Breast reduction is one of the aesthetics breast surgeries. Using different types of plastic surgery you can change the shape, apperance and size of the breast. Some women use this option for health reasons, others feel the need to change the apperance of the breast for purely aesthetics reasons.
Mammoplasty is a breast reduction procedure during which the reduction of adipose tissue, part of the mammary gland and removal of excess skin and subcutanous tissue takes place. Generally women suffering from too large breasts (ginecomastia, macromastia) undergo this procedure.
What are the indications?
Many women decide to undergo breast reduction surgery for health reasons. An overgrown mammary gland and excessive accumulation of fat in the breasts mean that the breasts lose their aesthetic apperance after exceeding a certain size. It is assumed that a propely built breast weighs about half of kilogram and the nipple is about 20 cm below the breastbone.
If the breasts are too heavy women may experience various ailments. Indications for breast reduction can be, for example hypertrophied mammmary gland, pain in the cervical and/ or thoracic spine due to excessive load or breast asymmetry.
What are the options for breast reduction?
Cosmetic surgeons can use one of several different surgical techniques when performing breast reduction; which technique a surgeon will use depends on the patient’s existing breast anatomy, the type and amount of tissue to be removed, and the patient’s desired outcome.
In certain cases, breast reduction can be performed using only liposuction. Main benefits of breast liposuction procedure is: shorter time of the surgery, less invasive procedure, virtually undetectable scars on the breast, and lasting results. This technique will only achieve optimal results in certain patients. İdeal candidates are those who need or desire a slight to moderate reduction in breast size, have good skin elasticity and little to no sagging to correct, and whose excess breast size is largely due to excess fatty tissue.
Those patients who need a moderate reduction in breast size and have more noticeable sagging are very good candidates for a vertical breast reduction. This procedure involves two incision sites: one is around the edge of the areola, and a second incision running vertically from the bottom of the areola to the inframammary fold, or the crease beneath the breast. This incision pattern allows a cosmetic surgeon to remove excess fat, skin and breast tissue, reshape the new smaller breast internally, and lift the breast into a more youthful position.
The last technique called as inverted-T breast reduction involves 3 incisions: one around the edge of the areola, one vertically from the areola to the breast crease, and one made along the crease underneath the breast. Because this technique allows for the maximum degree of tissue removal and reshaping, cosmetic surgeons will typically use this approach if a patient needs a more significant breast size reduction and/or has considerable sagging or asymmetry to correct.
Breast Lift Surgery (Mastopexy)
Breasts generally lose their aesthetic look, tightness and dynamic shape in time. Ageing, gravity, weight loss, heavy diet, pregnancy and breastfeeding contribute to the development of all sagging breasts.
Patients who are generally pleased with their size of breasts but have sagging breasts are ideal candidates for breast lift operation. Some patients can be unhappy because the volume of breasts may be significantly reduced in time. In such cases, breast prosthesis is placed and the size of breasts is increased and their shape and position are modified. During a breast lift, excess skin is removed and breast tissue is reshaped to restore firmness and raise the breasts and nipples on the chest. Incisions can be made around the darker area surrounding the nipples (areolae), downward to the breast creases and horizontally along the creases.
A breast lift won’t significantly change the size of your breasts. However, a breast lift can be done in combination with breast augmentation or breast reduction.
How it is performed?
During breast lift surgery, the surgeon removes excess skin and tightens the remaining skin. He/she starts by assessing the required lift and fullness needed to achieve the desired result. This is done by marking a new nipple position. Using a scalpel, the surgeon then makes an incision along the pre-marked lines and separates the skin from the tissue below. The excess breast fat is then removed, the nipple relocated to its new position and finally the new breast shape is reconstructed. The incision is usually made around the nipple and under the surface of the breast, like an upside down T, however a different technique may be used depending on the degree to which your breasts sag.
Breast augmentation is enlargement of the breast. This is usually done by inserting an implant beneath the breast to make it look larger. It will enlarge breasts that have always been small, but can also be used to fill out breasts that used to be larger.
Who should have breast augumentation?
• Those whose developmental breasts did not develop, ie those whose breasts are always small from the age of development. Generally, a hormonal disorder cannot be detected in these patients and is completely structural.
• Breast augmentation operation is applied in cases where the breasts are emptied and softened after pregnancy and lactation. In this patient group, sagging usually occurs at the bottom of the breast without much sagging at the nipple, which is eliminated by silicone.
• Another group benefiting from breast augmentation is those with serious asymmetry in volume and shape between breasts. In this case, breast augmentation operations are applied.
• There is no upper age limit for the use of silicone breast implants that are placed to make your breast steeper and larger. In general, a person’s health is sufficient. Furthermore, being eighteen years old is a lower age limit for this operation.
What techniques are involved?
Breast enlargement involves the placement of an implant under the patient’s breast tissue to enhance the size and shape of the breast. The implants are usually inserted using an incision placed under the breast at the crease, but can also be put in via an incision in the armpit or around the nipple. Implants can be placed either directly behind the breast (known as sub-glandular placement), or behind the breast and chest wall muscle (known as sub-muscular placement).
What types of implants should i have?
The outer layer, or shell, of all implants is made of silicone. Some implants have an additional polyurethane coating. The shell can be filled with either silicone gel or saline. You should ask your surgeon exactly which type and manufacturer of implant will be used and why. In general our surgeons use tried and tested implants made by reputable manufacturers. Most patients choose silicone gel filled implants. They tend to feel the most natural, can readily be made teardrop-shaped and are durable. Saline filled implants tend to feel less natural, folds and ripples may be more visible and they have a risk of deflation. The two most important decisions to make about your implants are their size and shape.
How it is performed?
Breast enlargement surgery takes about two hours, and it is usually done under general anaesthetic. The operation itself involves accessing and creating the pocket into which the implant will be placed, using one of the insertion routes mentioned above: breast-crease, armpit or nipple. Once the pocket has been created, the surgeon may insert a trial implant to check that the size chosen is appropriate. The trial implant is removed, the definitive implant inserted and the incision wounds are stitched.
You may be able to go home the same day, but many patients will spend one night in hospital. Postoperative pain in these procedures is easily controlled. Your chest will feel tight. Your breasts and ribs below your breasts will be tender. Patients will be mobile from day one and should be back to full exercise within six weeks. Patients are recommended to take about one week off work immediately after the operation in order to ensure you recuperate fully. At first your breasts may look too high and the skin appear tight. This tends to settle down over the first six weeks or so after the operation as a more natural shape emerges. Most patients are delighted with the change that has been achieved, but some find their new shape is difficult to get used to. You should be prepared for this possibility. The nature of the scars will depend on the technique that has been used. Scars tend to be quite red in the first six weeks, changing to purple over next three months and then fading to white. Most patients will form good quality scars over time. Abnormal scarring is rare in breast augmentation surgery.
What are the possible risks of breast cosmetic surgeries?
A breast cosmetic surgery poses various risks, including:
-Scarring. While scars are permanent, they’ll soften and fade within one to two years. Scars from a breast lift can usually be hidden by bras and bathing suits. Rarely, poor healing can cause scars to become thick and wide.
-Changes in nipple or breast sensation. While sensation typically returns within several weeks, some loss of feeling might be permanent. Erotic sensation typically isn’t affected.
-Irregularities or asymmetry in the shape and size of the breasts. This could occur as a result of changes during the healing process. Also, surgery might not successfully correct pre-existing asymmetry.
-Partial or total loss of the nipples or areolae. Rarely, the blood supply to the nipple or areola is interrupted during a breast lift. This can damage breast tissue in the area and lead to the partial or total loss of the nipple or areola.
-Difficulty breast-feeding. While breast-feeding is usually possible after a breast lift, some women might have difficulty producing enough milk.
-Like any major surgery, a breast surgery poses a risk of bleeding, infection and an adverse reaction to anesthesia. It’s also possible to have an allergic reaction to the surgical tape or other materials used during or after the procedure.
How to prepare before the operation?
Initially, you’ll talk to a plastic surgeon about your surgery. During your first visit, your plastic surgeon will likely:
-Review your medical history. Be prepared to answer questions about current and past medical conditions. Tell the doctor if you have a family history of breast cancer.
-Share the results of any mammograms or breast biopsies. Talk about any medications you’re taking or have taken recently, as well as any surgeries you’ve had.
-Do a physical exam. To determine your treatment options, the doctor will examine your breasts — including the position of your nipples and areolae.
-He or she will also consider the quality of your skin tone. Breast skin that has good tone will hold the breasts in a better position after a breast lift. The doctor might also take pictures of your breasts for your medical record.
-Discuss your expectations. Explain why you want a breast lift and what you’re hoping for in terms of appearance after the procedure. Make sure you understand the risks and benefits, including scarring and changes in nipple or breast sensation.
Before a breast surgery you might need to:
-Schedule a mammogram. Your doctor might recommend a baseline mammogram before the procedure and another mammogram a few months afterward.
-This will help your medical team see changes in your breast tissue and interpret future mammograms. Stop smoking. Smoking decreases blood flow in the skin and can slow the healing process. If you smoke, your doctor will recommend that you stop smoking before surgery.
-Avoid certain medications. You’ll likely need to avoid taking aspirin, anti-inflammatory drugs and herbal supplements, which can increase bleeding.
-Arrange for help during recovery. Make plans for someone to drive you home after surgery and stay with you as you begin to recover. You might need someone to help you with daily activities, such as washing your hair, during your initial recovery.