Breast surgery
Breast surgery involves several plastic surgery procedures designed to reshape one or both of your breasts.
Breast augmentation
What is it?
Breast augmentation is the enlargement of one or both breasts by the surgical insertion of specially designed implants.
Breast augmentation is performed to enlarge and enhance small or underdeveloped breasts, correct uneven size and or shape, to improve sagging following childbirth and breast-feeding or to achieve a larger, firmer and shapelier bust.
The procedure
A breast implant is inserted either behind the breast tissue or behind the pectoral muscle. A small incision is made under the breast, around the nipple or in the armpit and the implant is inserted.
Duration of surgery
Surgery duration is normally 1–2 hours.
Breast lift
What is it?
As the skin loses its elasticity, the breasts often lose their shape and firmness. A breast lift is the raising and reshaping of a breast or breasts to achieve a more shapely bust. Breasts of any size can be lifted, but the results may not last as long in heavier breasts.
While a breast lift will give your breasts a firmer shape, it is not permanent. The effects of gravity, pregnancy, ageing and weight fluctuations will affect your breasts.
The procedure
Your surgeon will examine and measure your breasts and discuss the size and shape of your breasts and the positioning of the nipple (as this will be moved higher during the procedure) with you.
Surgical techniques are varied but the most common technique is an anchor-shaped incision that follows the natural contour of the breast. The incision outlines the area for removal of breast skin and the nipple is moved to a higher position. The skin surrounding the nipple is then brought together to reshape the breast. Your stitches will usually be located in a vertical line extending downwards and along the lower crease of the breast.
Duration of surgery
Surgery duration is normally 1.5–3.5 hours.
Breast reduction
What is it?
A breast reduction is designed to reduce the size of large and heavy breasts to enhance your posture and allow for a greater range of physical activity.
The procedure
There are various surgical methods used for breast reduction. The most common method involves using an anchor-shaped incision around the nipple, your surgeon will remove fat, glandular tissue and skin from the breasts.
The reduction will reduce the medical problems previously caused by large breasts such as back and neck pain, skin irritations, skeletal deformities and breathing problems to give you smaller, lighter and firmer breasts.
In most cases the nipples remain attached to their blood vessels and nerves however if the breasts are very large they may have to be completely removed and grafted into a higher position. Your surgeon will discuss this with you prior to surgery.
Duration of surgery
Surgery duration is normally 2–4 hours.
Breast reconstruction
What is it?
Breast reconstruction is the restoration of the breast and nipple after the surgical removal of one or both breasts due to cancer or other disease.
The procedure
New medical techniques have made it possible for surgeons to create a breast then is close in form and appearance to a natural breast. Breast reconstruction can be carried out with the aid of a breast implant, by using your own tissue or a combination of the two.
Types of implants
There are a number of different breast implants to choose from and your surgeon will be able to advise which implant is best for you.
A breast implant is a silicone shell filled with either silicone or a saline solution. Some terms that your surgeon may use when describing an implant may include:
- Implant Filler
- The liquid filler of an implant may be saline (salt water), silicone gel, cohesive silicone gel which aids shape retention and other alternative fillers.
- Casings
- The external casing of an implant is usually a silicone elastomer. The surface can either be rough or smooth in texture. The rough texture allows for tissue adherence onto the surface.
- Shapes
- There are two implant shapes that you can have; a round or anatomical implant. The round implant is fuller at first but over time the upper part will become emptier and mimic natural breast shape. The anatomical implants are shaped like a teardrop and the upper part does not empty with the speed of the round implant, giving your breasts a longer lasting natural shape.
The choice of shape is entirely your decision.
Duration of surgery
Surgery duration may vary from 2–6 hours depending on the surgical method and type of implant. For more information on breast reconstruction methods please talk to your surgeon.
Side effects
Reconstruction has no effect on the recurrence of disease in the breast nor will it, in most circumstances, interfere with chemotherapy or radiation treatment should cancer recur.
If an implant is used, there is the possibility of an infection developing usually within the first two weeks following surgery. In some cases, the implant will have to be removed for several months until the infection clears.
Capsular contracture of implants can occur if the scar or capsule around the implant begins to tighten. This squeezing of the implant can cause the breast to feel hard. This can be treated several ways including the removal of the scar tissue or removal or replacement of the implant.
Side effects of breast surgery
Most breast surgery procedures will cause some degree of bruising and swelling, lasting up to three weeks. There may be altered sensations of the nipple which are likely to improve over time. No two breasts will ever be the same and post surgery there may be slight variations in the size and shape of your breasts
All breast surgery carries some uncertainty and risk such as bleeding, fluid collection, excessive scar tissue, or difficulties with anaesthesia however these risks are relatively uncommon.
As with any surgery smokers are advised that nicotine can delay healing, resulting in noticeable scars and a prolonged recovery.
Revisional surgery
In most circumstances breast surgery will not have to be repeated. However, revisional surgery may be necessary to correct minor irregularities.
Resumption of normal activity
Returning to your normal activities after surgery is an individual matter and your surgeon will advise you as to your recovery program. Most patients are able to return to work after 1–2 weeks but others may require longer rest periods due to the nature and extent of their procedure.
Follow your surgeon's advice on stretching exercises and normal activities. As a general rule, you should refrain from overhead lifting and strenuous sports for three to six weeks. Your surgeon will also advise you on matters of special care concerning bras, bathing and showering.
Anaesthesia
Depending on the surgery you are having, you may be placed under twilight sedation, local or general anaesthetic. Your surgeon will discuss your requirements during consultation.