Plastic Surgery Cosmetic Surgery

Breast reconstruction is a surgical procedure to restore the appearance of a breast for women who have had a breast removed (mastectomy) to treat breast cancer. The surgery rebuilds the breast so that it is about the same size and shape as it was before it was removed. The nipple and areola (the darker area surrounding the nipple) can also be added. Most women who have had a mastectomy can have reconstruction. Women who have had a lumpectomy usually do not need reconstruction. Breast reconstruction is done by a plastic surgeon.
This information is designed to give you the facts you need to make an informed decision about breast reconstruction. It will help you better understand the process and the words used when talking about breast reconstruction. The words in italics are further explained in the glossary at the end of this information.
The decision to have breast reconstruction is a matter of personal choice. Learn as much as you can about the process before making a decision. No single source of information can provide every fact or give you all the answers. You and those close to you should discuss any questions and concerns about reconstructive surgery with your health care team.

Why do women consider breast reconstruction?
Each woman seeking breast reconstruction has her own individual reason for it. Many find a sense of comfort knowing that breast reconstruction is an available treatment option. Some women appreciate being able to return to a physical appearance similar to that before the breast cancer surgery.
Women describe a sense of emotional healing, restoration of self-confidence/femininity, joy and peace of mind after breast reconstruction. Some women choose breast reconstruction because they feel it allows them to return to as “normal” an appearance and lifestyle as possible. Some women find the mastectomy scar constantly reminds them of the breast cancer. Other women prefer not to wear an external prosthesis (artificial breast) for a variety of reasons.

When can breast reconstruction be performed?
In the past, breast reconstruction was delayed for a period of time to allow women to recover both emotionally and physically after mastectomy surgery. Now breast reconstruction is often done at the time of mastectomy (immediate reconstruction). However, it can be done months or years after mastectomy (delayed reconstruction). Breast reconstruction must never interfere with the treatment of breast cancer

Ideally, women facing mastectomy should learn about their options for breast reconstruction from their general surgeons or medical oncologists before breast cancer surgery. Some doctors believe that it is better to delay reconstruction when chemotherapy and radiation treatment are necessary after the surgery or when a patient is at high risk for wound healing complications (women who are smokers, diabetic, obese or have large breasts). Some women prefer to delay the reconstruction to allow them more time to consider their options.

The decision of when to have breast reconstruction should be made by the woman with advice from the team of medical specialists familiar with her case (family doctor, general surgeon, oncologist and plastic surgeon).
Before surgery
Before a mastectomy, your doctor may recommend that you meet with a plastic surgeon. Consult a plastic surgeon who’s experienced in breast reconstruction following mastectomy. Ideally, your breast surgeon and the plastic surgeon will work together to develop the best surgical treatment and breast reconstruction strategy in your situation.

Your plastic surgeon will describe your surgical options and may show you photos of women who have had different types of breast reconstruction. Your body type, health status and cancer treatment factor into which type of reconstruction will provide the best result. The plastic surgeon provides information on the anesthesia, the location of the operation and what kind of follow-up procedures may be necessary.

Breast reduction is a type of plastic surgery esthetic surgery that will reshape a woman�s breast to be smaller. This is often desired by women who have very oversized breasts. There is actually a medical term for this: hypertrophy. This can happen when a female enters puberty or soon after. It can happen very quickly, as the breast will grow and enlarge to the point that a female can feel uncomfortable; a woman may have issues with back pain, as well. It is not known why this condition happens, but with breast reduction cosmetic surgery, this can be treated and a woman can have a more normal shape and the extra weight that her back was having to support will be removed.

Many women seek breast reduction surgery because of oversized breasts, a condition that is medically known as breast hypertrophy. Breast hypertrophy typically occurs in both breasts and happens at puberty or soon afterward. Sometimes the over enlargement of breasts occurs during pregnancy and then the enlargement persists. Although rare, the sudden onset of breast enlargement does occur. Plastic surgery - esthetic surgery can treat these conditions. The cause of over-enlarged breasts is unknown. These articles provide information about the procedure and what makes a good candidate for breast reduction surgery.

Breast reduction surgery is for women who have large breasts and want to resolve one or more of the following associated problems:

• Chronic back, neck and shoulder pain
• Poor posture
• Skin rash under the breasts
• Deep grooves in the shoulders from bra strap pressure
• Restricted levels of activity
• Low self-esteem
• Difficulty wearing or fitting into certain bras and clothing

You can have breast reduction surgery at any age, but it’s generally advisable to wait until you’re at least age 20, by which time your breasts are likely to be fully developed. However, sometimes surgery is performed in teens who suffer significant emotional and psychological effects of having too-large breasts.
If you want children, consider postponing breast reduction surgery until you’ve had them. Changes to breast tissue during pregnancy could alter your surgical results. Also, after the surgery, breast-feeding may be difficult.

Male breast reduction
Breast reduction surgery is not only an option for women. Some men who have large breasts, may need to have a breast reduction, which is a procedure called a gynaecomastia. Unlike the female breast reduction - which is carried out to both reduce and reshape the breasts - male breast reductions are usually required to flatten the breast area.
Large breasts in men are often believed to be a result of obesity, but this is not the only cause. Men, like women, can have an abnormal growth of glandular breast tissue, usually due to a hormonal imbalance. Some studies have shown that male breast growth could be as a result of high levels of the female hormone oestrogen being present in their bodies. Other causes of male breast enlargement include:

• excessive alcohol intake,
• use of certain drugs, particularly anabolic steroids (often used by body builders), and
• dramatic weight loss, causing skin to sag.

The surgical procedure for male breast reduction is exactly the same as the procedure carried out for women (see how it is performed section). However, the male operation usually only takes an hour. The recovery time is also the same (see recovery section), with men needing to wear an elastic garment (sometimes referred to as a pressure garment) for up to four weeks after the operation. The elastic garment helps to encourage smooth results.

Consultation with the surgeon
Before the breast reduction operation you should always have a consultation with the surgeon who will operate on you. This is your chance to ask questions about the operation. It is a good idea to bring a list of your questions to the consultation.
The surgeon will also give you advice on how best to prepare for the operation. If you are overweight, you may be advised to lose weight beforehand. Smokers will be advised to give up because smoking increases the risks of surgery, including delayed healing.
With your permission, the surgeon will also photograph your breasts for a confidential “before and after” reference image.
Many people find it helpful to take notes during the consultation, bring a friend for support, or tape-record the consultation. This is completely normal (and often encouraged by the surgeon).

The breast reduction operation
If you decide that you want to have the operation you will be asked to sign a consent form. This is to show that you are aware of what the procedure involves, including the possible risks, and give your permission for it to go ahead.
Breast reductions are carried out under a general anaesthetic. You will need to stay in the hospital overnight after the operation and sometimes for longer.
Your surgeon or the hospital will give you advice about recovery, including what home arrangements to make and who to contact if complications occur. You will need to wear a special, supportive bra for a few weeks after the operation.
Side-effects
These are the unwanted, but usually temporary effects of a successful procedure.

• You may feel sick as a result of the general anaesthetic or painkillers.
• There will be some pain and discomfort for a few days, and your breasts may feel tender and lumpy for weeks and even months after the procedure.
• You will always experience some scarring although this usually fades with time.
• You are also likely to lose sensation in the nipple, and this numbness may extend over part of the breast as well.
• It is unlikely that you will be able to breastfeed after a breast reduction, as your nipples are separated from the milk ducts in the operation.

Complications
Complications are unexpected problems that can arise during or after the procedure. Most people are not affected. However, in rare cases they can be severe and even fatal.
The major complications of any operation are:

• unexpected reaction to the anaesthetic
• excessive bleeding during or after surgery
• wound infection
• developing a blood clot, usually in a vein in the leg (deep vein thrombosis)

Specific complications of breast reduction include:

• occasionally, scars may stay thick, red and irritable for a long time
• rarely, abnormalities of the blood supply may result in loss of part, or even all, of a nipple
• breasts will always change shape slightly after the procedure, but occasionally the breasts may be more uneven than normal, or the nipples may not be level

A breast lift or mastopexy is designed to improve the shape and position of the breasts without reducing their size. It is used for breasts which sag but are not large. Sagging of the breasts may occur with normal development for some women or as part of aging. Pregnancy, breast-feeding, and weight loss are other conditions which increase breast ptosis (sagging). Some patients will have a better shape to their breast if an implant is used at the time of mastopexy.

Over the years, factors such as pregnancy, nursing, and the force of gravity take their toll on a woman’s breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. Breastlift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts–at least, for a time. (No surgery can permanently delay the effects of gravity.) Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. If your breasts are small or have lost volume–for example, after pregnancy–breast implants inserted in conjunction with mastopexy can increase both their firmness and their size. If you’re considering a breast lift, this brochure will give you a basic understanding of the procedure–when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask your doctor if there is anything about the procedure you don’t understand.

How do I know if breast lift surgery is right for me?
Take a few minutes to read through this check lift in order to ascertain whether or not you are a suitable candidate for breast uplift surgery:
• Are you happy with the size of your breasts but finding them too pendulous?
• Do your breasts lack substance and / or firmness? This can be shown up if your nipples and areolas point downward not forward.
• Are your breasts completely developed?
If you answered Yes to these questions, a lift could be ideal for you.
• Are your breasts unmatched in terms of size, firmness and / or shape?
• Are you breasts large and heavy?
A breast lift can be successful in these cases but your surgeon may recommend additional surgery. For example, while large breasts can benefit from a lift, they tend to sag sooner than smaller breasts so a breast reduction may be an option in such cases.
Age is rarely a factor as long as development is complete. If you have not yet had children and plan on doing so, you may wish to wait until after your child bearing and breastfeeding days are over. Many women however have a breast lift before childbirth and take further action later on if necessary.
It is usually quite possible to breast feed after a lift as the milk ducts and nipples are left intact. To make sure, discuss this with your surgeon.

What will happen at the initial consultation?
During the consultation, you and your surgeon will discuss the changes that you would like to make in your appearance. Because this is a highly personal decision, you�ll want to take time to discuss all of your concerns and desires. It will also be helpful to show your doctor pictures of breast sizes you like.
Your doctor will explain the procedure, including what kind of anesthesia he/she will be using. At this time, he/she will also ask about your medical history, and perform a visual examination. Once the surgery is scheduled, you will receive specific pre-surgery instructions on what you may eat and drink, and whether or not you may smoke and advice on weight loss prior to surgery.
Your surgeon will also measure your breasts, take photographs, and possibly require a mammogram (breast x-ray). He/she should also discuss the new placement of your nipples and ask if you want to reduce the size of the areolas (the darker skin around the nipples).
Be sure to ask all the questions you have about the breast lift surgery, and ask to see photos of recent patients, before and after surgery. Also ask for patient references. The key to making an informed decision is learning everything you can about your options, risks and benefits. See Questions to Ask Your Doctor below.

How will I be assessed by my surgeon for the suitability of my breasts for a successful lift?
Your surgeon will use a physical examination, measurements and if necessary photographs to assess your breasts for surgery. S/he will take into account your the size and shape of your breasts, skin quality, nipple and areola placement and general medical history, including information about any medical conditions, drug allergies, medical treatments, current medication and previous surgeries. In addition s/he will need to be told of your plans (if applicable) to lose a significant amount of weight in the future. Many women find their breasts sag / shrink with weight loss. In this instance your surgeon may recommend that you schedule surgery for once your target weight has been achieved.

What can I expect on the day of surgery?
You will be checked in at the clinic and basic check-in procedures will be followed. For your comfort, medication is administered to see you through the procedure. A general anaesthetic will be administered in order to allow you to sleep through the surgery. From the theatre you will be wheeled through to a recovery area for monitoring. Small drains may be inserted to avoid fluid build-up and you will have dressings on the breasts over the surgery site.

Breast augmentation is changing the shape of the world. Also known as augmentation mammoplasty, breast augmentation has been a growing area of plastic surgery every year for the past 10 years.
These articles provide information about breast augmentation, breats implants, various types of breast surgery and other related topics.
One of the defining characteristics of beauty, femininity, and sexuality of the human figure is the female breast. For whatever personal reason, many women want to have breast enhancement to create a larger, fuller, and shapelier bust line.
Breast augmentation has been available in the United States for over 40 years. During breast augmentation, implants are inserted through an incision - usually made just above the breast crease, around the pigmented skin surrounding the nipple, or in the armpit - and placed into a “pocket” created by the surgeon behind the breast tissue or the chest muscle to add volume and enhance shape to small or underdeveloped breasts, or to restore volume lost as a result of weight loss, childbirth, or aging.

What is breast augmentation?
Augmentation of the breast consists of insertion of a silicone bag (prosthesis) under the breast (submammary) or under the breast and chest muscle (subpectoral) and then filling the bag with saline (salt water). This prosthesis expands the breast area to give a fuller breast (increased cup size), give a better contour, and give more cleavage.

How is the incision made?
The incision (cut) may be placed at various locations such as: under the breast at the breast fold; periareolar which is at the edge of the areola (brown area consisting of nipple and areola); within the areola; in the armpit (axillary); or in the umbilical area.
The thinnest scar is usually in the areola. The umbilical incision approach is used with an endoscope (tube with a light for visualization and placement of the breast implant).

What are smooth and textured implants?
The smooth surface implant requires a large pocket and is associated with a 10% incidence of capsule contracture (tightening of the scar around the implant causing firmness or hardness). The smooth implant has only an occasional occurrence of rippling or wrinkling which gives the overlying skin a wavy appearance.

A textured (roughened surface) implant is associated with a 3% incidence of capsule contracture but has a 7-9% occurrence of rippling.
What are the choices of implant positions? The easiest surgical placement of the breats implant is under the breast tissue (submammary).
A slightly more difficult surgical placement is under the chest muscle (submuscular or subpectoral) but this position is associated with a lower incidence of capsule contracture and slightly less occurrence of rippling. There is more pain postoperatively than with a submammary placement.

Breast augmentation can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.