Breast Surgery

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Breasts are the major identity of the female gender and are important determinants of female beauty and psychology besides being an important functional organ.

Breast reshaping surgery is the most commonly performed cosmetic surgery in the west. In India and Asia too the figures are fast catching up.

BREAST UPLIFT AND AUGMENTATION:

Major indications for this surgery are:

Small size of the breasts

Drooping or lax breasts especially after child bearing and lactation.

Unequal or different sized breasts

Breast volume restoration after removal of breasts as in cancer.

Operative and post operative

After careful examination and discussion about the actual requirements the augmentation surgery is carried out under local or general anaesthesia and is painless. About 2 inches cut is made under the breast where it joins the chest wall. After making adequate space under the breast tissue or the underlying muscle the breast implant is placed and cut is closed. Most of the cases go back home same evening and can resume light routine activities in about 2 to 3 days time. Stitches are removed after 7 to 10 days after the surgery.

For uplifting the grossly drooping breasts surgery is of bit longer duration and entails fixing the breast tissues higher, removing excess of skin if present and inserting an implant if required. The resultant scar line is usually inverted T shaped.

About the implants

The implants are made of medical grade sialastic or silicone. It has outer shell and inner space filled either with saline or silicone gel. They are mostly rounded or spherical in shape however other shapes like oval or teardrop are also available. They come in different sizes and projections and are manufactured by different concerns. In the US only saline filled implants are used but in Europe and rest of the countries gel filled are more commonly used.

Results and complications

Increase in the size of breasts and upliftment gives a great feeling of satisfaction to most of the cases. It enhances one’s appearance and self esteem. Depending upon the size of the implant there is one or more increase in the cup size of the bra.

In the immediate postoperative period slight discomfort, swelling and pain is experienced temporarily. Feeling of numbness, altered sensations can remain under the nipple for a varying length of period. Formation of tight capsule around the implant causing it to feel hard or deformed is sometimes seen. This capsule contracture can be treated by closed maneuvers or may require an open surgery. Rarely infection can occur around the implant in which case it may require long-term antibiotics, replacement or even removal. Implant rupture, leakage or deflation can also occur requiring further surgical interventions.

BREAST REDUCTION

Oversized breasts are not only a matter of embarrassment but extremely uncomfortable too. These can result in constant discomfort, shoulder and neck pain. Oversized breasts are seen both in young and elderly females.

Operative and post operative: Breast size can be effectively reduced by surgical removal of the excess tissues. This surgery is done under general anesthesia and requires about 3 days of hospitalization. Dressings are required for about 7 to 10 days until the stitches are removed. There is a resultant scar around the nipple areola complex and inverted T shaped lines over the lower portion of breast and chest wall. All efforts are made to make the breasts of equal size and shape however if the size in the pre operative stage was too big this may not be achieved. But reduction in oversized breasts itself gives immense relief.

MALE BREAST OR GYNECOMASTIA

Enlargement of breasts in male is very common anomaly. It is estimated that more than 30 percent boys have this problem starting during adolescence. It often leads to social embarrassment and boys are hesitant to go to swimming pool or gyms. Some cases also complain of pain in the enlarged glands.

Commonest cause is some kind of transitory hormonal imbalance during early teens. Obesity is another important cause. Rarely, some liver disorders, drugs like anabolic steroids can also cause this problem. There is increase in the glandular tissue and fat in varying amounts leading to the increase in size, in some cases the nipple and areola also become large.

Operative and post operative

The surgical procedure involves removal of both glandular tissues and the excessive fat. Through a small cut along the margins of the nipple entire tissues causing the bulge are removed by combination of direct excision and or Liposuction. After the removal a negative pressure drain tube is kept under the skin for next 24 hour or to remove out any excessive collection of fluid or blood. Most of the cases go back home the same evening with dressings applied over the chest wall. Stitches are removed after about 7 to 10 days and a pressure band or elasticized vest like garment is worn for next 3 weeks or so for the extra skin to settle back.

Results and complications

This operative procedure is absolutely painless and is usually done under local or general anesthesia. The results are very good and are permanent. No fatal complications are there because of surgery. Collection of blood requiring aspiration or drainage, mild skin irregularities, depression of nipple region, temporary loss of sensations over the nipples are some of the correctable complications that might occur in small percentage of the cases.