Breast Surgery

Breast asymmetry

What is the operation?

Nipple asymmetry may be corrected with a small skin or areola excision.  Breast asymmetry in volume may require either a differential augmentation (if increased volume is required), or breast reduction (if a smaller volume is required).

What are the main body concerns it helps to improve?

  • nipple/ areola asymmetry
  • breast volume asymmetry

What is involved?

  • nipple/areola correction – day surgery
  • breast implants/ reduction – see relevant section

 

Breast augmentation

What is the operation?

The insertion of breast implants usually under the pectoralis major muscle via an incision in the lower breast fold (IMF).

What are the main body concerns it helps to improve?

  • congenital – small breasts
  • deflation post breastfeeding

What is involved?

  • 2-hour operation
  • overnight stay in hospital
  • 6 weeks in a supportive bra with activity restrictions
  • annual surgical review for the life of the implants
  • most breast implants require revision surgery within 10-15 years

Breast implant removal

What is the operation?

Removal of breast implants via an IMF incision.  If there is no capsular contracture there is potentially no need for a partial capsulectomy.

What are the main body concerns it helps to improve?

  • problems with implants eg capsular contracture or rupture
  • concerns about Breast Implant Illness (BII) or Anaplastic Large Cell Lymphoma (ALCL)

What is involved?

  • capsulotomy via an IMF incision – 1-hour operation
    • day surgery
  • total capsulectomy for ALCL or BII
    • overnight stay in hospital (potentially longer)
    • drains inserted
  • The only medical indication for total capsulectomy is for ALCL. A total capsulectomy is more painful and has a higher risk of bleeding than simply removing the implants via a capsulotomy.
  • Breasts will appear deflated and ptotic (droopy) once the breast implants are removed. A mastopexy may be required to address this.

Breast implant revision

What is the operation?

The removal of breast implants and replacement with new ones.  These may be in the same plane (under the muscle), or a different plane.  Depending on the reason for revision surgery, at least half the breast implant capsule is removed (partial capsulectomy).

What are the main body concerns it helps to improve? 

  • asymmetry
  • capsular contracture (implants become tight, distorted, and potentially painful)

What is involved?

  • 2-3-hour operation
  • overnight stay in hospital
  • may require drains
  • 6-weeks in a supportive bra with activity restrictions
  • annual surgical review for the life of the implants
  • most breast implants require revision surgery within 10-15 years

Breast lift (mastopexy)

What is the operation?

An operation to lift the nipple and breast to a more youthful position.  The breast volume does not change.

What are the main body concerns it helps to improve? 

  • nipple ptosis
  • breast ptosis (droopy breasts)

What is involved?

  • 1-2 hour operation
  • day surgery
  • 6-weeks in a supportive bra with activity restrictions

Breast reduction

What is the operation?

Removal of part of the breast gland, preserving the nipple and areola.

What are the main body concerns it helps to improve?

  • neck pain and back pain
  • shoulder grooving
  • intertrigo (rashes under the breast fold)

What is involved?

  • 2-hour operation
  • overnight stay
  • 6-weeks in a supportive bra with activity restrictions

Fat grafting – breast

What is the operation?

Liposuction of fat from an area of fat excess eg abdomen or outer thighs.  The fat is processed and injected to add volume to the breasts.

What are the main body concerns it helps to improve?

  • breast contour irregularities eg after breast surgery
  • to increase breast volume in specific areas eg cleavage
  • It is difficult and unreliable to enlarge the whole breast with fat grafting alone
  • Successful fat grafting is permanent. However, the proportion of fat that survives in the new location varies between patients and is unpredictable.

What is involved? 

  • 1-hour operation
  • day surgery
  • activity restrictions 1-2 weeks

Gynaecomastia

What is it?

Males develop persistent breast tissue.

What is the operation?

Liposuction or direct excision of breast tissue, preserving the nipple and skin.

What are the main body concerns it helps to improve?

  • create a more masculine chest contour

What is involved?

  • 1-2-hour operation
  • day surgery
  • 6-weeks in a compression garment with activity restrictions

Tuberous breasts

What is it?

A congenital abnormality of breast development.  There is a constricting ring of tissue causing the breast shape and areola to be distorted.

What is the operation?

The constricting tissue needs to be released.  In addition, the prominent areola may need to be reduced and commonly breast volume requires augmentation with breast implants.

What are the main body concerns it helps to improve?

  • abnormal breast shape (pointy instead of round)
  • prominent large areola

What is involved?

  • 2-3 hour operation
  • overnight stay in hospital
  • 6-weeks in a supportive bra with activity restrictions
  • annual surgical review for the life of the implants
  • most breast implants require revision surgery within 10-15 years