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Breast Surgery Procedures: Augmentaion, LIft, Reduction

Oct 26, 2007
Breast augmentation is performed to increase breast fullness and volume for women with small breasts or those who have experienced a decrease in breast size due to pregnancy or weight loss. There is a wide variety of implant designs, shapes, sizes, and textures, all of which have certain advantages and disadvantages. A breast implant is basically a soft, silicone envelope with various fillers that is surgically implanted under the tissues of your chest to simulate natural breast tissue.

The breast implant used for primary breast augmentation in the US is made of a silicone shell filled with a saline solution. Saline filled adjustable implants that are similar to the standard saline filled implants with the addition of a small connector tube through which the surgeon can adjust the size via injection.

This implant requires a second incision to remove the injection port in an additional surgical procedure. Under certain conditions, including breast reconstruction, breast lift and other secondary breast procedures, silicone gel implants are now approved by the FDA.

Breast augmentation may be performed under local anesthesia with intravenous sedation, or general anesthesia. General anesthesia may be recommended for women desiring implant placement below the muscle. The surgery consists of making an incision, lifting the breast tissue, creating a pocket in the chest/breast area, and placing an envelope containing a soft, implant material underneath.

An incision may be made either in the crease below the breast, around the areola, or under the armpit. The implants can be placed either under the chest muscle or directly under the breasts. Placement considerations include the anatomy of your breasts, breast feeding, and your personal preference. All of the options will be discussed in detail to allow you to make an informed decision.

A breast lift or mastopexy is a surgical procedure to raise and reshape breasts that have sagged as a result of pregnancy, breastfeeding, aging, weight changes, and the natural force of gravity. We can also reduce the size of the areola, the darker skin surrounding the nipple.

A breast lift can sometimes be combined with the placement of an implant in some cases where volume needs to be enhanced or replaced. Several different techniques can be used to correct this condition, depending on the degree of sagging and breast tissue.

Breast lift surgery can be performed under local anesthesia with intravenous sedation, or general anesthesia. The standard breast lift has four components; the areola is reduced, breast tissue is repositioned, the nipple and areola are elevated to a better position, and excess skin and breast tissue is removed so that a new skin envelope is formed.

The most common procedure involves an anchor-shaped incision following the natural contour of the breast. The incision outlines the area from which breast skin will be removed and defines the new location for the nipple. When the excess skin has been removed, the nipple and areola are moved to a higher position. The skin surrounding the areola is then brought down and together to reshape the breast.

Stitches are usually located around the areola, in a vertical line extending downward from the nipple area, with or without a suture line along the lower crease of the breast, depending on the method used.

In general, the more tissue that is removed, the more shaping is possible. In women with extensive sagging, the skin may be so stretched and thinned that a smaller incision will not allow us to remove sufficient tissue to lift the breast. In these cases, longer incisions may be required.

The vertical mastopexy falls somewhere in-between the traditional and minimal scar technique, and is widely suitable for many types of breasts. We often favor this technique because the end result is a lollipop scar, and our patients find this technique very acceptable.

Women commonly choose to undergo breast reduction surgery because the size and weight of their breasts is affecting their comfort and health. Breast reduction represents a means to an end to the physical symptoms and discomfort they have suffered with for years, and sometimes decades.

Breast reduction is performed under general anesthesia. Most often, the incisions for breast reduction are similar to those used for breast lift techniques. Breast reduction surgery is a trade-off between the extent of the scars and the extent of the reshaping and size reduction possible.

Whenever possible, we attempt to limit the number and length of the incisions for the best aesthetic outcome by incorporating liposuction to treat the lateral portion of the breast.

The most common technique for reducing the breasts involves an anchor-shaped incision that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. Incisions outline the area of skin, breast tissue, and fat to be removed and also outline the new position for the nipple. In most cases, the nipples remain attached to their blood vessels and nerves.

Excess glandular tissue, fat, and skin are removed, and the nipple and areola are moved into their new position. We then bring the skin from both sides of the breast down and around the areola, shaping the new contour of the breast. If the breasts are very large or pendulous, the nipples and areola may have to be completely removed and grafted into a higher position.

We then remove excess glandular tissue, fat, and skin, and moves the nipple and areola into their new position. Skin that was formerly located above the nipple is brought down and joined to reshape the breast. Sutures are used to close the incisions, giving the breast its new contour. The resulting scars around the areola, below it, and in the crease under the breast are permanent. I

n general, the more skin that is removed, the better and smaller shape you can expect.
About the Author
Dave Stringham is the President of LookingYourBest.com an online resource for plastic surgery procedures. Learn more about breast augmentation and other plastic surgery procedures.
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