Breast Plastic Surgery
Breast enlargement, or augmentation mammoplasty, enhances the body contour of a woman who is unhappy with her breast size. This procedure can also correct a reduction in breast volume after pregnancy or balance a difference in breast size. In certain cases where the breasts have sagging or droopiness, a simultaneous breast lift may be necessary.
During the procedure, an implant is inserted through an incision made in the inframammary fold (the crease under the breast) or around the areola (dark tissue around the nipple), or through the armpit. The implant may be placed under the breast tissue or beneath the chest wall muscle or we may use the newer technique of subfascial augmentation, which means that the implant is placed under the fascia of the muscle. Women may choose to have saline or silicone implants, although nowadays we tend to use only silicone implants.
Breast augmentation is an outpatient procedure which usually takes 1-1.5 hours under sedation or general anesthesia. Stitches are absorbable but the incisions are usually covered with tape for 1-2 weeks. Most patients return to routine activity within the first week but aerobic activity and strenuous upper body activity are limited for 3-4 weeks.
Breast reduction, or reduction mammoplasty, is for a woman experiencing health problems and/or extreme self-consciousness associated with very large, heavy breasts. Medical problems associated with large breasts include back and neck pain, caused by the excessive weight, skin irritation, bra strap indentations, poor posture and interference with normal daily activities, such as exercise.
The surgery removes fat, glandular tissue, and skin from the breasts, making them smaller, lighter, and firmer. It can also reduce the size of the areola, the darker skin surrounding the nipple. This can alleviate the health problems associated with large breasts and improve a woman’s confidence in her appearance.
Breast reduction surgery is an outpatient procedure. It is done under general anesthesia and typically takes 2-3 hours. The scars go around the areola and straight down only. The most modern technique “the vertical reduction” eliminates the long scar in the inframammary crease which had caused a lot of problems in the past. The new technique provides also better shape to the breast, less bleeding, less pain and more longevity. Patients will need to limit strenuous upper body activity and wear a sports bra for few weeks after surgery.
A mastopexy or breast lift will raise and reshape a woman’s breasts. Over the years breasts can lose their shape and firmness due to pregnancy, nursing, weight fluctuations and gravity. A breast lift, often done in conjunction with a breast augmentation, can eliminate this inevitable sagging. If the nipple areola complex has become enlarged, it can be restored to a smaller size at a preferred height on the breast.
A mastopexy is done under general anesthesia and takes 2-3 hours.
Incisions extend around the areola and as a vertical line down the lower pole of the breast. Through these incisions excess skin is removed and the nipple areola complex is elevated to a more central position on the breast mound. Strenuous upper body activity may be limited for the first month and often a supportive bra is worn around the clock for the first several weeks.
Correction of Gynaecomastia
Gynaecomastia is a medical problem that occurs in the male population. Basically is the abnormal fat concentration in the male breast area or the hypertrophy of the male breast gland or the combination of both. Gynaecomastia may be diagnosed during childhood or early adolescent. Most often it subsides and disappears during adulthood. In case the problem remains or reoccurs later due to weight gain, anabolic or steroid use and specific medication use it can be treated with different procedures. In rare cases gynaecomastia may appear due to other medical problems or in rare syndromes, which are investigated and excluded before surgery.
Usually correction of gynaecomastia is performed with liposuction of the male breast area. Using very small incisions, excess fat is aspirated. Postoperatively patients will need to wear a sports bra for few weeks. In some cases liposuction may not be enough and excision of the hypertrophic male gland is necessary, through a small incision in the areola. The above procedures are performed on an outpatient basis, under sedation or light general anesthesia.