Breast reconstruction restores a natural, symmetrical appearance to the bosom, maintains body proportion, allows clothes to fit better, and most important of all, boosts self-confidence for women who have lost one or both breasts to mastectomy or who lack breasts due to a congenital or developmental abnormality. Reconstructive surgeons strive to create a new breast and nipple that resemble the woman's natural breast as closely as possible in shape, size and position.
Women whose cancer seems to have been eradicated with mastectomy are the best candidates for breast reconstruction. Those with health problems such as obesity and high blood pressure and those who smoke are advised to wait. Others prefer to postpone surgery as they come to terms with having cancer, consider the extent of the procedure, or explore alternatives.
The reconstruction itself consists of multiple operations, the first of which involves creation of the breast mound and is performed during or after mastectomy in a hospital under general anesthesia. Later surgeries, if necessary, may be done in the hospital or an outpatient facility, with either general or local anesthesia.
There are several ways to reconstruct the breast, both with and without implants; Dr. Samson will work together with you in deciding which is the best for you.
Breast augmentation is one of the most frequently performed cosmetic surgery procedures in the U.S. It can give women with small or unevenly-sized breasts a fuller, firmer, better-proportioned look through the placement of implants in the breast. Women may elect to undergo breast augmentation for many different medical and aesthetic motivations, including balancing breast size and compensating for reduced breast mass after pregnancy or surgery. The procedure may be combined with others such as a breast lift for more satisfying results.
Implants are silicone shells filled with either saline (salt water) or silicone gel (recently approved by the FDA). They are placed behind each breast, underneath either breast tissue or the chest wall muscle. The procedure lasts one to two hours and is typically performed with general anesthesia. After surgery the patient's bustline may be increased by one or more cup sizes.
Large breasts can cause pain, improper posture, rashes, breathing problems, skeletal deformities, and low self-esteem. Breast reduction surgery is usually done to provide relief from these symptoms. Performed under general anesthesia, the two- to four-hour procedure removes fat and glandular tissue and tightens skin to produce smaller, lighter breasts that are in a healthier proportion to the rest of the body.
Breast reduction surgery is not recommended for women who intend to breast-feed, since many of the milk ducts leading to the nipples are removed.
During the procedure an anchor-shaped incision is made from the new location of the nipple down to and around the crease beneath the breast. The surgeon removes excess glandular tissue, fat, and skin, relocates the nipple and areola, and reshapes the breast using skin from around the areola before closing the incisions with stitches. Liposuction may be needed to remove excess fat from the armpit area, and in some cases when only fat needs to be removed from the breasts, liposuction alone is used for breast reduction.
For a few days after surgery the breasts are bound with an elastic bandage or a surgical bra and you may be given surgical drainage tubes for fluid removal. Stitches come out in a week and the surgical bra must be worn for about a month.
A little pain is normal after surgery, whether it's mild discomfort, swelling during menstruation, a measure of numbness or sensitivity, or random, shooting pains that may last for a few months. Swelling, bruising, crusting and slight changes in breast size are also common. Most patients return to work in about two weeks, although you should avoid heavy lifting for three to four and only gentle contact with the breasts should occur for six weeks.
Breast Lift (Mastopexy)
A woman's breasts may droop as a result of the natural effects of aging, heredity, gravity, pregnancy, breastfeeding, or weight loss. A breast lift, also called a mastopexy, is performed to return youthful shape and lift to breasts that have sagged or lost volume and firmness.
Breast lifts rejuvenate the breasts by trimming excess skin and tightening supporting tissues to achieve an uplifted, youthful contour. After a mastopexy, the breasts are higher on the chest and firmer to the touch. Breast lifts can also reposition and reduce the size of the areola-the dark skin surrounding the nipple-which may have stretched or drooped.
Mastopexy is usually performed on an outpatient basis under general anesthesia and lasts from 1 to 3 hours. Most patients are immediately satisfied with their new breasts and can typically return to work one to two weeks following the procedure.
Although rarely discussed, enlarged male breasts is a common condition. Gynecomastia affects approximately 40 to 60 percent of men. There is often no known cause for gynecomastia, although there has been some correlation with various drugs or medical conditions.
Men who feel self-conscious about their appearance are helped with breast reduction surgery. The procedure removes fat and/or glandular tissue from the breasts, and in extreme cases removes excess skin, resulting in a contoured chest that is flatter and firmer.