the breast’s appearance. In such cases, surgery may be desirable to modify or remove the scar tissue, or perhaps remove or replace the implant.

Surgical treatment can involve expanding the pocket (capsulotomy) or removing the entire capsule (capsulectomy). To help prevent the recurrence of the capsule contracture, options can involve positioning the new implant under the chest muscle (subpectoral), if the old implant was in front of the muscle (pre-pectoral/subglandular). The options are will dependent upon factors that are individualized to each person’s needs; Dr. Zwiebel will explain this to you at your consultation and make an individualized recommendation.

Implant Malposition

After breast augmentation, it is possible for one or both implants to drift or scar so that the implant does not sit in an ideal position for attractive breast aesthetics or symmetry. This can result from scar capsule contracture (discussed above) or as a result of a capsule that has stretched too far. The position of the implant can be corrected by modifying the capsule (capsuloplasty or capsulorrhaphy) with internal sutures or other more sophisticated techniques to adequately support the implant.

Symmastia (“Uni-Boob”)

Symmastia (connection or blending of the breasts) results from the breast implants touching across the middle of the chest, filling in the cleavage between the breasts. This occurs infrequently; women with a concave breast bone (pectus excavatum) are more susceptible to this problem, as are women who have implants too large for the size of their chest. Repair can be accomplished with internal suturing, often reinforced with an internal graft to prevent recurrence. Implant removal or exchange may be recommended if the original implants are too large for the chest.

Double-Bubble Deformity

The “double bubble” refers to the presence of a crease along the lower curvature of the breast above the breast fold. This can give the appearance that the breast is stacked on top of the implant, rather than a blended homogeneous contour of the breast and implant.

The causes include a short tight breast crease before augmentation or a tight pectoral muscle edge. Possible treatments can include release of the internal tight tissues, repositioning the implant, a breast lift procedure or use of a different shaped implant.

Implant Rippling or Visible Implant Edge

Rippling of the implant or an unnaturally abrupt defined edge of the breast can result from inadequate tissue coverage of the implant. This can occur in very slender women with too little breast tissue or fat to cover the implant, especially if the implant is placed in front of the muscle. This is a bit more likely to occur with saline-filled implants.

Treatment options may include repositioning the implant under the muscle, switching from saline- to newer silicone gel-filled implants, internal grafting (to add tissue thickness), or a different shape or size implant. During your personal consultation and thorough examination, Dr. Zwiebel will assess the factors contributing to your individual issues and discuss the options to provide you with the best outcome.

Other Post-Surgical Deformities

Because of Dr. Zwiebel’s reputation, experience and expertise, he is frequently consulted regarding deformities or unsatisfactory results from previous breast surgery. Patients often express their appreciation for his careful evaluation, thorough explanation and answering of their questions. Through the years, many women have expressed their gratitude for the results they have obtained from Dr. Zwiebel’s skillful breast revision surgery procedures.

Breast Revision or Secondary Breast Surgery

Breast Revision or Secondary Breast Surgery is performed to correct unsatisfactory results, repair complications or improve upon the results of a previously performed breast procedure (breast augmentation or breast implant surgery; breast lift or mastopexy;or breast reduction).

There can be many reasons a woman might consider Revisionary Breast Surgery. Even after proper planning and expert performance of a breast surgery, complications can occur or changes can occur over time, leading to the consideration of undergoing breast revision surgery. Common reasons might include:

• capsular contracture (scar tightening around an implant, “hardening of the implant”)
• implant deflation or leak
• desire to change breast size
• desire to change breast shape (natural changes or implant-related)
• desire to change implant type (e.g., saline vs. silicone, round vs. tear-drop)
• asymmetry
• implant malposition or shifting of the implant
• contour irregularity
• drooping, sagging or laxity
• irregularity of the nipple or areola

Your Personal Consultation

At the Zwiebel Center for Plastic Surgery, we understand that at woman’s decision to undergo breast surgery is highly personal and private. We will treat you in a respectful manner, and with utmost professionalism. We fully respect your privacy and will be very discreet during your confidential consultation with Dr. Zwiebel. Your questions and concerns will be addressed and your information will be treated with complete confidentiality. Dr. Zwiebel will advise you if you are a good candidate for breast revision surgery and determine what techniques are best for your unique situation. Dr. Zwiebel will educate you about the procedure and what to expect during your recovery.

Your Surgical Experience

For your privacy and safety, Dr. Zwiebel performs breast revision surgery as an out-patient procedure in our nationally accredited surgical suite. Our facility is specially designed to provide you the privacy and confidentiality you desire, with the discreet and personal attention of our dedicated professional staff.

For your comfort, breast revision surgery is usually performed with intravenous sedation (“twilight anesthesia”). Because we use fast-acting modern sedation techniques, you will be asleep and unaware during the entire procedure, yet awaken quickly and refreshed, at the conclusion of the procedure. Long-acting local anesthetics will be used for your continued comfort. The technique and design of the procedure is individualized to improve the shape and symmetry of the breasts, with attention to optimize healing and scarring. Dissolving stitches are usually used.

Recovery and Follow-Up

Care A good recovery starts with good pre-op preparation. During your pre-op visit, we will provide you with detailed post-op instructions appropriate for you and your specific breast revision procedure. We encourage you and your planned post-op caregiver to read these post-op instructions thoroughly in advance of your surgery date, so you can be well prepared for an uneventful and comfortable recovery. We will provide you with all the needed prescriptions so you may have them filled and prepared prior to your surgery day.

Don’t overlook the importance of good nutrition: protein is the building block of healing and immunity. We will provide you with recommendations for vitamins and supplements to optimize healing. Probiotics play an important role in bolstering immunity and avoiding gastro-intestinal side effects of antibiotics.

To guide you through your recovery and optimize your results, Dr. Zwiebel and his staff will schedule regular post-op visits to monitor your healing and answer your questions.

Expect to be sore for a few days after the procedure. Post-op care includes careful local hygiene and dressing changes. Plan to wear comfortable loose-fitting clothing. Most women return to work and most normal daily activities within a few days following a breast revisionary procedure. It is critical to allow adequate time for proper healing and for your comfort. For certain breast revisionary procedures, you may have to abstain from strenuous or high impact activities like running/jogging, or big arm swinging (like tennis or golf) or repetitive motions (like vacuuming, sweeping) for six weeks.

Your Research

We would like to emphasize that breast enhancement is a surgical procedure and, as such, carries with it some risk. We encourage all patients to learn as much about the process before undergoing the procedure. Our patients should gather as much information as possible and also direct questions to our friendly staff. Unlike most practices, breast implants patients will be provided with anesthesia pumps following an operation. An anesthesia pump drips local anesthetic into the treatment area for several days and numbs the surgical site to reduce pain and the need for other pain medication. In Denver, breast augmentation patients are much more comfortable with this device and have experienced easier recovery.

Next Steps

To learn more about breast revision surgery and find out if you are a candidate for a breast revision procedure, call our office today at (303) 586-3931 and schedule your private consultation with Dr. Zwiebel. You can feel confident you will be in good hands with Dr. Zwiebel, recognized for his expertise, experience and reputation for excellence in the field of Plastic Surgery.

We look forward to meeting you and answering your questions about your breast surgery.