Breast Augmentation/Reduction

Breast augmentation is designed to increase the size of small or underdeveloped breasts. Breast surgery can also restore and enhance your breast volume if it has decreased as a result of pregnancy and breast feeding. In addition, breast implants can serve one or more of a number of purposes; breast cancer victims can use breast implants for reconstructive purposes after mastectomy, or women with asymmetrical breasts may use a single breast implant to balance the difference in size.

 

Procedure

 

Breast surgery recovery time varies from patient to patient, but you should plan on taking 1 week off work. Breast surgery is performed under a general anesthetic, given by an anesthetist, in an accredited hospital, so you are assured of the highest standard of care

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Your plastic surgeon will examine your breasts and perhaps take photographs for your medical record. He or she will consider such factors as the size and shape of your breasts, the quality of your skin and the placement of your nipples and areolas (the pigmented skin surrounding the nipples). If your breasts are sagging, a breast lift may be recommended in conjunction with augmentation.

 

You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries including breast biopsies, and medications that you currently take. You will be asked whether you have a family history of breast cancer and about results of any mammograms. It is important for you to provide complete information.

There is no scientific evidence that breast augmentation increases the risk of breast cancer. The presence of breast implants, however, makes it more technically difficult to take and read mammograms. This may be a special consideration for women who perhaps are at higher risk for breast cancer because of their family history or other reasons.

 

Placement of the implant underneath the pectoral muscle may interfere less with mammographic examination, but other factors may also need to be considered with regard to implant placement. Your plastic surgeon will discuss this with you.


If you are planning to lose a significant amount of weight, be sure to tell your plastic surgeon. He or she may recommend that you stabilize your weight prior to undergoing surgery.


If you think that you may want to become pregnant in the future, you should mention this to your surgeon. Pregnancy can alter breast size in an unpredictable way and could affect the long-term results of your breast augmentation. There is no evidence that breast implants will affect pregnancy or your ability to breast-feed, but if you have questions about these matters, you should ask your plastic surgeon.

 

There are three common incision sites for the insertion of breast implants:

• under or in the breast fold – inframammary

• around the nipple – periareolar

• Through the armpit – transaxillary.

Breast augmentation is not simply about achieving bigger breasts; it can enhance the breast contour as well as size, and may give your body a more harmonious balance by making it more proportional.


It can also correct and dramatically improve your breast balance if you have breasts of different sizes or shapes – a very common problem – or if you have lost breast shape due to breastfeeding or simply getting older.

 

Types of implants

 

Breast implants come in many shapes and sizes, and are made with a range of materials. The outer, pliable shell of an implant is thin, solid silicone and the surface may be either smooth or textured. A textured surface lessens the formation of scar tissue around the implant, while smooth-surface implants have a slightly softer shell and are less likely to be felt through the skin and tissue.


Breast implant shells are filled with either saline or silicon. Saline naturally comprises most of the human body, so if the implant should leak (this occurs in less than 5% of implants) its fluid can be easily and safely absorbed. Silicone is one of the most intensively researched materials used in medicine and has been subjected to extensive safety testing. It has been scientifically proven that silicone gel implants carry no increased risk of:

 

• breast cancer

• autoimmune diseases

• risks when breast-feeding

 

Complete recovery is generally achieved after 6 weeks. You will experience the most discomfort at the beginning of your recovery period, in the 24 to 48 hours after surgery. Your breasts will be swollen and tender, although this will settle quickly. Mild bruising will fade over 5 or 6 days. A small amount of swelling may remain for 3 to 5 weeks. The gauze dressings over your incisions can be removed after 3 days and then you may shower.


You can resume light activities within 48 hours.
You can resume regular activities within a week.
Do not undertake any strenuous activities for 4 weeks.
Do not undertake chest or weights exercises for 6 weeks.
You may experience a burning sensation in your nipples for 1 to 2 weeks, but this will gradually subside.
Your breasts will probably be sensitive to direct stimulation for 2 to 3 weeks, so avoid too much physical contact.
Your scars will be firm and pink for at least 6 weeks. After several months, your scars will begin to fade, although they will never disappear completely.
Due to the personal nature of breast surgery, these recovery time frames should be used as a guide only.

 

Breast reduction  


Patients with excessively large pendulous breast benefit by this surgery. In this operation, the size of the breast is reduced by removing excess fat, breast tissue and skin from the breast. The nipple is relocated higher and the breast is reshaped and contoured and given proper shape and a younger look. Large breasts lose shape and firmness, the upper pole becomes empty and the nipples point downwards. Breast reduction surgery restores the firm feel and round contour of the breast, brings back fullness in the upper pole, and re-positions the nipples to point forwards and outwards. 

 

Procedure

 

Breast reduction can be performed at any age, but plastic surgeons usually recommend waiting until breast development has stopped. Childbirth and breast-feeding may have significant and unpredictable effects on the size and shape of your breasts. Nevertheless, many women decide to undergo breast reduction before having children and feel that they can address any subsequent changes later. If you plan to breast-feed in the future, you should discuss this with your plastic surgeon.


During the consultation, you will be asked about your desired breast size as well as anything else about your breasts that you would like to see improved. This will help your plastic surgeon to understand your expectations and determine whether they realistically can be achieved.

 

Your plastic surgeon will examine your breasts, taking measurements and perhaps photographs for your medical record. The size and shape of your breasts, the quality of your skin, and the placement of the nipples and areolas will be carefully evaluated.


You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries including breast biopsies, and medications that you currently take. It is important for you to provide complete information.


You should tell your plastic surgeon if you plan to lose a significant amount of weight, particularly if you have noticed that your breasts become smaller with weight loss. Your surgeon may recommend that you stabilize your weight before having surgery.

This surgery is done under general anesthesia and requires 1 or 2 days hospital stay.

 

Is it a safe Procedure?

 

Fortunately, significant complications from breast reduction are infrequent. Every year, many thousands of women undergo successful breast reduction surgery, experience no major problems and are pleased with the results. Anyone considering surgery, however, should be aware of both the benefits and the risks.


The subject of risks and potential complications of surgery is best discussed on a personal basis between you and your plastic surgeon, or with a staff member in your surgeon's office.

 

Some of the potential complications that may be discussed with you include bleeding, infection and reactions to anesthesia. Rarely, a patient may require a blood transfusion during the operation. This usually can be anticipated in advance, and your plastic surgeon may, under certain circumstances, advise you to donate your own blood in preparation for surgery.

 

Following reduction, sometimes the breasts may not be perfectly symmetrical or the nipple height may vary slightly. If desired, minor adjustments can be made at a later time. Permanent loss of sensation in the nipples or breasts may occur rarely. Revisionary surgery is sometimes helpful in certain instances where incisions may have healed poorly. In the unlikely event of injury to or loss of the nipple and areola, they usually can be satisfactorily reconstructed using skin grafts.


You can help to lessen certain risks by following the advice and instructions of your plastic surgeon, both before and after surgery.

 

After breast reduction surgery, it is often possible to return to work within just a couple of weeks, depending on your job. In many instances, you can resume most of your normal activities, including some form of mild exercise, after several weeks. You may continue to experience some mild, periodic discomfort during this time, but such feelings are normal. Severe pain should be reported to your doctor.


Any sexual activity should be avoided for a minimum of one week, and your plastic surgeon may advise you to wait longer. After that, care must be taken to be extremely gentle with your breasts for at least the next six weeks.

 

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