The breast in a women is composed of mammary glands and fatty tissue. The mammary glands are connected to the nipple through the lactiferous sinus. A pigmented ring, which is known as the areola encircles the nipple.
A woman may opt for getting her breasts augmented for various reasons.
▣ Smaller size of breast
▣ Assymetrically size or shape
▣ Drooping or Sagging of breasts due to multiple child births & breast feeding
▣ To improve the firmness of the breasts
▣ Breast reconstruction after a breast cancer surgery
Breast augmentation can be done using saline or silicone implants. The implant comes in various sizes and would be chosen based on the requirement. A Breast lift is done by removing the excess skin to provide a better shape.
The procedure followed varies from person to person and depends on the patient requirement. Your surgeon will discuss all implant options with you prior to surgery.
Implants can be placed either in front or behind the breast muscle. The various options and benefits of each type of procedure is discussed between you and your surgeon. The areas for incision normally are below the breast, around the nipple, in the area of arm pit or in the navel area. To position the implant, an incision is made in a suitable area as desired and the implant is inserted into a pocket created through the incision. It may be placed under either the breast tissue or the chest muscle beneath the breast. After the implant has been carefully positioned and adjusted to the correct shape the incision is closed with stitches.
Breast Augmentation A breast lift (mastopexy) is done to raise sagging or drooping breasts and elevate the nipple and areola. To lift the breasts, excess skin from the bottom of the breast and the area around the areola is removed. The remaining skin is then brought together, which tightens and raises the breast. Larger incisions are required for this in comparison to breast enlargement. Incisions may extend from the areola down to the crease where the bottom of the breast meets the chest.
Breast enlargements and lifts are usually done as outpatient procedures in a hospital or outpatient surgery center. An overnight stay in the hospital is not needed unless there are complications during surgery. The surgery takes 1 to 2 hours.
General anesthesia is usually used, although local anesthesia or an epidural may be used in some cases.
There are several potential complications and risks associated with this procedure.
▣ Infection though rare can occur within days or weeks after surgery.
▣ Contraction of the implant can occur with a capsular formation around the implant during the healing process. This compresses the implant which could leqads to a distorted look.
▣ Symmastia also known as "breadloafing"can occur in women with chestwall deformities. This can happen at anytime after surgery from a few days to several months.sia or an epidural may be used in some cases.
It's very important that you follow your surgeon's follow-up care for the incision site. There would be swelling and tenderness on the breasts after the surgery. Over time the incision scars fade off and the breasts take a more natural shape. Your breasts will be covered with a bandage of gauze or a suitable surgical bra for some time to aid in healing.
Breast implant surgery is a procedure in which a silicone shell is implanted into the breast. An incision is made Breast implant in the crease of the armpit, beneath the nipple, underneath the breast or in the abdomen to insert the implant. The incision is made with a special instrument which helps create a space for the implant. A bandage will be applied over your breasts for two days after surgery to speed up healing.
All breast implants utilize a silicone shell but contain different kinds of filler, gel or saline. The outer silicone shell may be smooth shiny and polished, or a slightly rough texture. Breasts augmented with the textured implants are less likely to develop contracting capsules than those with the smooth implants.
There are two techniques adopted for placing implants. The options are discussed between the patient and the surgeon prior surgery to adopt the most suitable one. The implants can be placed under the breast tissue and over the chest muscle or under the chest muscle and breast tissue.
The procedure takes approximately one hour and is done under local anaesthesia with sedation or general anaesthesia. The surgeon will decide the most suited in consultation with the patient.
All dressings and bandages will be removed on the third day following the operation following which the patient can bathe as usual. Basic exercises and movements as adviced by the doctor has to be done to improve breast contour and assist healing.
Breast lift surgery is done to make the breast appear higher and to reposition the nipple.
There are different techniques that can be adopted and it involves reshaping of the tissue and fat and removal of the excess skin. The operation is done with the patient asleep under general anesthesia.
The method is tailored to each patient. Incisions are made along the natural creases in the breast and around the dark pink skin surrounding the nipple (areola). A common method of surgery adopted is to mark the new nipple position. Then with the blood supply of the nipple preserved on a pedicle of tissue, the excess breast is removed. The nipple is then moved into its new position and the new breast shape is reconstructed. The incision is often around the nipple and on the under surface of the breast, like an upside down T.
The surgery takes 1 to 3 hours. After the procedure the area is wrapped in an elastic bandage or gauze dressing with surgical bra. The dressings will be replaced by a soft bra which needs to be worn for several weeks. A suitable drain is positioned to drain the fluids from the surgical area. This will be removed usually the next day.
Cold compress or ice packs are used to remove swelling if any. There may be loss of sensation around the nipple and area of incision. This would return in due course of time.
Breast reduction is a surgery done to remove fat, glandular tissue and skin from the breast. The operation usually lasts between two and four hours and takes place under a general anesthesia. Surgeons, in some cases may also use local anesthesia and sedation.
The surgeon makes an incision around the areola (the brownish area around the nipple), vertically down the breast and then along the natural crease beneath the breast. The excess tissue and skin is removed and the nipple and areola are moved into their new positions. Skin from both sides of the breast is then pulled down and around the areola, making the new shape of the breast. Any excess fat can also be removed.
In most cases, the nipples remain attached to their blood vessels and nerves as they are being moved. However, in certain cases if the breasts are very large, the nipples and areolas may have to be completely removed and grafted into a higher position - this may result in a loss of sensation in the nipples and areola. A overnight stay in the hospital is required and one would need to take approximately two weeks off work to rest.
Avoid lifting weights and physical exercise for about six weeks. It is important that the breasts are well supported by means of a firm dressing initially and then by a supportive bra. The sutures will be removed between seven and fourteen days and it is important to keep the incision sites out of the sun for one year.
Reconstruction of a breast is achieved through several plastic surgery techniques that attempt to restore a breast to near normal shape, appearance and size following mastectomy. After a mastectomy or radiation therapy insufficient tissue on the chest wall will be available to cover and support a breast implant. The use of a breast implant for reconstruction almost always requires either a flap technique or tissue expansion. A TRAM flap uses donor muscle, fat and skin from a woman�s abdomen to reconstruct the breast. The flap may either remain attached to the original blood supply and be tunneled up through the chest wall or be completely detached and formed into a breast mound.
General anesthesia is administered for this procedure.
Reconstruction with tissue expansion allows an easier recovery than flap procedures, but it is a longer reconstruction process. It requires multiple visits over 4-6 months after placement of the expander to slowly fill the device through an internal valve to expand the skin.
A second surgical procedure will be needed to replace the expander if it is not designed to serve as a permanent implant. A breast implant can be an addition or alternative to flap techniques. Saline and silicone implants are available for reconstruction.
Following your surgery for flap techniques and/or the insertion of an implant, gauze or bandages will be applied to your incisions.
Breast reconstruction is a physically and emotionally rewarding procedure for a woman who has lost a breast due to cancer or other conditions.
Inversion of the nipple is caused by a short milk duct system running from the chest wall to the nipple. This can be corrected through surgical procedures. There are two types of surgeries used to correct the inverted nipple: those that leave the milk ducts intact and those that do not. The objective to reshape the nipple and areola, is to make the nipple project out from the breast, enhancing the appearance of the breast while preserving sensitivity of the nipple.
Inverted nipple repair with partial preservation of milk ducts: Your doctor will administer a local Inverted Nipple Repairanesthetic as well as a sedative to help you relax. An incision will be made just around the base of the nipple on the areola.
The exact procedure depends upon the condition of the nipple. In some cases, an incision can be made in order to draw out the nipple and to have a natural protrusion. In certain cases, a nipple has to be created from the surrounding tissues. In certain cases it may be necessary to cut through the milk ducts to complete the surgery. If the surgery only involves releasing an inverted nipple, it generally takes only about half an hour to complete and may be conducted under local anesthesia.
Inverted nipple repair with detached milk ducts: This is a more common procedure and may be necessary in more difficult cases. A sedative along with a local anesthetic is administered. An incision is made at the base of the nipple and the shortened milk ducts are detached. This allows a natural-looking projection of the nipple. The incision is sutured closed, and medicated gauze is applied to the site.
The procedure takes one to two hours, depending on the technique used. Nipples and the surrounding area will be sore and swollen for two or three days after the procedure, and then decreases rapidly over the following days. Stitches are usually removed in 3 to 5 days after surgery. Basic activities can be resumed within 1 to 2 days.
As with any surgery, there are certain risks associated with this procedure. These include re-inversion, infection, injury to the tissue, excessive bleeding and reaction to anesthesia. Noticeable scars can also form after healing along with permanent pigment changes. Ther is also a chance that the nipples are not matched. There also could be changes in nipple protrusion on stimulation. In case of a nipple inversion reoccuring or a significant change in symmetry, a second procedure may be required.
Nipple reduction surgery is sought after by women who have overly large nipples or areolas. Overly Nipple reduction surgery large nipples can cause embarrassment when erect as well as make the fitting of bras uncomfortable. A smaller nipple as well as a less prominent areola is preferred as both are less noticeable under clothing.Nipples can be enlarged, swollen or prominent in appearance, through prolonged stimulation or sexual practices which may involve pinching or pulling, tugging and piercing. Previous breast surgeries and nursing can also produce enlarged nipples. Many women request a nipple reduction because breast feeding has permanently altered the shape and size of their nipples, making them longer and somewhat droopy. Nipple reduction surgery can also be done in conjunction with areola reduction surgery. Areola reduction around the nipple can give as much aesthetic appeal as a nipple reduction.
There are a few factors that needs to be looked into to assertain whether or not a nipple is too large. A nipple that requires reduction surgery normally is long and droopy or fat and squat, also never invert and always remains in an erect condition. A nipple reduction is almost always done for cosmetic reasons as enlarged nipples rarely cause any physical discomfort. Sensation is almost always normal following a nipple reduction and the ability to breast feed can usually be easily preserved.
Nipple Reduction Surgery - Procedure
There are many methods to perform a nipple reduction surgery. A few options may include:
▣ Removing just the top of the nipple and closing it with sutures to make it shorter
▣ Removing a band of skin from the base of the nipple, pushing it back into the breast and then sealing it in that position with sutures
▣ Removing fatty tissue from beneath the areola to allow the nipple to sit deeper in the breast.
The procedure is done on an outpatient basis and is done under local anesthesia. Sedation is not required unless it is combined with other larger procedures. There may be several trips required for touch ups to attain symmetry. This procedure may also be combined with an areola reduction. Areolas require reduction when they become large, puffy and uneven in color and diameter. Sometimes this condition is caused by genetics and sometimes it is caused by trauma to the breast through sexual practices or breast feeding. In this case skin may be gathered at the point around the base of the nipples and removed as part of the overall reduction.
There are certain risks associated with nipple reduction surgery. Some of these include:
▣ Bleeding
▣ Bruising
▣ Infection
▣ Scarring
▣ Swelling
Other potential risks associated with nipple reduction surgery include:
▣ Asymmetrical results, meaning the nipples do not match in size or shape following the surgery
▣ Feeling unhappy with the results because too much or not enough tissue was removed
▣ Loss of ability to breast feed, though this complication is rare and should not occur unless the ducts are cut
▣ Loss of sensation in the nipple or breast area
Recovery after a nipple reduction is usually very rapid and usually you can return to work on the same day. Some people experience a loss of nipple sensation that lasts about a week. Since it is complex network of nerves there are chances of permanent loss of sensation as a result of surgery.
The sutures may be dissolvable or the patient may return to the doctor's office 4 to 7 days after the nipple reduction to have the stitches removed. If scars occur in the form of a lightening of the tissue where the nipple has been operated on, a procedure called areola tattooing does exist to give the affected area back its earlier shade.
This procedure cannot be reversed and hence one needs to consult with a surgeon in depth for attaining the best results.
