Cosmetic breast surgery is one of the most common operations performed by plastic surgeons in the United States. Women may seek to alter the appearance of their breasts for any number of reasons including a desire for larger breasts, a desire for more youthful-looking breasts, to improve breast symmetry, or to replace volume lost after childbirth and breast-feeding. Today more than ever, there many choices with respect to incision placement, the type of implant used (silicone gel or saline), and the location of the implant (above or below the muscle). A thorough understanding of the options available is critical to a successful result and a satisfied patient.
Breast Augmentation (augmentation mammaplasty)
Breast enlargement surgery involves several very important decisions. The implants can be filled with saline (salt water) or gel (silicone), the implants can be placed under the pectoralis muscle or directly underneath the breast gland, and the implants can be placed either through an incision underneath the breast or around the nipple. Most importantly, the decision to enlarge the appearance of one’s breasts is a decision that should be made only after careful consideration. For this final reason, every initial breast augmentation consultation involves speaking with the patient about both the risks and benefits of breast augmentation surgery. A second consultation is usually scheduled so that the patient has time to think about the information conveyed during the initial consultation and has the opportunity to try on implants by placing implant sizers in her bra. In addition, she has the opportunity to ask questions about the procedure.
Once the decision to have surgery is made, a surgical date is selected. The procedure itself is performed on an outpatient basis under general anesthesia and usually takes less than 2 hours. After the operation a supportive bra is worn for several days to weeks. The initial discomfort is controlled with local anesthesia given at the time of the operation and with oral medication. Patients may resume light activity after 1-2 days, but generally, most patients take a week off from work. Light exercise is permitted at two weeks. At first, there may be some swelling and bruising which temporarily affects the breast shape. Often, however, the final implant location “settles” after a few months. The final results of breast augmentation should only be judged three to six months after surgery.
Breast Lift (mastopexy)
Breast sagging (also known as ptosis [pronounced "toe-sis”]) often seems to be an inevitability that goes hand in hand with aging and breast-feeding. Breast lift surgery is designed to re-shape the breast, remove excess skin and to re-position the nipple to re-approximate that youthful breast position on the chest wall. As with breast augmentation, there are several techniques which can be used to achieve these results. In fact, breast lift surgery is often combined with breast augmentation.
Much like breast augmentation surgery, a breast lift is done under general anesthesia and takes 3-4 hours. Patients are advised to take one week off from work, but often feel well enough to begin non-strenuous exercise in two weeks; heavy exercise must wait for six weeks. Swelling and bruising are slightly more prominent than with breast augmentation but begin to improve within two weeks. The final outcome can be judged three to six months after surgery.
Breast Reduction (reduction mammaplasty)
Very large breasts (macromastia) can result in back pain, neck pain, and shoulder pain, grooves where the bra straps meet the neck and occasionally skin irritation beneath the breast skin. Breast reduction surgery can often alleviate many of these symptoms as well as improve one’s self-image.
This procedure is performed under general anesthesia and often takes from 3-5 hours depending on the degree of reduction. An anchor-type incision is made through the skin, the excess breast tissue removed, and the skin re-draped to produce the final breast shape. The final breast appearance and position are usually seen 3-6 months after surgery. Occasionally, breast reduction is performed in conjunction with other procedures such as a tummy tuck (abdominoplasty).
Just as each patient is unique, there are a myriad of possibilities when it comes to the problem of breast asymmetry. Simple breast re-shaping with or without the use of implants of various kinds enables the surgeon to individualize the outcome to your specific problem and body-type. Post-operative pain is usually mild and recovery relatively quick, but there can be wide variability depending upon the exact nature of the procedure performed.
For additional information about the surgical procedures discussed on this page, please contact our office.