The breast is a sign of femininity and maternal instinct, so it is justified that women could feel frustrated if they think that their breasts are defective or not self- satisfactory in any way. Women could feel insecure about breasts due to oversized, undersized, non-uniform, or flaccid breasts. To these problems, Plastic surgeons have dedicated their time and efforts to solve such problems. Four different breast beautification procedures will be discussed in details in this section:

Breast Reduction

Women with big breasts might be suffering from health issues, which is due to the large weight causing back and neck pains and, in some cases, breathing difficulties, which could act as an obstacle in a woman’s life. As for the psychological side of the problem, women with oversized breasts might feel insecure about their general appearance.

Breast reduction has been designed to solve these problems by removing surplus fats, glands, and skin to give the patient the required results. If you are considering undergoing breast reduction surgery, then this guide will clarify the issues regarding this operation, such as acceptable age, expected results, and possible locations.

Breast reduction provides more physical comfort as well as beautification and improvement of the body shape. In most cases, Breast reduction can only be performed when breasts have reached full growth. Exceptions are made when case could have potential tumors.

It is best that adult women understand the operation and the possible results. Women who are planning to breastfeed in the future, should not undergo breast reduction, as it could cause some difficulties with breastfeeding. Breast Reduction is a safe procedure when done by a professional plastic surgeon. Like any other operation, breast reduction has its possible complications, which may include bleeding and inflammation which are dealt with by using antibiotics and dressings.

Following surgeon instructions before and after surgery can reduce risks from breast reduction surgery. Surgery leaves a permanent scar, which is usually covered by clothes or swimming suits, especially with smokers. Depending on the skill of the surgeon, side effects such as imbalanced breasts or nipples could be apparent or completely indistinguishable.

In some rare cases, the nipples or the dark area surrounding them loses sensation. Another rare complication is that skin of that area loses its blood supply, which causes loss of skin. This can be reconstructing using wit using skin grafts later on.

Planning Your Surgery

During the preliminary consultancy, you should discuss with your doctor all the expectations and exchange opinions as every doctor and patient have a different idea of how breasts should look like.

The doctor then examines and measures the breasts of the patient by inspection and photographs as medical records during the surgery. The doctor should explain the resulting scars, possible risks, and the kind of anesthesia to be used, as well as the location and cost of the surgery.

The doctor may ask for an X-ray of the breast before the surgery. You should also give serious attention to the doctor’s instructions about certain foods, drinks, and smoking. Some doctos may suggest a certain diet before the surgery for better results.

Normally, breast reduction does not need blood transfer, but in cases where huge amounts of tissue are removed, the doctor may suggest you provide the blood needed for your own surgery before the operation to be used during operating. You should have someone to drive you to the hospital and accompany you for a couple of days.

Location of Operation

Breast reduction operations are usually done in hospitals, taking from two to four hours, and some special cases may take more than that. So, patient may stay in the hospital from one to three days depending on the case. Leaving on the same day of the operation is not recommended, despite what is advertised in some media.

Type Of Anesthesia

Nearly all breast reduction surgeries are performed under complete anesthesia, so you will be sleeping during the whole time of the operation. In cases of small breasts, operation could be done under local anesthesia

The Surgery

There are different approaches to breast reduction, but in the most common method, a circular cut is made around the dark area surrounding the nipple and another vertical cut extending to the bottom of the breasts. Another horizontal cut may be needed at the natural curve at the bottom of the breast. The surgeon uses these cuts to remove extra tissues, nodes, fats, and skin and moves nipples and surrounding area to the new, more appropriate location. The surgeon then pulls the skin from both sides of the breast below the nipple area to give the breast its new, shape. Liposuction may be used to get rid of extra fat around the armpits.

The nipples remain connection to blood vessels and feeding nerves. In some cases, some methods are used to get rid of the vertical and the occasional horizontal scars resulting from surgery. Also, if the case needs to decreases fat only, then a simple liposuction may be used for breast reduction, which results in minuscule surgical effects.

Post Surgery

A surgical brazier covers breasts over a bandage, and a small pipe may be left to drain fluids for two days. You may feel some pain during the first days, especially with movement, and a feeling of uneasiness will be there for several days. Your surgeon may give prescribe certain medicines and antibiotics to relieve the pain. The bandage can be removed after one or two days after the surgery, but you will need to keep wearing the medical brazier for a couple of weeks. You can always use moisturizers on the course of the day, but you must keep the surgery area dry at all times.

Your first menstruation after surgery may cause swelling and pain in the breasts. There may be pain during the first months, as well as loss of sensory in the nipple area due to the swelling, but these symptoms vanish after six weeks following the surgery in most cases. In some cases, pain may remain for a year and more, or pain may be recursive.

You can resume your normal life after two weeks, but you will feel pain from time to time. You should refrain from carrying or pushing heavy objects for three weeks. Your doctor should give you detailed instructions and guidelines to resume your life. Most women go back to their jobs and social life in two weeks, but you will be a little under the weather for several weeks, You must refrain or limit exercise, straining, bending your body, and swimming until you regain your energy levels. It is important that you wear the supporting brazier. You may be instructed to refrain from sexual intercourse for six weeks as excitement may swell the surgery effects and harm the operation.

A small amount of fluids will be dripping from the scar, as well as some crust; do not panic, this is natural. If you exhibit any abnormal side effects, like bleeding, or sever pain, do not hesitate to call your doctor. In fact, the removed parts are usually tested for tumors, which makes this surgery a tool for early discovery of tumors, unlike what some people think.

Breast Lift

Using the same approach as the one used in Breast reconstruction, it is possible to lift the breast without reducing its size. This is done by removing surplus skin only, without removing any fat tissues. This process is simpler and quicker than breast reduction. Moreoever, breasts can be lifted by using silicon fillings like those used in breast enhancement, which will be discussed in the following section.

Breast Enhancement

The breast’s suitability with the rest of the body adds to the woman’s beauty and femininity. Some women see small breasts as more compatible to their own persona as it adds to their slenderness, and female athletes see smaller breasts as a plus. However, other women might see it as a flaw in their appearance, which could consequently affect them in one or many ways.

The breast consists of fat glands and tissues that have arteries, veins, lactating ducts, glands, sensitive nerves, and a layer of fat all around to provide the breast with compactness and uniformity. There is also large muscle that helps the motion of the arm under the breasts, which varies widely in shape and size.

The shape and size of the breasts are determined by the amount of tissues and fats. There are also other factors such as age, number of pregnancies, genital issues, and skin flexibility. This variability could even be apparent within each breast of a same body; such differences are normal and appear in most women. Also, some women suffer from breast atrophy after multiple breastfeeding cycles.

The only solution to this is undergoing a breast enhancement surgery. Despite what you may hear about hormonal treatments, which could cause tumors. Also, do not believe there is a massage therapy or a device that would do the job; it will only waste your time and money. So far, the breast enhancement operation is the only scientifically certified solution.

Types of breast filling:

Breast fillings come in many shapes, sizes, and internal materials. The choice of filling is up to you and your doctor to decide upon considering your case and after understanding which type would best serve the results you want. In this part, we will discuss the types of breast implants and their main differences Firstly, all kinds of implants have a soft outer layer that encapsulates a salty solution or a silicon-based gel. Usually, they come in oval or spherical shapes with soft outer surface. Lately, there as been a new type with a … outer surface.

The salty solution is similar to the fluid making up 70% of the human body, and in case of leakage, the body dissolves it. The silicon-based gel has also been tested and confirmed to not cause tumors, rheumatoid, and is widely used in the United States and Europe.

Usually, the body rejects any foreign body, and the degrees of rejection are partially based on the biological constitution of the foreign body. The more biologically coexistent the substance is, the less the rejection from the body becomes. Scientists are in constant search for substances that receive no rejection from the body. At the moment, Silicon provides the most commonly accepted substance; it is used in breast implants as well as joint replacements and heart surgery. The body create a thin wall of collagen around the surface of the implant, which is called the capsule and is a natural reaction to any implant. In some cases, this capsule causes fibrosis, which results in uneasiness and pain. However, the tissue surface of some types restricts the collagen formation and does not allow any pain to occur.

There is another type called Spectrum, which was designed to allow the doctor to control the size of the filling post-surgery- up to several weeks, but this type is more expensive.

Some companies offer a lifetime exchange policy for all breast implants filled with salt solution, and this is due to the deficiency or malfunction of the external surface.

Preparing for this surgery, involves making the patient understand how the operation is done, the expected results, the possible complications, and discussing the desired size within feasibility ranges. First of all, the patient should be checked and tested. The breasts should be checked for tumor and a mammography may be needed.

Your doctor takes the necessary measurements to know the shape, size, and dimension of the filling. Then, a suitable kind of filling is chosen along with the time and place of the surgery. The time of your operation should not coincide with menstruation as it will increase bleeding and inflammation of the wounds. This operation is performed under full anesthesia in most cases, and local anesthesia in few cases.

The location of the surgical cut:

There are three possible locations for the cut through which the breast implant is applied: first is a cut directly under the breasts. The second is a cut around the dark area surrounding the nipple. The third is an opeing in the armpits. All these three openings allow the breast implants to be applied in any of the two possible ways: either under the breast muscle or between the breast muscle and the breast tissue. There is no single appropriate cut for all patients, so you need to know your options and discuss them with your doctor and decide what is suitable for you accordingly.

The surgical cut under the breast is the most common, where the filling is inserted under the breast skin and tissues and leaves no apparent scar as wound is coincident with the natural curvature on the bottom of the breast. As for the cut around the dark area surrounding the nipples, the cut is camouflaged by the darkness of this area, but the breast tissue is affected as a result of inserting the filling through it. Lastly, the cut under the armpits is characterized by being away from the breast itself and that it disappears under the armpits, but the surgery requires more skill and time. I, personally, prefer this in younger cases such as newly weds.

The surgery takes about two hours, after which bandage is applied in a certain way. After waking up, patients normally feel some pain or uneasiness, which is treated by pain killers. Patients can leave on the day of the operation if no complication such as bleeding or vomiting arises. In that case, it is better to spend the night at the hospital and leave the next day.

I recommend that women who have undergone the operation should rest for a week and reduce motion of the arm. It is also necessary to stay away from heat so as to avoid sweat and inflammation and give a chance for the tissues to mend. Women should also refrain from sexual intercourse during that period of time and take caution during the following month. The applied bandages are removed after three days, after which I allow my patients to take baths and apply anti-biotic spray.

There will be no need to change stitches bas the plastic surgeon uses dissolvable suture for this operation.

Special breast supports are recommended for the first month and you can get them from your surgeon’s clinic to suit your size and shape; this special brazier helps relief pain and limit swelling.

Most Common Risks

• Deflation: It is not expected that the breast implant remain forever. But it is extremely rare that implants deflate during the first months, after that, the implants remain intact for years. After that, you cannot expect its lifetime, but most implants remain for more than ten years, after which it can be changed.
• Discovering Cancer: It requires a great deal of expertise to discover cancer by seeing afflicted tissue. It is also necessary that patient notifies X-ray specialist, so that special technology would be used to increase chance of discovering any tumors.
• The Capsule: Normally, a capsule is formed around the implant. With the passing of months or years, solidification may take place and cause breast pain, which will require surgical interference to remove and replace the implant. However, from my expertise, I have seen that Arab women are less prone to that risk than non-Arab women, for a reason I am yet to understand.
• Precipitation of Calcium around the tissues surrounding the implant: This is harmless and can be seen during the X-ray. This is a different calcium precipitation than the one associated with cancer and can be tested for without removing the implants.
• Infection: Infection can occur during any surgery. The infection that occurs during breast implants is unknown. So, the patient should discuss previous cases with doctor. Infection always prevails during the first days of post-op and can be treated with anti biotics.
• Blood accumulation: causes swelling and pain. The reason for blood accumulation remains unknown. Patient should notify doctor of any early blood accumulation cases. The body can suck small blood accumulation, but major blood accumulation require small surgical openings to drain blood.
• Delay of wound healing: requires a longer time of dressing. Generally, this operation is one of the most common operation with one of the highest success and patient satisfaction rates.
• Breast Enhancement by Fat-injection : This is a relatively advanced approach. It is rather simple and easy and can be used for minute cases. You can understand how this operation works from the information mentioned in fat injection section just applied to the breast.