Breast Procedures

Breast Augmentation
(aka Augmentation Mammaplasty)

Breast augmentation referred to as augmentation mammaplasty or as patients commonly request “a boob job,” involves using implants or fat transfers to restore or increase the size of breasts. The results help to achieve a more rounded breast shape or improve natural breast size asymmetry.

Breast augmentation uses three general options silicone gel implants, saline implants, or fat grafting.

Saline breast implants are filled with sterile saltwater. Should the implant shell leak, a saline implant will collapse, and the saline will be absorbed and naturally expelled by the body. Saline breast implants provide a uniform shape, firmness, and feel, and are FDA-approved for augmentation in women age 18 or older.

Silicone breast implants are filled with silicone gel. The gel feels a bit more like natural breast tissue. If the implant leaks, the gel may remain within the implant shell or may escape into the breast implant pocket. A leaking implant filled with silicone gel will not collapse. Silicone breast implants are FDA-approved for augmentation in women age 22 or older.

Gummy bear breast implants are considered form-stable because they hold their shape even when the implant shell is broken. The difference from traditional silicone implants lies in the thicker consistency of the gummy bear implants’ gel. When compared with traditional implants, gummy bear implants are firmer, hold their shape better, and feel more natural to the touch.

Fat transfer uses liposuction techniques to remove your fat cells from a predetermined location then inject the fat into your breasts.

Why You May Want to Consider Breast Augmentation?
  • If you want to increase the fullness and projection of your breasts
  • If you want to improve the balance of breast and hip contours
  • If you want to enhance your self-image and self-confidence
  • If you want a better proportioned or more appealing figure
  • To restore symmetry if one of your breasts is smaller than the other.
  • If you wish your clothes fit better
  • When pregnancy, weight loss, or aging has affected the size and shape of your breasts

Pros:

  • You can look better in clothes and swimwear.
  • You can have a more youthful-looking figure.
  • You can feel more proportional.
  • Augmentation is a long-term solution for achieving an ideal figure.

What Makes You a Good Candidate for Breast Augmentation?

  • You are healthy and you aren’t pregnant or breastfeeding.
  • You have realistic expectations.
  • Your breasts are fully developed.
  • You are bothered by the feeling that your breasts are too small.
  • You are dissatisfied with your breasts losing shape and volume after pregnancy, weight loss or with aging.
  • You are unhappy with the upper part of your breast appearing “empty”.
  • Your breasts are asymmetrical.
  • You are a non-smoker.

How Long Will the Results Last?

While a breast augmentation yields larger breasts right away, the final results may take a few weeks as the swelling subsides, and the skin stretches. Some patients may need to wear a bandeau to help shape their breasts, especially if they have underlying asymmetry or very small breasts to start with. Incision lines may take several months, even a couple of years, to fade.

Over time, your breasts will change due to aging, weight fluctuations, hormonal factors, and gravity. As the appearance of your breasts changes with time, some patients have a breast lift or an implant exchange to restore a more youthful contour.

Breast implants are not considered to be lifetime devices, and they may need to be replaced. You can see your plastic surgeon for an annual examination to evaluate your breast health and implant integrity.

Breast Lift
(aka Mastopexy)

A breast lift, also known as mastopexy, can rejuvenate your figure with a breast profile that is more youthful and uplifted. A woman’s breasts often change over time, losing their youthful shape and firmness. Sometimes the areola becomes enlarged over time, and a breast lift will reduce this as well. Breast lift surgery does not significantly change the size of your breasts or round out the upper part of your breast. 

Why You May Want to Consider a Breast Lift?
  • If pregnancy, nursing, gravity, weight gain or loss, normal aging, and heredity have taken a toll on the shape of your breasts, resulting in sagging or excess skin.
  • If your breasts lack substance or firmness.
  • If your breasts appear different from each other.
  • If your breasts are not equal in size.
  • If your breasts are adequate in size.
  • If your breasts are large and heavy and need to be lifted.
  • If the tissue surrounding the nipple or areola has become stretched.
  • If your nipples and areolas that point downward.

Pros:

  • You will have improved breast shape, projection, and symmetry.
  • Your breasts will have a more youthful appearance.
  • You will look better in and out of clothes and feel more self-confident.

What Makes You a Good Candidate for a Breast Lift?

  • You are finished with childbearing and breast-feeding. (If you plan to have children, you may want to postpone cosmetic breast surgery.)
  • You are physically healthy and maintain a stable weight.
  • You are bothered by the feeling that your breasts sag or have lost shape and volume.
  • Your breasts have a flatter, elongated shape or are pendulous.
  • When unsupported, your nipples fall below the breast crease.
  • Your nipples and areolas point downward.
  • You have stretched skin and enlarged areolas.
  • One breast is lower than the other.
  • You are a non-smoker.

How Long Will the Results Last?

The results of your breast lift surgery will be long-lasting and are immediately visible. Over time, post-surgical swelling will subside, and incision lines will fade. The final results of your breast lift will appear over the next few months as breast shape and position continue to settle. Over time, your breasts can continue to change due to aging and gravity.

Breast Reduction
(aka Reduction Mammaplasty)

The goal of breast reduction surgery, also known as reduction mammaplasty, is to reduce the size of your breasts and reshape them so that they are proportionate to the rest of your body and are no longer a source of physical discomfort. This commonly requested, predictable procedure has the dual benefits of improving your appearance while relieving the physical and emotional burden of overly large breasts.

Why You May Want to Consider a Breast Reduction?
  • If your breasts are too large for your body frame and create back shoulder, or neck pain.
  • If you have heavy breasts with nipples and areolas that point downward.
  • If one breast is much larger than the other.
  • If you are unhappy and self-conscious about the large appearance of your breasts.

Pros:

  • Your breasts will be in better proportion with your body and will feel firmer.
  • Surgery will alleviate neck, back, and shoulder pain and make it easier to breathe and exercise.
  • Your clothes will fit better, and you will feel more confident about your appearance.

What Makes You a Good Candidate for a Breast Reduction?

You may be a candidate for breast reduction surgery if:

  • You are physically healthy.
  • You have realistic expectations.
  • You are bothered by feeling that your breasts are too large.
  • You have breasts that limit your physical activity.
  • You experience back, neck, and shoulder pain caused by the weight of your breasts.
  • You have shoulder indentations from bra straps.
  • You have skin irritation beneath the breast crease.
  • You are a non-smoker.

What Will Recovery Involve?

When your breast reduction procedure is complete, dressings or bandages will be applied to the incisions. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect. An elastic bandage or support bra may be worn to minimize swelling and support the breasts as they heal.

If you experience shortness of breath, chest pains, or unusual heartbeats, seek medical attention immediately. Should any of these breast reduction complications occur, you may require hospitalization and additional treatment.

How Long Will the Results Last?

The results of breast reduction surgery will be long-lasting. Your new breast size should help relieve you from the pain and physical limitations experienced prior to breast reduction. Your better-proportioned figure will likely enhance your self-image and boost your self-confidence. However, over time your breasts can change due to aging, weight fluctuations, hormonal factors, and gravity.

Nipple/Areola Reduction

Nipple reduction surgery is a relatively quick, safe procedure that can reduce the size of one or both nipples. This procedure shortens nipple length and reduces width, creating more balance between the nipple and areola. It can be performed on men and women, though it’s more commonly sought out by women whose nipples have become stretched and droopy after breastfeeding. Nipple reduction is not recommended for women who plan on breastfeeding after surgery as this can affect results.

Why You May Want to Consider a Nipple/Areola Reduction?
  • If you have inverted nipples.
  • If your nipples/areolas have changed with aging.
  • If you have overly large nipples/areolas.
  • If you have asymmetrical nipples/areolas.
  • If your nipples that point downward.
  • If you’ve had a mastectomy or gynecomastia surgery.

Pros:

  • It can make stretched, droopy nipples smaller and more symmetrical.
  • It can make nipples look more well proportioned.
  • The procedure is minimally invasive and doesn’t usually require significant downtime.
  • Nipple reduction can make both the breasts and nipples look more youthful.
  • The appearance of your breast is as close as possible to the appearance prior to your mastectomy or gynecomastia surgery.

What Makes You a Good Candidate for Nipple/Areola Reduction?

You may be a candidate for nipple/areola reduction surgery if:

  • You are dissatisfied with your nipple/areola shape and volume after pregnancy, weight loss, or with aging
  • You are finished with childbearing and breast-feeding. (If you plan to have children, you may want to postpone surgery.)
  • You are healthy and you aren’t pregnant or breastfeeding
  • You are maintaining a stable weight
  • When unsupported, your nipples fall below the breast crease
  • Your nipples and areolas point downward
  • You have stretched skin and enlarged areolas
  • Your nipples/areolas are asymmetrical
  • You have realistic expectations
  • You are a non-smoker

What Will Recovery Involve?

Following the procedure, a non-adherent gauze dressing and a generous amount of ointment will be placed onto your breast and held in place by surgical tape. The dressing will need to be changed every few hours for the first few days. If you have been tattooed as a part of your reconstruction, it is important not to let the tattoo get dry, or to allow excessive friction between clothing and the tattoo during this time.

Reconstruction of the nipple and areola is usually an outpatient procedure requiring less than an hour to complete. Most patients will have some mild pain or discomfort which may be treated with mild painkillers and will be able to return to their normal activities within a few days.

How Long Will the Results Last?

The results of nipple/areola surgery are permanent. An initial period of swelling and bruising often obscures the results. As the swelling subsides, your breasts will settle into their final position. You’ll notice that your areolas appear smaller and more centered. You’ll also notice a ring-shaped scar around your new areola. This can take up to one year to heal.

Mastectomy

A mastectomy is a surgery to remove all breast tissue from a breast as a way to treat or prevent breast cancer. There are five different types of mastectomy: “simple” or “total” mastectomy, modified radical mastectomy, radical mastectomy, partial mastectomy, and subcutaneous (nipple-sparing) mastectomy.

Simple or total mastectomy concentrates on the breast tissue itself:

  • The surgeon removes the entire breast.
  • The surgeon does not remove lymph nodes in the underarm area. (Sometimes, however, lymph nodes are occasionally removed because they happen to be located within the breast tissue taken during surgery.)
  • No muscles are removed from beneath the breast.

Modified radical mastectomy involves the removal of both breast tissue and lymph nodes:

  • The surgeon removes the entire breast.
  • Axillary lymph node dissection is performed, during which levels I and II of underarm lymph nodes are removed.
  • No muscles are removed from beneath the breast.

Radical mastectomy is the most extensive type of mastectomy:

  • The surgeon removes the entire breast.
  • Levels I, II, and III of the underarm lymph nodes are removed.
  • The surgeon also removes the chest wall muscles under the breast.

Partial mastectomy is the removal of the cancerous part of the breast tissue and some normal tissue around it:

  • The surgeon removes more tissue in partial mastectomy than in lumpectomy.

During nipple-sparing mastectomy:

  • All of the breast tissue is removed, but the nipple is left alone.

Deciding between a mastectomy and lumpectomy can be difficult. Both procedures are equally effective for preventing a recurrence of breast cancer. But a lumpectomy isn’t an option for everyone with breast cancer, and others prefer to undergo a mastectomy. A mastectomy is a way to treat breast cancer.

Why You May Want to Consider a Mastectomy?
  • If you have a tumor that is larger than 5 centimeters.
  • If your breast is small and a lumpectomy would leave you with very little breast tissue.
  • If your surgeon has already made multiple attempts to remove the tumor with lumpectomy but has not been able to completely remove the cancer and obtain clear margins.
  • If lumpectomy plus radiation is not an option for your small tumor (under 4 centimeters).
  • If you have had prior radiation to the same breast, you have a connective tissue disease you are pregnant, or you do not want to commit to daily radiation treatment.
  • If you believe mastectomy would give you greater peace of mind in order to prevent any possibility of breast cancer occurring.

Pros:

  • You might feel more confident your cancer won’t come back.
  • You usually won’t need radiotherapy after the surgery.
  • You can have radiotherapy to the area if your cancer comes back in the future.

What Makes You a Candidate for Mastectomy?

You may be a candidate for a mastectomy if:

  • You have two or more tumors in separate areas of the breast.
  • You have widespread or malignant appearing calcium deposits throughout the breast that have been determined to be cancer after a breast biopsy.
  • You’ve previously had radiation treatment to the breast region and the breast cancer has recurred in the breast.
  • You’re pregnant and radiation creates an unacceptable risk to your unborn child.
  • You’ve had a lumpectomy, but cancer is still present at the edges of the operated area and there is concern about cancer extending to elsewhere in the breast.
  • You carry a gene mutation that gives you a high risk of developing a second cancer in your breast.
  • You have a large tumor relative to the overall size of your breast. You may not have enough healthy tissue left after a lumpectomy to achieve an acceptable cosmetic result.
  • You have a connective tissue disease, such as scleroderma or lupus, and may not tolerate the side effects of radiation to the skin 

What Will Recovery Involve?

When your mastectomy is complete, dressings or bandages will be applied to the incisions. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect. You’ll probably stay for 1 or 2 days, though it might be longer if you had reconstruction.

Once you’re home, make sure to get plenty of rest, take your medications as prescribed, keep the area dry until your drains and stitches are removed. Exercise to keep your arms from getting stiff. Get all the help you can with meal prep, shopping, housework, childcare, pet care, rides to doctors’ appointments, and whatever else you aren’t ready to take on by yourself.

An elastic bandage or support bra may be worn to minimize swelling and support the breasts as they heal. Some people have numbness in the upper arm after surgery. It’s caused by damage to small nerves in the area where the lymph nodes are taken out. There’s a good chance that you’ll regain most of the feeling in your arm over time.

If you experience shortness of breath, chest pains, or unusual heartbeats, seek medical attention immediately. Should any of these breast reduction complications occur, you may require hospitalization and additional treatment.

How Long Will the Results Last?

The results of a mastectomy will be long-lasting.