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Breast surgery options
Breast surgery
typically can be divided into three general categories: augmentation, reduction
and reconstruction.
Breast augmentation
Breast
augmentation is performed to enhance the appearance, size and contour of a
woman's breasts. Women consider breast augmentation -- or augmentation
mammoplasty -- for different reasons. Some women feel their breasts are too
small in relation to their body contour. Some women desire augmentation after
size loss associated with pregnancy. Others desire to correct an asymmetry in
breast size.
Breast augmentation is performed with implants that can be placed under a
chest muscle or over a chest muscle. The incision can be placed in the axilla
(armpit), areola or lower breast. Breast augmentation can be assisted with
endoscopes.
A breast implant is a silicone shell filled with either saline (a salt water
solution) or silicone gel. A woman determines her desired size by fitting trial
implants. Currently, saline filled implants are used on an unrestricted basis.
Silicone gel filled implants are available only to women participating in
approved studies.
Breast augmentation is a relatively straightforward procedure. As with any
surgery, some uncertainty and risk are associated with breast augmentation
surgery. Know your concerns and expectations. Review the benefits, risks and
alternatives. Seek consultation with a board certified plastic surgeon.
Breast reduction
Women with large,
heavy, pendulous breasts can be miserable. The excess weight can cause neck
pain, back pain, skin irritation, bra strap indentations, numbness or weakness.
Breast reduction is known as reduction mammoplasty. The procedure involves
removal of excess skin, fat and glandular tissue.
With this type of surgery, scarring can be extensive. Normal breast
sensation, nipple-areola sensation and milk production are preserved except in
the massively oversized breasts. Massively oversized breasts often require a
more resectional type of procedure with grafting of the nipple-areola complex
rather than a reduction procedure. The reduction type of procedure reduces
breast appearance, volume and contour, while preserving breast sensation and
function. After breast reduction, women report tremendous improvement in their
symptoms.
Breast reconstruction
Breast
reconstruction seeks to recreate a breast with the desired appearance, contour
and volume. The nipple-areolar component also is recreated. Normal breast
sensation and normal breast function, as with nursing, are not reconstructible
when the sensory nerves or milk glands and ducts have been removed or
significantly injured.
The appearance, contour and volume of the breast can be recreated with
implants or with a woman's own tissue. If an implant is used, the implant is
sized to match the opposite breast. When possible, the implant is placed beneath
a chest muscle. A breast also can be recreated using a woman's own tissue. At
times, a segment of the lower abdominal wall can be used. Other tissue options
for autologous (using your own tissue) reconstruction include back muscle and
skin or a segment of a buttock.
Breast lifts
In some women, the skin
is not strong or resilient enough to support the weight of the breast, causing
the breasts to sag. With this condition, called ptosis, there is too much skin
compared to breast tissue. To give the breast a lift, the excess skin must be
removed. There are three surgical techniques generally used:
- Wise pattern: The incision, in the shape of an anchor, goes around the
chest and below the breast.
- LeJeour: The incision goes around the areola and down.
- Donut or peri-areolar: The incision goes around the areola only.
This surgery involves some degree of permanent scarring, but product are
available that may help to minimize the appearance of scars.
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