FAT TRANSFER TO BREASTS »
BREAST LIFT (MASTOPEXY) »
BREAST REDUCTION »
MALE BREAST REDUCTION (GYNECOMASTIA) »
breast surgery is done to improve the appearance
of the breast. It may be done to increase or decrease
size, improve symmetry or reduce sagging. Increasing
the breast size is called breast augmentation or
breast enhancement. This is most commonly done with
breast implants which can be filled with saline (a
salt water solution) or silicone gel. Recent reports
describe breast enhancement with the patients own
fat. This is still not widely accepted as safe.
Large breasts can be reduced in
size for improved cosmetic appearance or to reduce
symptoms. While the cosmetic breast reduction is
the same operation as a functional breast reduction,
the indications and goals vary greatly. Additionally,
insurance companies will often place certain requirements
for coverage. This
section will address cosmetic breast reduction only.
Breast sagging (or ptosis) can
result from childbearing, weight changes or simply
from aging. It is defined as the relationship of
the nipple and the fullest part of the breast to
the fold under the breast (called the inframammary
fold). When the nipple descends below the fold,
there is sagging or ptosis. Sagging
is the result of the loss elasticity of the supportive
tissues of the breast. The support is both internal
(fibers that run through the breast called Coopers
Ligaments) and from the skin (referred to as the
skin brassier). Surgery to improve sagging repositions
the nipple and breast tissue above the inframammary
fold and tightens the skin. It does not change the
characteristics of the poorly elastic support tissue.
Changes in the breast are a sequelae of pregnancy
and/or aging. These changes may also include loss
of breast volume and thus placement of a breast implant
is commonly included in breast lift surgery.
Finally, male breast reduction
is included in this section. The vast majority
of males will develop breast enlargement at the
time of puberty. This enlargement goes away in
most males who experience it. A few will not and
this may lead to embarrassment in these young men.
Surgery to reduce the male breast varies with the
size of the reduction and the degree of skin excess.
Though this is a common non-pathologic process,
patients must be evaluated to rule out medical
conditions that can lead to male breast enlargement.