Breast Reduction
Some of the happiest plastic surgery patients are those who have had breast reductions. This is interesting considering that the scars from a breast reduction are not insignificant. To me this illustrates two things:
- Shape and form are seen by patients as the top priority.
- Large breasts are a serious lifestyle hindrance -
- back and breast pain
- embarrassed to be seen in public
- can't play sport
- can't find clothes that fit properly
I perform various types of reduction - both long and short scar techniques. The technique used will depend on your current breast size and shape and also on what size and shape you would like to be.
I strongly recommend that you are at your ideal weight for height before embarking on any surgery. Weight loss or gain after a breast reduction may alter the shape and size; adversely affecting the final outcome.
You are extremely unlikely to be able to breastfeed after a breast reduction. Pregnancy will also alter breast size and shape after a reduction. I recommend that a woman completes her family before considering a reduction; however, some women in their late teens have extremely large breasts necessitating the procedure despite the above mentioned problems.
Nipple sensation will be decreased in the vast majority of patients following a breast reduction.
Gynaecomastia
Overdeveloped male breasts are embarrassing to most men. There are a number of causes, mainly hormonal problems, which warrant investigation. There are various grades of gynaecomastia. Surgery and/or liposuction can achieve satisfying results.
Mastopexy
A mastopexy is a common request after breastfeeding, pregnancy or weight loss. The various mastopexy techniques are designed for a patient wishing to undergo a breast “lift” without a reduction. This can be combined with an Augment (Breast enlargement) in which case the procedure is referred to as a Pexy-Augment. Often, however, it is better to perform the Augment and the Mastopexy as two separate procedures; especially in smokers.
Breast Augmentation
Breast Augmentation is my most commonly performed cosmetic procedure. I only use top quality approved prostheses.
I make recommendations depending on breast shape, size, height, width, skin thickness, patient requirements and other factors.
A number of options will be presented to you during your consultation. I generally use either round or anatomical, textured silicone prostheses. My most common approach is via an inframammary incision. This leaves a 4 to 6cm scar in the lower breast fold. I believe that this is the most hidden scar; however, I do use other approaches, depending on patient preference. The implant is placed either below or above the muscle.
Breast Reconstruction
After a mastectomy a patient can choose either immediate or delayed reconstruction of one or both breasts. The type, grade and progression of a breast cancer will influence this decision.
I offer reconstructions using either autologous tissue (a patient's own tissue) or prosthetic reconstruction (using a silicone implant).
Prosthetic reconstruction usually involves a number of staged procedures -
- A temporary skin expander is placed either at the same time as the mastectomy or as a second procedure
- The expander is replaced by a permanent silicone prosthesis
- The Nipple and Areola are reconstructed
Autologous reconstruction
If you have enough lower abdominal skin and fat to spare, the excess can be used to create a breast. There are a variety of ways that the tissue can be transferred. This is limited in smokers and patients with certain medical conditions. Other less commonly used autologous reconstructions make use of muscle transfers; these are usually combined with an implant.
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