Breast Procedures
Breast Augmentation
Breast augmentation, technically known as Mammoplasty, is a surgical procedure intended to add size and shape to the breasts as well as bring balance to disproportionate breasts by inserting breast implants either directly beneath the skin, or under the chest muscle.
Women choose Breast Augmentation surgery for several reasons:
- Increase overall size and volume
- Balance size and shape for better symmetry
- Bring breasts into proportion with rest of the body
- Restore volume and shape after pregnancy
- Reconstruct breast(s) after Mastectomy
And certainly there are other factors motivating women to enlist the help from cosmetic surgery to improve the shape and size of this very private part of their anatomy. Dr. Marouk’s first priority is to discuss these motivations to provide his patients with the type of professional input only available through decades of education and experience. Then together they can make a well-informed decision, and plot the best course of action accordingly.
The Surgery
Working through the incision, Dr. Marouk inserts the implants either directly behind the breast tissue or underneath the muscles of the chest wall. There are pros and cons to each placement. For example, placing the implants behind the chest muscle may reduce the potential for capsular contraction, and interfere less with mammogram breast examination.
But it is more invasive, requiring more healing time and generally causing more pain and discomfort than if the implant is placed directly behind the breast tissue. Dr. Marouk covers this topic in detail during initial consultation as well as formulates an opinion as to which location is best for each patient given their anatomy, intended outcome and other factors.
Breast Augmentation Recovery
For the first few nights, most patients report feeling more comfortable sleeping with their upper body propped up a bit. Patients should minimize discomfort by taking the prescribed pain medication. The day after surgery, patients return to the office to replace the ace wrap (initially placed around your chest to control swelling and muscle contraction) with a sports bra. The sports bra will then be worn for approximately three weeks with 99 percent of patients stating that they feel most comfortable while wearing it following surgery.
Optimally, patients are encouraged to take a few days off work. Restrictions will apply based on the work environment and expectations, with no heavy lifting or straining allowed for two weeks. Nearly all sutures are dissolvable, but some used in breast lifts must be removed. Patients are generally moving around freely after a few days and expected to raise thier arms over their head the day after surgery. The more the arms are moved after the surgery, the sooner patients get rid of the “tight” feeling.
Breast Implants: Saline vs. Silicone
Saline breast implants are currently the most common type of implant used in Breast Augmentation procedures. It has an exterior sack made of solid silicone filled with a sterile saline solution, same solution commonly administered intravenously for a variety of reasons. One of the advantages of this solution is its safety. Should the implant for some reason leak, the saline simply gets absorbed by the body. Yet another advantage is the low infection rate associated with saline implants, usually less than one to two percent.
More than 1.5 million American women currently have silicone breast implants that, instead of saline, are obviously filled with a silicone gel. These implants typically have a more natural look and feel because the consistency of silicone is more similar to human breast tissue than saline. Silicone implants are also known to carry less risk of causing a rippling appearance under the skin. Women who are extremely thin or patients undergoing breast reconstruction often achieve better results with silicone breast implants.
However, silicone implants have a number of risks, including ruptures that can go undetected. When a saline implant ruptures, the saline gets absorbed into the body, making the breast go flat in an noticeable way. On the other hand, because silicone gel does not get absorbed by the body, there is little to no deflation to signal a rupture. Silicone breast implants also have a higher incidence of capsular contracture than saline implants.
Women wishing to achieve better symmetry may opt for saline implants. First of all, they are filled after inserting so the incision is smaller. And secondly, the amount of saline injected is adjustable.
One disadvantage of saline breast implants is their higher risk of developing a condition called rippling. In addition, there is a risk of capsular contracture, a condition caused by scar tissue surrounding the implants, making the breasts feel hardened. Saline breast implants are also heavier than silicone implants, which can cause drooping after a few years.
Breast Lifts
Over the years, factors such as pregnancy, nursing, and the force of gravity take their toll on a women’s breasts. As the skin loses its elasticity, the breasts often lose their shape, firmness and begin to sag. Breast lift, or Mastopexy, is a surgical procedure that raises and reshapes sagging breasts.
Although breasts of any size can be lifted, the best candidates for Mastopexy are women with small, sagging breasts. Those planning to have more children should strongly consider postponing a breast lift. Pregnancy is likely to re-stretch the breasts, thereby offsetting the benefits of the procedure. But ultimately, there are no special risks that affect future pregnancies e.g. Mastopexy doesn’t interfere with breast feeding.
Mastopexy does leave permanent scars although they’ll be covered by your bra or bathing suit. Poor healing and wider scars are more common in smokers. The procedure can also result in unevenly positioned nipples, or a permanent loss or feeling in your nipples or breasts.
The Surgery
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 and sometimes along the lower crease of the breast.
Some patients, especially those with relatively small breasts and minimal sagging may be candidates for modified procedure requiring less extensive incisions. One such procedure is the doughnut or concentric Mastopexy, in which circular incisions are marked around the areola, and a doughnut-shaped area of the skin is removed.
Breast Lift Recovery
For the first few nights, most patients report feeling more comfortable sleeping with their upper body propped up a bit. Patients should minimize discomfort by taking the prescribed pain medication. The day after surgery, patients return to the office to replace the ace wrap (initially placed around your chest to control swelling and muscle contraction) with a sports bra. The sports bra will then be worn for approximately three weeks with 99 percent of patients stating that they feel most comfortable while wearing it following surgery.
Optimally, patients are encouraged to take a few days off work. Restrictions will apply based on the work environment and expectations, with no heavy lifting or straining allowed for two weeks. Nearly all sutures are dissolvable, but some used in breast lifts must be removed. Patients are generally moving around freely after a few days and expected to raise thier arms over their head the day after surgery. The more the arms are moved after the surgery, the sooner patients get rid of the “tight” feeling.
Breast Reduction
Women with very large breasts may experience a variety of medical problems caused by the strain of the additional weight including back and neck pain, skin irritation, skeletal deformities and breathing problems.
Breast reduction, technically known as reduction Mammoplasty, is designed for such women. The procedure removes fat, glandular tissues, and skin from the breast, making them smaller, lighter, and firmer. It can also reduce the size of the areola. The goal is to give the woman smaller, better-shaped breasts in proportion with the rest of her body.
Breast reduction is usually performed for physical relief rather than simply cosmetic improvements. Most women who have the surgery are troubled by very large sagging breasts that restrict their activities and cause them physical discomfort.
In most cases, breast reduction isn’t performed until a woman’s breasts are fully developed; however, it can be done earlier if large breasts are causing serious physical discomfort. The best candidates are those who are mature enough to fully understand the procedure and have realistic expectations about the results. Beast reduction is not recommended for women who intend to breast feed.
The Surgery
The procedure does leave noticeable, permanent scars, although they’ll be covered by the bra or bathing suit. The procedure can also leave patients with slight mismatched breast or unevenly positioned nipples. Future breast feeding many not be possible, since the surgery removes many of the milk ducts leading to the nipples.
Techniques for beast reduction vary, but the most common procedure involves an anchor-shaped incision that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. Dr. Marouk removes excess glandular tissue, fat and skin and moves the nipple and areola into their new position. He then brings the skin from both sides of the breast down and around the areola, shaping the new contour of the breast. Liposuction may be used to remove excess fat from the armpit area.
Stitches are usually located around the areola, in a vertical line extending downward, and along the lower crease of the breast. In some cases, techniques can be used that eliminate the horizontal part of the scar. And occasionally, when only fat needs to be removed, liposuction alone can be used to reduce breast size, leaving minimal scars.
Breast Reduction Recovery
For the first few nights, most patients report feeling more comfortable sleeping with their upper body propped up a bit. Patients should minimize discomfort by taking the prescribed pain medication. The day after surgery, patients return to the office to replace the ace wrap (initially placed around your chest to control swelling and muscle contraction) with a sports bra. The sports bra will then be worn for approximately three weeks with 99 percent of patients stating that they feel most comfortable while wearing it following surgery.
Optimally, patients are encouraged to take a few days off work. Restrictions will apply based on the work environment and expectations, with no heavy lifting or straining allowed for two weeks. Nearly all sutures are dissolvable, but some used in breast lifts must be removed. Patients are generally moving around freely after a few days and expected to raise their arms over their head the day after surgery. The more the arms are moved after the surgery, the sooner patients get rid of the “tight” feeling.
Nipple Reduction
Large nipples may be long and protruding or merely have a very wide diameter. In either case, such prominent nipples are bothersome to women or men because they can be seen through clothes. Whatever the cause, correction is done for cosmetic reasons and and will stop your chest or breast from standing out in clothes. Enlarged nipples rarely cause pain or any nipple discharge issues.
The Surgery
Nipple reduction can be done by several different methods, depending upon the shape and length of the nipple and to what degree of the reduction that the patient wants. One method involves removal of the top of the nipple in a v-shaped wedge and then closing it with small dissolveable sutures. Another method involves removal of a strip of skin around the neck of the nipple which when sutured closed, reduces the height of the nipple by pushing a portion of the nipple back into the breast tissue. With either method, feeling in the nipple is not usually changed and the ability to breast feed is possible. The top reduction method can reduce the length of the nipple the most while the strip redction method is designed to have the least potential for any effect on nipple function. Once reduced, the shortened nipple length will be preserved forever.
Nipple reduction surgery is a simple procedure that can be done under local anesthesia in the office. Once injected, the procedure is painless and done in less than one hour. Small incisions are made right on the nipple and the excess nipple tissue removed. Dissolveable sutures are used so there is no need for suture removal later. Band-aids are used for dressings. While easily dont alone in the office, nipple reductions can also be done with other breast procedures such as breast augmentation, breast reduction, or breast lifts. When combined with these procedures, they are done in the operating room with the main breast procedure.
Nipple Reduction Reco very
One can return to work or any other physical activity the same day. Showering and getting the nipples wet can be done the next day. Other than some mild nipple sensitivity, there is no swelling or bruising of any consequence.
Nipple reduction produces a very natural appearing nipple that causes less protrusion in clothes while maintaining feeling.
Inverted Nipple
For many women these can create emotional and functional concerns. Nipples that are flat and indented can be corrected. The incision is very inconspicuous and usually located around the nipple only. The surgeon releases the tacked down tissue using small sutures to close the area. Sutures are usually removed within 4-7 days. Swelling and bruising are minimal to moderate and disappears within 3 weeks. Patients can shower the next day and almost immediately resume regular activities.
The Surgery
Inverted Nipple surgery details go here
Inverted Nipple Recovery
Inverted Nipple recovery details go here
