Breast

Breast augmentation involves inserting an implant behind the breast in order to enhance the size and/or shape of the breast. Women choose to have breast augmentation surgery for a number of reasons. Some women want larger breasts, while others wish to correct a volume reduction occurring after pregnancy. Breast implants may also be used in breast reconstruction after breast surgery, or to balance a naturally occurring asymmetry. Multiple techniques are used by surgeons in performing breast augmentation, and the best procedure is selected based upon the individual patient’s needs and preferences. In most cases, saline-filled (salt water) implants are used, although silicone gel-filled implants may be used in some circumstances.* Different styles of implant are available, and these are selected depending upon the surgical needs of the patient. The surgery usually lasts from one to two hours, and can be performed on an outpatient basis. Local anesthesia with sedation or general anesthesia may be chosen. Incisions may be placed in the areola (the pigmented area around the nipple), in the crease under the breast, or in the armpit. The implant itself is placed either under the breast gland, or under the chest muscle (pectoralis major), and centered under the nipple. Drainage tubes are sometimes placed at the time of surgery, and are typically removed in one or two days. Pain and discomfort following the surgery are typically controlled with oral pain medication, and are not severe. Stitches are removed within seven to ten days after surgery, and within one week most patients can return to work. The surgeon may recommend wearing a support bra or tape for a few weeks after surgery. While most bruising resolves in a week or two, some swelling may persist for four to six weeks or longer, depending on the exact nature of the surgery and the patient. *Breast implants are made from a silicone shell filled typically filled with salt water (saline), or silicone gel. Because of insufficient information demonstrating the safety of silicone gel-filled implants, the Food and Drug Administration has restricted the use of new gel-filled implants to surgery on women participating in approved studies only. Some patients requesting primary ("first-time") breast augmentation may be candidates for silicone gel-filled implants within such studies, and this can be discussed with your surgeon in consultation.

Mastopexy or breast lift: As women age, the breasts may begin to sag or become ptotic. This process is often accelerated by pregnancy and nursing. Mastopexy, or breast lift, may be performed to enhance the shape of the breast and create a more youthful contour and appearance. Mastopexy may be performed under local anesthesia with sedation, or under a general anesthetic. Multiple techniques may be used, depending on the nature and degree of ptosis. Breast implants are sometimes used in conjunction with mastopexy, or even as an alternative to mastopexy for correction of modest ptosis (also termed pseudoptosis). Most breast lift surgeries involve placing an incision around the areola (the pigmented skin around the nipple), and sometimes under the nipple and within the fold under the breast. Excess skin is removed, and the breast is reshaped to recreate a more youthful appearance. The surgery usually lasts for one or two hours, and can be performed on an outpatient basis. Pain and discomfort following the surgery are typically controlled with oral pain medication, and are not severe. Stitches are removed within seven to ten days after surgery, and within one week most patients can return to work. The surgeon may recommend wearing a support bra for a few weeks after surgery. While most bruising resolves in a week or two, some swelling may persist for four to six weeks or longer, depending on the exact nature of the surgery and the patient.