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Breast Enlargement (Breast Augmentation)

If you wish to enhance your breasts' size and improve the shape, breast enlargement may help you. This surgery is used for multiple reasons -- enlarging a woman's bustline, restoring the appearance of breasts after multiple pregnancies, and providing balance to uneven breasts. However, be aware that breast implants may interfere with mammography screening tests. You may need additional views of the breast with a breast implant. Also, if you are planning to breastfeed, you should make your plastic surgeon aware of this.

The Procedure: There are several types of breast enlargement surgery -- an incision can be made either via the crease under your breast, the nipple, or the armpit. There is also a newer, lesser-used method that involves the belly button. Your surgeon will discuss all the possible methods with you so you can determine which best suits your needs.

There are different types of implants as well, including saline-filled or silicone gel-filled breast implants. Your plastic surgeon will discuss these options with you. Breast implants are typically done as an outpatient procedure.

Common Side Effects: Side effects can include soreness and increased or decreased sensitivity in the nipple region, bruising or swelling. The swelling may last for several weeks.

Complications: In rare instances, you may have:

  • Scar tissue
  • Sagging of implants
  • Implants settling toward the middle of the chest, giving the appearance of one continuous breast
  • Rupture or deflation of implants
  • Blood or fluid collecting around the implant
  • Infection

Recovery: You may have drainage tubes and gauze bandages. You will have stitches that will be removed in about one or two weeks. If you are physically active in sports, it may take up to six weeks before you can return to those. You should be able to return to work within a few days after surgery.

Results: Revision may be required to change the size or shape. On average, implants will last 10 to 12 years, but this is extremely variable. In some women, implants may last a lifetime. In other women, the implants may sag with age and require replacement or an additional procedure such as a breast lift (mastopexy).

Find out more about breast enlargement.

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WebMD Medical Reference

Reviewed by Brunilda Nazario, MD, February 23, 2009.

SOURCES: Christopher K. Livingston, MD, assistant professor of plastic surgery, University of Texas Medical School, Houston. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Breast Augmentation."

Breast Lift (Mastopexy)

Droopy breasts are a problem for many women -- the result of weight loss, pregnancy, breastfeeding, or the normal aging process.

The Procedure: The most common surgery to provide breast lift is the mastopexy, which involves removing excess skin and a variable amount of breast tissue followed by repositioning the nipple higher on the chest. This surgery involves making incisions around the nipple and moving it higher on the chest wall. Often a breast implant is included to enhance the breast's shape. It is usually done on an outpatient basis, but in some cases the patient is hospitalized.

Length: 2 to 4 hours

Anesthesia: Local with sedation or general anesthesia

In/outpatient: Usually outpatient. Sometimes inpatient depending on type and length of procedure and patient's age

Common Side Effects: Temporary bruising, swelling, discomfort, numbness, dry breast skin. The incisions are typically red and noticeable for up to a year, and sometimes longer.

Complications: Complications are relatively uncommon. The main three are bleeding, infection, and scarring. Occasionally there may be some incision irregularities, in which case touch-up procedures or scar revisions may have to be done. There may be slight differences between the two breasts. If so, the plastic surgeon will perform a small touch-up procedure to reposition the nipple. Loss of nipple or breast skin sensation is rare.

Recovery: Following the procedure, it is very important to limit activity. Within two to three weeks, all sutures are removed. Recovery is generally complete four or six weeks after surgery. The size and shape of the breast continues to get better as time proceeds.

Results: Breast lift procedures may last a lifetime; however, as a women ages the breast will continue to sag and may require a revision or an additional breast lift or breast implant augmentation. You will need to consult your plastic surgeon as to which procedure is best for you.

Find out more about breast lifts.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

SOURCES: Christopher K. Livingston, MD, assistant professor of plastic surgery, University of Texas Medical School, Houston. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Breast Augmentation."

Breast Reduction

Many people suffer much pain and other physical problems because of uncomfortably large breasts. For women and men both, breast reduction surgery may be a good option. But it's important to keep in mind -- as you discuss this with your doctor -- to be honest about your medical history and your emotions regarding your breast size. This will help your doctor give you the best advice concerning this surgery.

The Procedure: During breast reduction surgery, you will have an incision at your nipple, then downward on the breast. The surgeon will remove the excess skin, tissue, and fat -- and relocate your nipple so the breast's appearance will be natural. You'll go home with your breasts wrapped in gauze and wearing a surgical bra.

Common Side Effects: Different techniques can produce scars of varying size and shape. However, there is essentially no technique at this point that can provide a scar-free breast reduction.

Complications: In rare cases, there may be certain complications such as inadequate healing along the incision line, which is more common among smokers. Inadequate healing or delayed healing can lead to a need for dressing changes for a period of time. Tissue loss can occur, which is most worrisome if it occurs in the nipple area. In rare cases, there may be loss of sensation. Breastfeeding is generally possible after breast reduction surgery, but this may vary from patient to patient.

Recovery: You will need to take at least one week off from work or school. Some patients require two weeks, but each situation varies. If you are a physically active person, you will not be able to resume your activity for at least one month after surgery.

Results: After the procedure, most people are very satisfied with the results.

Find out more about breast reduction surgery.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

SOURCES: Jeffrey Marcus, MD, assistant professor of surgery and pediatrics at Duke University School of Medicine. WebMD Medical Reference in collaboration with The Cleveland Clinic: "Breast Reduction."

Breast Reconstruction

After a mastectomy for breast cancer, many women choose to have breast reconstruction -- which involves replacing skin, breast tissue, and the nipple. The ultimate goal is to restore symmetry between the two breasts. There are many types of procedures for breast reconstruction, depending on your health, goals of surgery, and amount of recovery you are willing to accept. The more involved procedures carry slightly higher risks -- but also greater reward in terms of aesthetic appearance.

Women are generally encouraged to begin breast reconstruction at the same time they have the mastectomy -- to reduce emotional trauma, expense, and discomfort. However, if chemotherapy or radiation treatments have already started, reconstruction is usually postponed.

The Procedure: The patient's goals, medical condition, and previous surgery will determine whether to use breast implants or flaps of tissue moved from other parts of the body. A nipple is constructed using a skin flap. The areola is then created with a medical tattoo.

Common Side Effects: After you go home, you can expect some soreness, swelling, and bruising for two to three weeks. The mastectomy and breast reconstruction will leave areas of numbness and tightness where the surgery was performed. The shape of your reconstructed breast will gradually improve over the next months.

Complications: These will depend entirely on the type of reconstruction you have. Your surgeon can discuss all the options available, the risks, and potential benefits of each.

Recovery: Most women return to normal activities within six weeks after surgery. It may be several weeks before you can do strenuous exercise. In time, some feeling may return in your breasts. Most scars will improve over time.

Results: The results of breast reconstruction are considered permanent. However, you must continue regular breast cancer exams and screening (a breast reconstruction rarely if ever hides a cancer recurrence in a mammogram). Any recurrence can still be treated with surgery, radiation, and chemotherapy.

Find out more about breast reconstruction.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

SOURCES: Christopher K. Livingston, MD, professor of plastic surgery at The University of Texas Medical School at Houston. WebMD Medical Reference in collaboration with The Cleveland Clinic: "Breast Reconstruction."

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