It is no surprise that many women are preoccupied with body image. According to one American study, approximately 80-90 percent of women dislike their bodies.

The perception of our bodies begins at a very early age in life. Childhood messages about our bodies form the foundation of our body image later in life. The way family members react to the changes we encounter and comments from others is an important part of how our body image develops. How we perceive and internalize these childhood messages about our bodies determines our ability to build self-esteem and confidence in our appearance.

Body image is an individual’s perception of his/her physical self. It is the mental picture a person has of their body, as well as the individual’s associated thoughts, feelings, judgments, sensations, awareness and behavior. Body image is not a static concept. It is developed through interactions with others and the social world.

Thus, what society holds up as ideal is often what women strive for. Preferences for body shape vary over time and among all cultures. Historically, most societies have associated extra weight in women with desirable social status — an overt sign of wealth when food was not abundant. “Rubenesque” women were considered the epitome of femininity and beauty.

Because women today are inundated with beautiful faces and “perfect” bodies, we must strive to maintain a realistic and healthy body image. A healthy body image is evident when a person’s mental picture of her body is accurate, and her feelings, assessment and relationship toward her body are positive, confident and self-caring.

Healthy body image is more than the absence of struggles around food, weight or appearance. It is having the support and resources necessary to: 1) care for the body;
2) find outlets for self-expression; 3) develop confidence in one’s physical abilities and capacities; and 4) develop a positive self-concept.

Women today have resources to help them resist negative environmental messages, the most important being education and the awareness that we are all unique individuals. Good nutrition and regular exercise help to keep us both physically and mentally fit, as well as promotes a healthy body image. And sometimes cosmetic surgery is appropriate to help women feel better about their bodies and looks in general

Women who already have a healthy body image and desire to enhance, but not change their appearance, will generally benefit the most from cosmetic surgery. Striving for improvement — not perfection — is the key. Women who have realistic expectations can greatly improve their body image with appropriate cosmetic surgery. Of course, before having any cosmetic surgery, you should discuss any questions or concerns, as well as your expectations, with your physician.

It’s not about looking like a movie star or a runway model. It’s about being accepting and nurturing of the body you have. Since a healthy body image is directly related to self-esteem, it is important that women understand that the images in the media have nothing to do with realistic expectations. After all, what could be more beautiful than a woman confidant about her appearance, both inside and out!

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Diane Gibby, M.D., P.A., F.A.C.S
Dr. Diane Gibby is board-certified by the American Board of Plastic Surgery and the founder of The Women’s Center for Cosmetic and Plastic Surgery. Dr. Gibby’s office is located at Medical City Dallas, Building C, Suite 820, (972) 566-6477. Individuals interested in brochures or names of qualified plastic surgeons in their area may call the American Society of Plastic and Reconstructive Surgeons at 1-800-635-0635.

Sagging or loose breasts are sometimes the result of pregnancy, changes in weight, or due to the natural aging process. The breast lift, or mastopexy, is a procedure that elevates and reshapes the sagging breast.
Breasts are carefully marked in an anchor-shaped form to indicate where the incisions are to be made. The anchor-shaped incision follows the natural contour of the breast, outlines the area where the breast skin will be removed, and defines the new nipple location.

Excess skin is removed and the nipple and areola are moved to a higher position appropriate for the woman’s chest wall proportions. The skin around the areola is brought down to shape the breast.

Stitches are placed around the areola, in a vertical line extending down from the nipple, and along the lower crease of the breast.

Some patients, especially those with small breasts and minimal sagging, may be candidates for less extensive procedures, such as the “doughnut (or concentric) mastopexy,” in which circular incisions are made around the areola, and a doughnut-shaped area of the skin is removed.

A breast augmentation may be performed at the same time as a mastopexy. If an implant is inserted at the time of the breast lift, it will be placed in a pocket directly under the breast tissue or under the muscle of the chest wall.

On the other hand, some women may prefer to have their breasts made smaller, or reduced, at the time of the breast lift. A reduction-mastopexy can be performed through the same operative incisions.
Following surgery, an elastic band or a support bra is worn over gauze dressing. The bra is worn for the patient’s comfort for about three to four weeks.

Before proceeding with a breast lift, it is important to have a thorough understanding of the options available and to discuss any questions or concerns you might have with your doctor. Every patient is unique and her specific needs should be addressed

Diane Gibby, M.D., P.A., F.A.C.S.
Dr. Diane Gibby specializes in breast and body contouring surgery to help women look and feel their best. She is board-certified by the American Board of Plastic Surgery and the founder of The Women’s Center for Cosmetic and Plastic Surgery, where her practice is based on caring service from a woman’s perspective. Dr. Gibby’s office is located at Medical City Dallas, Building C, Suite 820. For a free brochure or to schedule an appointment with Dr. Gibby, call (972) 566-6477, or log onto www.drgibby.com. Complimentary consultations with Patient Coordinator available.

Once a woman decides on breast augmentation the next decision is often what size implant to use. This is a very important and personal choice and should be considered carefully. Some women desire a very subtle look while others want a more dramatic contour. Body shape, weight, height, and size of breasts prior to augmentation should also be considered when considering implant size.

Never look at someone else’s choice of implant in making your final decision. It’s what you start with…plus what you add, superimposed upon the shape of your own body that determines your final results. The same size implant may look completely different on another person. Formulas, standards, and comparisons may work in theory, but it is not uncommon to ask two women with exactly the same size breasts what size they are, and for one to say she is a C cup, while the other is positive she is a D. Breasts size is often “in the eye of the beholder!” Also, bra cup size varies between manufacturers, styles and how you wear your bra.

I suggest that my patients come to the office with photographs of the size breasts they wish to have, as well as pictures of breast sizes that they do not want. This helps eliminate all but a certain range of sizes and also gives me a good visual idea of what my patient’s goals are for surgery. When deciding on implant size It is also important to consider that as the implants settle they usually look slightly smaller.

Once breast size has been determined, saline filled implants are used to increase breasts to that desired size. This procedure is performed either in an office facility, outpatient surgical center, or hospital, and may be performed under general, or local anesthesia with IV sedation. The incision necessary for the implant can be made in the crease at the lower breast fold, around the areola, or in the armpit.

Working through the incision, the breast tissue and skin will be lifted to create a pocket either directly behind the breast tissue or underneath the chest wall muscle.

Placing the implants behind the chest muscle may reduce the potential for capsular contracture. This placement may also interfere less with breast examination by mammogram than if the implant is directly behind the breast tissue.

The surgery usually takes one to two hours to complete. Stitches are used to close the incisions, and a gauze bandage is applied over the breast. The patient will probably feel tired and sore for a few days following surgery, but should be up and around in 24 to 48 hours.

Stitches are removed in five to seven days, but the swelling in the breasts may take several weeks to disappear. A woman should be able to return to work within a few days depending on the level of activity required at her job.