Breast Surgery

Breast Augmentation (Implants)

 

Reasons for undergoing Breast Augmentation

The genetic coding for breast development is complex.  On occasions it does not proceed as fully intended.  In some cases both sides developed differently.  Sometimes pregnancy can result in a significant reduction in breast volume.  Reduced or asymmetric breast development can be very depressing and, due to psychological pressures, limit activities and dress choice of patients.

Surgery

Breast enlargement is usually achieved using implants. These can be silicone or saline filled, round or tear-drop and are inserted in pockets directly under the breast tissue, (sub glandular), or deeper, under the underlying muscle, (sub muscular). These decisions and  choices, along with the implications and risks are fully explored during consultations.

 

Anaesthetic

General, usually overnight stay

Back to work

Usually within two weeks, depending on the type of work

Scars

4-5cm in the fold under the breast.

Generally fades to a thin white line

Feeling

Usually retained but can diminish

 

Breast feeding

Should be unaffected

Further information

Breast Implant Registry; Patient Information

 

Anaplastic Large Cell Lymphoma (ALCL) & Breast Implant related illness (BII)

MHRA Information for Women Considering Breast Implants

Symptoms sometimes referred to as Breast Implant Illness

Reasons for undergoing a Breast Reduction

Variations in breast development can be dramatic and can change during adulthood, especially after pregnancy. Some ladies develop large breasts that are completely out of balance with the rest of their frame.  They can be heavy, uncomfortable, impede activities and dress sense as well as incurring unwanted attention.

Surgery

Breast tissue and skin are removed, thus reducing the volume of the breast and improving its shape. The nipple usually remains attached but is moved and can also be reduced if required. The implications and risks are fully explored and explained during consultations.

Anaesthetic

General, overnight stay, sometimes two nights

Back to work

Two to three weeks but it depends on the type of work

Scars

Around the areola, vertically down and usually along the crease below the breast.

Fade with time, may take up to 18 months. (Photo taken at 3 months in this vertical

scar technique example)

Feeling

Often retained but can diminish

 

Breast feeding

Often successful despite the reduction

Further information

British Association of Aesthetic Plastic Surgeons (web page)

British Association of Aesthetic Plastic Surgeons (patient information)

 

Breast Reduction

Mastopexy (Breast Uplift)

 

Reasons for undergoing a Mastopexy

All mature breasts fold to some degree with time. The extent to which this folding occurs is extremely variable and can be influenced, for example, by pregnancy.  In some cases the folding, called ptosis, can be dramatic influencing clothing and sporting activities.  In some cases the degree of folding can cause hygiene problems.

Surgery

Excess skin is removed, lifting and gathering the underlying breast tissue to improve shape and reduce folding. The nipple usually remains attached but is moved and can also be reduced if  required. A mastopexy can be performed in association with implants but the surgery is often two staged. The implications and risks are fully explored and explained during consultations.

 

Anaesthetic

General, overnight stay, sometimes two nights

Back to work

Two to three weeks depending on the type of work

Scars

Around the areola, often vertically down and  below the breast.

Fade with time, may take up to 18 months.

 

Feeling

Often retained but can diminish

 

Breast feeding

Often successful 

Further information

British Association of Aesthetic Plastic Surgeons (web page)

British Association of Aesthetic Plastic Surgeons ( information)

 

Congenital / Developmental Breast Abnormalities

Reasons for undergoing corrective surgery

The genetic coding for breast development  is extremely complex and does not always go according to plan. Various abnormalities can result, including mismatch of volume or shape, or both, There are many variations and significant differences are more common that most would realise. It is quite natural that those who are affected  do not  talk openly about something that can be extremely embarrassing. Patients can therefore feel very isolated.

Surgery

Aimed at improving the appearance and symmetry, surgery can sometimes be straight forward but in other cases may need a series of operations. The various options, their implications and associated risks need exploring, often over time and in more than one consultation. This enables the formulation of an individual plan and the full understanding of what is involved 

Anaesthetic

General, overnight stay, sometimes two nights

Back to work

Two to three weeks depending on the type of work

Scars

Depend on the anomaly

Fade with time

 

Feeling

Often retained but can diminish

 

Breast feeding

Usually unchanged 

 

Reasons for undergoing corrective surgery

Inverted nipples are common and can cause embarrassment. If a nipple has recently become inverted it is important to rule out any sinister cause by seeking the advice of your GP who may refer for either a mammogram of advice from a breast clinic.

Sometimes it is possible to achieve correction using a propriety suction cup. If this fails inversion caused by shortened ducts can be corrected by a minor procedure. It is important to note that breast feeding after inverted nipple correction surgery is not possible.

Surgery

A small incision is made on the undersurface of the everted nipple through which the shortened ducts are divided. This stops them drawing the nipple in and so  maintains eversion. 

Anaesthetic

Local or General. Day case

Back to work

Next day

Scars

5-8mm under nipple

Feeling

Usually remains but can diminish

Breast feeding

This procedure cuts the lactiferous ducts. Breast feeding is therefore not possible 

Inverted Nipple Correction

 

Revision Breast Surgery

(Augmentation/ Reduction/ Mastopexy/ Reconstruction)

Reasons for undergoing Revision Breast Surgery

There are a multitude of reasons for undergoing revision breast surgery.  Gravity takes its toll with time, our weight and fat distribution fluctuates.  Breasts can change significantly with age even if they have not had surgery in the past.  Implants have a lifespan and this can be quite variable.  Some implants used in past years have been found to be unsafe and should now be removed. (Mr Morris has never used Trilucent or PIP implants). They are man-made and can eventually fail.  Our bodies react differently to implants and sometimes the fine surrounding capsule becomes dense and hard. It can alter the shape of the breast and cause pain.

On occasions decisions made years ago may not be appropriate today; size or shape of implant for example.  Significant episodes such as pregnancy can alter the results of past surgery.

Surgery

Secondary breast surgery is usually more difficult than the original procedure.  Previous scars can dictate the placement of new incisions.  Breast tissue thins with age especially if implants have been used in the past.  Removing a breast capsule thins breast tissue further rendering any subsequent implant more obvious both visually and to the touch. 

By definition patients have aged since the original surgery.  The ability of the skin to tighten up reduces; it becomes less compliant as the elasticity decreases with time.

These factors combine to make secondary surgery difficult.  Added to this as we get older we often become more critical of the outcome.

 

Anaesthetic

Minor adjustments can be performed under local anaesthetic. 

Significant procedures requires a general anaesthetic

Overnight stay if GA

Having sight of the original surgeons notes, (implant details) helps