BREAST ENLARGEMENT

Candidates:
Women who feel that her breasts are too small, when clothes fit well around the hips but are too large around the bust line. This can be due to the fact that, the breasts have not developed properly, or evenly, leaving one breast smaller than the other or that the original shape and volume may have been lost due to weight loss, childbirth or aging.

Objective:
To enhance the size of the breasts using either silicone gel or saline implants

Incisions and technique:
There are several choices either an incision of one to two inches underneath the breast along the fold, a half moon following the lower edge of the areola, or an incision within the armpit. Whether the implant will be placed on top of or underneath the chest muscle will depend on each case and on the type of implant chosen. After the incision a pocket is made into which the implant will be inserted, either behind the breast or under the pectoral muscle. If the breasts are flaccid a breast lift may be recommended in conjunction with the augmentation.

Operating Time:
1 to 1 and half hours..

Anesthesia:
General anesthesia

In/Outpatient:
Usually performed inpatient .

Recovery period:
There will be temporary soreness and sensitivity, swelling, a change in nipple sensation and possibly bruising for two to three weeks.

Recovery Time:
A return to work, if not physically strenuous, is possible in a few days. The scar will fade after several months but can be up to a year or more in some cases. Dressings will be changed over several days immediately post operatively. Showering is permitted between three and seven days following surgery, and stitches are removed after 7 days. A support bra is worn for a month, driving is permitted after two weeks and exercise after two to three weeks.

Risks:
Nipple or breast sensation may change, usually temporarily. Surgical removal and replacement of the implants may be required to treat capsular contracture, which can provoke breast hardness.

Details:
A computer consultation helps tremendously when choosing the appropriate new breast size and shape. The patients' image can be seen with various breast sizes and the location of the incision is chosen.

Duration of the Results:
Results are variable but usually long-lasting, however implants may require removal or replacement. Mammograms are routinely prescribed annually after the age of 40. Significant weight loss can affect the result. Pregnancy and breast-feeding can alter breast size in an unpredictable way, although breast implants do not affect pregnancy or the ability to breast-feed. If, with aging, the appearance of the breasts change, it is possible to undergo a breast lift to improve contour.

BREAST LIFT

Candidates:
Women who are generally satisfied with their breast size but unhappy with the breasts lack of firmness, or the fact that the nipples point to the floor. This is due to a loss of the skins' elasticity, caused by weight loss, pregnancy, breast-feeding or just the passage of time.

Objectives:
To elevate and reshape sagging breasts by removing excess skin and repositioning the nipples. The breast lift will restore a more youthful appearance. There are cases where the breasts develop into different sizes, sometimes quite markedly different and in these instances an implant, often on one side only, is inserted in conjunction with a breast lift to increase the size and help restore the breast to its normal position.

Incisions and technique:
The incions for a breast lift vary according to three different techniques; the "inverted T," is one incision around the nipple, one in the fold below the breast and a third vertical incision joining them. The second is the "vertical" technique with two incisions, one around the nipple and a vertical one. The third is called "periareolar" and uses only an incision around the nipple. The choice of the appropriate technique varies according the type of breast and the desired shape. More incisions usually mean a better shape can be achieved and this should be discussed during the consultation.

Operating Time:
1 to 3 hours

Anesthesia:
Local with sedation, or general anesthesia as required for each case..

In/Outpatient:
Usually inpatient.

Recovery period:
Temporary pain is treated with analgesics. Swelling, tenderness, numbness of abdominal skin, bruising, and tiredness, some, or all of these can last up to several weeks. Small drains, removed after a few days, are used to help avoid the accumulation of fluids. Dressings are applied and will be changed every other day for the first two weeks. You may be required to wear a girdle for 90 days. Stitches will be removed in stages over a period of one or two weeks.

Recovery Time:
Back to work: in 1 to 2 weeks. Strenuous activities can usually be resumed after 1 month, and the fading of scars can take from several months to a year.

Side Effects:
Temporary bruising, swelling, discomfort, numbness, dry breast skin, bad scaring.

Risks:
Can include a collection of liquid (seroma) in the operated area that will have to be drained. Blood clots. Infection. Bleeding under the skin flap. Delayed healing or poor healing resulting in visible scarring or skin loss and the possibility of wide scars (keloids) in patients with a tendency. Unevenly positioned nipples. Temporary or permanent loss of feeling in nipples or breast. The need for a second procedure.