Breast Enhancement Surgery
Mastopexy (or Breast Lift) reshapes the breasts and repositions the areolas. This procedure is usually performed on women who have been pregnant multiple times and breastfed their babies, or on bariatric surgery patients who have lost a significant amount of weight. In either case, the deflated look or excess skin in the breast area can be disconcerting to the individual, who may desire aesthetic improvement. When performed on bariatric surgery patients, the procedure is usually combined with breast augmentation (enlargement) to better fill the empty space vacated by the fat loss.
The breast lift operation is performed under general anesthesia or heavy sedation combined with a local anesthetic. The skin below the breast is generally removed to excise excess skin from the area. The nipple is then moved higher up on the breast to better situate it in relation to the new breast positioning. The skin above the breast is pulled around to create a swell and to tighten the remaining area of skin around the glands and fatty tissue of the breast for a more youthful appearance. The areolas can also be resized if necessary. Some doctors may also place small drains to help reduce swelling for the first day or so following surgery; these drains will be removed soon after in a follow-up visit less than three days after surgery.
The full recovery time of this procedure is usually around a month, but patients can generally return to desk jobs within 10 to 14 days. A supportive bra must be worn everyday for the full recovery period to ensure proper healing. Pain medication is prescribed for the week following surgery, as well as antibiotics to reduce the likelihood of infection. Although scarring is likely, most of the scars associated with breast lift surgery are readily hidden by a normal bra. These scars will fade over time to become almost invisible to the naked eye.
Modern surgical technology makes it possible to construct a natural-looking breast after mastectomy (breast removal) for cancer or other diseases. The procedure is commonly begun and sometimes completed immediately following mastectomy, so that the patient wakes with a new breast mound instead of no breast at all. Alternatively, reconstruction may begin years after mastectomy. Many insurance companies cover reconstruction following breast cancer surgery, and legislation is currently before Congress to make coverage mandatory.
Women whose cancer seems to have been eradicated with mastectomy are the best candidates for breast reconstruction. Those with health problems such as obesity and high blood pressure and those who smoke are advised to wait. Others prefer to postpone surgery as they come to terms with having cancer, consider the extent of the procedure, or explore alternatives.
The reconstruction itself consists of multiple operations, the first of which involves creation of the breast mound and is performed during or after mastectomy in a hospital under general anesthesia. Later surgeries, if necessary, may be done in the hospital or an outpatient facility, with either general or local anesthesia.
There are several ways to reconstruct the breast, both with and without implants; your breast surgeon and plastic surgeon should work together with you in deciding which approach is best for you.
Breast reconstruction has not been proven to affect the recurrence of cancer or other diseases, chemotherapy or radiation treatment.
Nevertheless, in addition to the complications possible from any surgical procedure (bleeding, fluid collection, excessive scar tissue, or difficulties with anesthesia), there are some risks inherent in breast reconstruction, including infection around the implant, if an implant is used, and capsular contracture, when the scar (capsule) around the implant tightens, causing the breast to feel hard. Treatment for capsular contracture varies from "scoring" the scar tissue to removing or replacing the implant. Some patients may need time to come to terms emotionally with their new breasts.
Large breasts can cause pain, improper posture, rashes, breathing problems, skeletal deformities, and low self-esteem. Breast reduction surgery is usually done to provide relief from these symptoms. Performed under general anesthesia, the two- to four-hour procedure removes fat and glandular tissue and tightens skin to produce smaller, lighter breasts that are in a healthier proportion to the rest of the body.
Breast reduction surgery is not recommended for women who intend to breast-feed, since many of the milk ducts leading to the nipples are removed.
During the breast reduction procedure an anchor-shaped incision is made from the new location of the nipple down to and around the crease beneath the breast. The surgeon removes excess glandular tissue, fat, and skin, relocates the nipple and areola, and reshapes the breast using skin from around the areola before closing the incisions with stitches. Liposuction may be needed to remove excess fat from the armpit area, and in cases when only fat needs to be removed from the breasts, liposuction alone is used for breast reduction.
For a few days after surgery the breasts are bound with an elastic bandage or a surgical bra and you may be given surgical drainage tubes for fluid removal. Stitches come out in a week and the surgical bra must be worn for about a month.
A little pain is normal after breast reduction, whether it's mild discomfort, swelling during menstruation, a measure of numbness or sensitivity, or random, shooting pains that may last for a few months. Swelling, bruising, crusting and slight changes in breast size are also common. Most patients return to work in about two weeks, although you should avoid heavy lifting for three to four and only gentle contact with the breasts should occur for six weeks.
Scars fade with time but will not disappear, although they can be hidden with a bra, bathing suit or low-cut top.
Risks are rare and usually minor but may include bleeding, infection, reaction to the anesthesia, small sores around the nipples, slightly mismatched breasts or unevenly positioned nipples, and permanent loss of feeling in the nipple or breast.
To learn more about our Breast Enhancement Surgery Services, please contact us at (817) 473-2120 today to schedule an appointment.