Plastic surgeons in the Phoenix area say they are seeing a dramatic uptick in the number of individuals who are coming in during tax season, using their tax refund check to cover all or part of a procedure.

Kristy Harris in Phoenix chose to use her tax refund to pay for part of her breast lift surgery and used some savings to cover the rest of the $8,400 procedure (cost based on patient-reported averages on RealSelf.com). The mother of two said that raising children took a toll on her body and she wanted to do something to help herself achieve a “different look.”

Another popular procedure for the breasts is breast augmentation, which costs approximately $6,600. This surgery can improve shapeliness and body proportion.

Liposuction remains one of the most sought-after body procedures and costs about $5,600. Liposuction is often performed to remove stubborn fat deposits nearly anywhere on the body.

Even if your tax refund check is a bit smaller than you would hope, non-surgical treatments are available at a fraction of the cost of surgery. The ever-popular Botox, is used to reduce lines and wrinkles on the face. Chemical peels are also non-invasive and remain one of the key facial rejuvenation treatments and work to reduce many skin imperfections like a dry, dull complexion, blemishes and pigmentation issues. Botox and chemical peels cost about $472 and $610 for full treatments, respectively.

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Erica, who underwent breast augmentation for what she called her “zero” breasts, actually an A-cup, said that her silicone gel implants made her feel like she had “the Bentley of boobs.” As an alternative to silicone implants similar to Erica’s, saline implants, which may feel less natural, are available at a lower cost. As well as the implant type, other options include the size, shape, placement and the location of incisions.

Another woman, Jeanne, underwent a breast reduction due to her D-cup sized breasts that caused back, neck and shoulder pains on her small frame. More than just the associated pain, she also experienced indentations from her bra straps and had difficulty finding clothing that fit comfortably. In the type of breast reduction procedure that Jeanne underwent, the surgeon removes excess skin and tissue that add weight to the breasts and often moves the nipple areola to a more youthful position.

In addition to the cosmetic breast augmentation and reduction procedures, breast lifts are often performed to lift breasts that have begun to sag over time or after weight loss. While excess skin is removed and the nipple areola often moved in a breast lift, implants may also be used to restore breast fullness.

According to study results, performing breast surgery in an ASC rather than a hospital saved 69 minutes on average, and most of the time savings was attributable to decreased preoperative time, or time spent preparing for surgery.

Key time-saving advantages of the ASC include:

• Avoidance of unscheduled surgeries, such as add-on cases and emergency cases common in hospitals
• Better case flow as a result of having a surgeon assigned to a single room in the ASC
• Smaller, more consistent ASC staffing
• Smaller physical ASC facility that makes it easier to move patients and equipment

The study also concluded that while the type of anesthesia used during surgery can also affect recovery time immediately following surgery, this did not significantly affect overall surgical time from the preparation stage to the patient discharge stage.

Hospital vs. ASC study details

In 2005, the study authors’ ASC facility was closed, which forced all outpatient breast surgeries to be performed alternatively in a hospital setting.

Study authors Drs. Terrence Trentman, Jeff Mueller, Richard Gray, Barbara Pockaj and Daniel Simula compared the surgical records of 92 patients who had breast surgery in an ASC facility between January 2004 and December 2005 with the surgical records of 92 patients who had breast surgery in a hospital facility starting January 2006.

All study subjects were female patients of similar age, with similar recovery room times, and each breast surgery procedure was performed by the same two salaried surgeons who did not receive additional bonus pay for productivity.

ASC pre-op vs. post-op

In addition to concluding that ASC facilities offer significant preoperative time-savings, the results of the study also suggest that breast surgery patients spend an almost identical amount of time in an ASC as in a hospital once they reach the operating room.

What causes breast ptosis?

Breast ptosis is caused by a combination of factors including large breast size, aging, and gravity.  Large breasts may be gradually pulled down by gravity and the skin becomes thinner and less elastic with age.

A recent study sheds light on the lifestyle factors that contribute to breast ptosis.  Plastic surgeons at the University of Kentucky found that age, significant weight loss, higher BMI, larger bra cup size, number of pregnancies, and smoking were found to be significant risk factors for breast ptosis, while “breast-feeding, weight gain during pregnancy, and lack of participation in regular upper body exercise were not found to be significant risk factors.”

Evaluating Breast Ptosis

Plastic surgeons often measure breast ptosis using the Regnault classification, which is as follows in simplified form:

1. Pseudoptosis – the nipple falls above the fold, but the breast is hypoplastic and hangs below the breast crease.

2. Glandular Ptosis – the nipple is above the fold, but the breast hangs below the crease.

3. Minor Ptosis – the nipple is level with the breast crease.

4. Moderate Ptosis – the nipple is below the breast crease, but above the lower breast contour.

5. Severe Ptosis: the nipple is below the breast crease and below the lower breast contour.

Correcting Breast Ptosis

Using the classification system above, a surgeon can recommend the right procedure to correct breast ptosis.  Surgery to correct minor ptosis may be quite different from the procedure to correct a severe case of ptosis.  The usual procedure of choice is breast lift surgery / mastopexy.

During such procedures, some patients may benefit from a breast lift, when down sizing or after weight changes.  Over time, skin loses its elasticity, which requires excess skin to be removed and/or tightened.  The amount and degree are determined by the patient’s desired breast size and the amount of elasticity remaining in your skin.

Site location, above or below the muscle, as well as the type of implant (saline or silicone) will also determine the appropriate procedure and your final result.  In some circumstances, patients may not need a lift and instead may benefit from a site change.