Procedures >> Breasts
Breast Augmentation is the surgical placement of breast implants to increase fullness and projection of the breasts or to improve symmetry of the breasts. In general, it is a cosmetic procedure strictly performed to fulfill your personal desire for fuller breasts or to restore breast volume lost after weight reduction or pregnancy. Your plastic surgeon performs breast augmentation using implants made of a silicone shell filled with saline solution. Should the implant rupture or leak, the saline is safely absorbed by the body and poses no health hazard. Implant placement, type and size will be determined based on your breast anatomy, body type and desired increase in size, as well as your plastic surgeon's judgment. Breast implants have not been shown to impair breast health. However, breast implants are not guaranteed to last a lifetime and maintenance is required. This includes mammograms and possibly replacement of one or both implants over the course of the patient's lifetime. Incision sites include infra mammary (near the crease under the breast), axillary (in the underarm area), periareolar (in the pigmented skin around the nipple), or transumbilical (through the navel). Incision patterns vary based on the type of implant, degree of enlargement desired, patient anatomy, and patient and surgeon preference. Through the incision a pocket is created usually directed beneath the pectoral muscle (submuscular). Breast augmentation is performed in an outpatient setting under general anesthesia. Initial healing may include swelling and discomfort which are controlled with pain medication and a muscle relaxant. Arm movement is limited the first few days, and most people are able to resume to normal life activities at 7 to 10 days.
Breast Lift
Breast lift, technically called mastopexy, is a surgery to uplift and improve the shape of a female breast that sags or is pendulous, has lost firmness, and has stretched skin and an enlarged areola. Incision patterns for a breast lift are determined based on the amount of excess skin, skin elasticity, and degree of lift necessary to achieve realistic goals. The incisions may include a circle around the areola, a line extending down the lower portion of the breast from the areola to the crease underneath the breast and a line along the crease under the breast. Once the excess skin is removed, the breast tissue is reshaped and lifted, and the remaining skin tightened as the incisions are closed. Incision lines are permanent, but in most cases will fade and significantly improve in appearance over time. Surgery is performed in an outpatient setting under general anesthesia. Swelling and discomfort is common, but can be controlled with medication. Use of the arms is limited the first few days, but most people can generally return to normal activities within 7-10 days.
Breast Reduction
Breast reduction is a surgical procedure to reduce the size of large pendulous breasts that are disproportionate to a woman's body and can cause physical pain. A breast reduction reduces the breast size, improves shape, and reduces symptoms including back, neck and shoulder pain. Some health insurance companies cover breast reduction. This can vary depending on the amount of tissue that needs to be removed, patient's symptomatology, and various health insurance criteria. Breast reduction reduces the size and improves the shape and position of overly large, pendulous breasts through the surgical removal of excess breast fat, tissue and skin. This includes repositioning the nipple and reducing the size of the areola if necessary. The most common incision used for breast reduction is the keyhole pattern. This begins around the areola, continues vertically down the breast and then horizontally along the crease under the breast. Although permanent, incision lines are scars that usually fade and improve in appearance over time. Breast reduction is generally performed in an outpatient setting under general anesthesia. Arm movement is limited the first few days, and most people are resuming normal life activities in approximately 14 days.
Breast Reconstruction
Breast reconstruction is achieved through several reconstructive plastic surgery techniques that attempt to restore a breast to near normal shape, appearance and size following mastectomy and may include flap techniques that reposition a woman's own muscle, fat and skin to create or cover the breast mound, tissue expansion that stretches healthy skin to provide coverage for a breast implant, surgical placement of a breast implant to create a breast mound, and grafting and other specialized techniques to create a nipple and areola. While breast reconstruction can effectively rebuild a woman's breast, it will not have the same sensation and feel as the breast it replaces. Visible incision lines will always be present on the breast, whether from reconstruction or mastectomy. In addition, flap techniques will leave incision lines at the donor site, common ly located in less exposed areas of the body such as the back or abdomen. A TRAM flap (transverse rectus abdominus myocutaneous) uses donor muscle, fat and skin from a woman's abdomen to reconstruct the breast. A latissimus dorsi flap uses muscle, fat and skin tunneled under the skin and tissue of a woman's back to the reconstructed breast. A breast implant can be an adjuct or alternative to flap techniques. Reconstruction with an implant alone usually requires tissue expansion. An expander placed beneath the chest muscle is filled with sterile saline solution over many weeks, creating enough healthy tissue to cover the breast mound. Once filled, the expander forms the breast mound, or it is surgically replaced with an implant. Initial healing from breast reconstruction will include swelling and discomfort at the donor site for flap techniques. Medication will be prescribed to control the discomfort. Recovery can vary greatly dependent upon the type of reconstruction performed. This can range from several days to several weeks.