Breast:
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Breast Augmentation:
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Breast augmentation, also known as augmentation mammaplasty, is a surgical enhancement procedure that accentuates the size and shape of a woman’s breasts. Breast augmentation offers a tremendous improvement for patients who simply desire a fuller profile, or who have lost breast volume due to pregnancy. While breast augmentation will make the breasts larger, this surgery will not correct severely sagging breasts (see breast lift surgery).
Reasons to consider Breast Augmentation:
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Enhance the size of the breasts
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Increase breast volume after pregnancy and nursing
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Create symmetry between breasts of different size
General Procedure:
Breast augmentation involves making a small incision to insert a breast implant under the breast tissue in order to enlarge the breast. The surgery is commonly performed on an outpatient basis at a hospital or state-of-the-art surgical center with the patient under general anesthesia. There are several possible locations for the small incision that will be used for inserting the breast implant. The most frequent technique utilizes an incision made in the lower portion of the breast, beneath the fold. Another technique makes an incision beneath the areola (the darker skin surrounding the nipple). A third, less frequently used incision, involves making an incision in the armpit. The best technique is individualized, and will be decided upon between the patient and the surgeon during the consultation.
During surgery, the breast tissue is raised to create a pocket under the breast tissue or beneath the chest wall (pectoral) muscle. Inserting an implant behind each breast can increase a woman’s breast size by one or more bra cup sizes. The breast implant may be filled with silicone gel or saline. Both of these are proven to be extremely safe and the final choice will be made after thorough discussion between the patient and surgeon prior to surgery. Surgery typically lasts from 1 to 3 hours.
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| Another view of the most common incision used in breast augmentation. |
Recovery Process
Detailed instructions will be given to the patient prior to surgery. In general, it is important to get plenty of rest and limit arm movement after surgery in order to speed up the healing process and recovery time. Supportive bandages are placed over the breasts after surgery and usually worn for one week. Discomfort will be treated with oral pain medications, and usually improves rapidly over the next few days. Breast swelling will be present initially and will diminish completely over the next few weeks. While complications are infrequent, it is important to review the potential risks with your doctor. Patients can help minimize potential problems by carefully following the directions given to them after surgery.
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Breast Lift:
As a woman ages, the breasts begin to lose their youthful shape, position, and firmness. Descent of the breasts is a natural process that occurs over time due to the effects of aging and gravity. A breast lift, also known as a mastopexy, is a procedure designed to elevate and reshape sagging breasts allowing the restoration of a more youthful appearance. This procedure is more complex than augmentation and thus takes more time to complete. A breast lift may also be performed in conjunction with breast enlargement surgery (breast augmentation).
Reasons to choose a breast lift:
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Lift sagging breasts caused by the effects of aging and gravity
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Firm the breasts if they have lost substance due to pregnancy and breast feeding
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After massive weight loss, a breast lift, with or without an implant, will restore the natural suppleness of the breasts
General Procedure:
The breast lift procedure may be performed utilizing various techniques depending on your breast shape, how much the breasts droop, and how much enhancement you desire.
A popular procedure involves an anchor-like incision along the underside of the breast. The incision goes around the areola as well. The excess skin is removed and the remaining breast tissue, nipple, and skin are repositioned.
There are several other popular techniques that are tailored to specific breast shapes. Some of these include the “short-scar”, “periareolar” and “Passot” breast lifting techniques. After examination, the surgeon will discuss the options most suitable to meet your needs and expectations.
Recovery Process:
Detailed instructions will be given to the patient prior to surgery, but generally call for plenty of rest and limited movement in order to speed up the healing process and recovery time. Bandages and a support bra are placed on the incisions after surgery. The specialized bra will be worn for several weeks. No under wire bra is used during this process. Discomfort will be treated with oral pain medications. This improves after several days. The breasts are swollen initially and will improve gradually during the recovery process. While complications are infrequent, it is important to review the potential risks with your doctor. Patients can help minimize potential problems by carefully following the directions given by the physician prior to surgery.
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Breast Reduction:
Breast reduction, or reduction mammaplasty, is an enhancement procedure that reshapes and reduces the size of the breasts in order to make them smaller, lighter, and firmer. Large breasts can cause physical pain as well as emotional and social anxiety. Reduction is accomplished by removing excess fat, breast tissue, and skin, then redraping the breast envelope. Women who undergo a breast reduction procedure find that they are able to lead a healthier, more comfortable life.
In some cases, breast reduction surgery may be covered by your insurance company. Women with very large breasts, frequent infections or rashes under the breasts along with documented neck and shoulder pain may be candidates for insurance coverage.
Reasons for choosing a breast reduction:
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Back, neck or shoulder pain caused by heavy breasts
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Correcting sagging, or pendulous, breasts with downward facing nipples
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Restriction of physical activity due to the size and weight of the breasts
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Painful bra strap marks and/or rashes as a result of large breasts
General Procedure:
Techniques for breast reduction vary; however, the most common procedure involves an anchor-like incision along the underside of the breast and around the areola as well. The excess skin and breast tissue is removed. The remaining breast tissue, nipple, and skin is repositioned and tightened.
There are several other popular techniques that are tailored to specific breast shapes. After initial consultation with the surgeon, the most suitable procedure will be determined.
Of all plastic surgery procedures involving the breasts, the reduction results in the quickest body-image improvement. Patients are pleased with the elimination of physical pain as well as a better proportioned chest, enhanced appearance, and better fitting clothes.
Recovery Process:
Detailed instructions will be given to the patient prior to surgery, but generally call for plenty of rest and limited movement in order to speed up the healing process and recovery time. Bandages and a support bra are placed on the incisions after surgery. This specialized bra will be worn for several weeks. No under wire bras are used during this process. Any discomfort will be treated with oral pain medications. This improves significantly after two or three days. The breasts are swollen initially, and healing can take up to 4-6 weeks. While complications are infrequent, it is important to review the potential risks with your doctor. Patients can help minimize problems by carefully following directions after surgery.
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Breast Revision Surgery:
Some women who have had prior cosmetic or reconstructive breast surgery may develop unsatisfactory results or changes in their breasts over time. If a woman is not satisfied with her previous breast surgery or reconstruction, there are many options available for revision. After your consultation, a plan to correct your concerns will be discussed between you and the surgeon. This treatment strategy is tailored to each patient’s specific needs.
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Breast: Reconstruction
Reconstruction After Mastectomy (removal of the breast tissue):
Breast reconstruction is a surgical procedure that restores shape and fullness to a breast that has been removed for medical reasons. There are two basic categories of breast reconstruction: Implant reconstruction or "own tissue" reconstruction. All types of breast reconstruction are covered by your insurance company, including any procedures to the unaflicted breast to restore balance and beauty.
Implant reconstruction uses prosthetic breast implants to reshape the breasts. First, a tissue expander is placed under the chest skin and muscle. A tissue expander is like a balloon that is slowly (over several weeks) filled with saline until the desired size and fullness are achieved. Once this is accomplished, the tissue expander is removed and a silicone gel or saline implant is placed in the pocket created by the tissue expander. This procedure can be done at the same time as your mastectomy (immediate reconstruction) or a period of time after your mastectomy (delayed reconstruction). This is agreed upon and arranged prior to the mastectomy in conjunction with you and your general surgeon.
A second option for breast reconstruction following mastectomy is called, autologous tissue "or own tissue" transfer. This involves moving muscle, fat, and skin from a separate location back into the area from which the breast was removed in order to restore breast fullness. There are several muscles that can be used to achieve this type of reconstruction. Most commonly, your back muscle (Latissimus) or your belly muscle (Rectus) is used for this purpose. Some women may not qualify for this type of procedure depending on their body shape, medical condition, or smoking history. This more extensive operation is associated with a longer recovery and convalescence time, but may be ideal for some women. All of this information will be reviewed during a thorough discussion with your surgeon.
Breast reconstruction of any type will not recreate the exact look and feel of your natural breast. However, the contour of your new breast may restore a silhouette similar to what you had before or may even be larger and firmer than your original breasts. Get all the information you need to know about breast reconstruction. Find out more, click here: Breast Reconstruction.org.
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Nipple-areola Complex Reconstruction:
After reconstruction of the breast mound is complete, the next step is to recreate the nipple and the areolar complex (darker skin around the nipple). This new nipple will not have the sensation of your original nipple. However, this will often restore a women’s sense of completeness by achieving the desired nipple projection and appearance similar to that of her original nipple and areola.
General procedure:
A small area of skin on the reconstructed breast is lifted and fashioned to resemble a nipple. Next, A piece of skin, usually from the darker pigmented area of your inner thigh, is removed and sutured into position on your new breast. The result is a nipple and a darker areola positioned over the new breast. A dressing that secures this newly created nipple is placed over the area and remains in place for 3 to 5 days without being removed. After this time period the patient returns to the office for removal of the dressing. Over the next several weeks you will be instructed on how to care for the healing nipple and areola.
Recovery process:
The inconspicuous area on the inner thigh is closed with absorbable sutures, so there is little recovery time and maintenance needed for this to heal. There is minimal pain associated with this procedure. The time for recovery depends on how fast the new nipple heals. Patients generally return to a normal lifestyle after about one week.
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Nipple Tattooing:
This is a procedure that simply recreates the appearance of an areola and nipple by a darker colored tattoo. There is no projection with tattooing. This is a good option for women who do not want to undergo a nipple areola complex reconstruction.
General procedure:
The patient will come to the office and have the tattoo designed on the skin of the reconstructed breast by our aesthetician.
Recovery process:
This is done in the clinic and there is no “down time”. This procedure does require routine post-tattoo care to the site.
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