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Breast

Breast Augmentation

One of the most frequently performed cosmetic surgery procedures in the U.S., breast augmentation can give women with small or unevenly sized breasts a fuller, firmer, better-proportioned look through the placement of implants in the breast. Women may elect to undergo breast augmentation for many different medical and aesthetic motivations, including balancing breast size and compensating for reduced breast mass after pregnancy or surgery. The procedure may be combined with others such as a breast lift for more satisfying results.

Implants are silicone shells filled with saline (salt water) or filled with with silicone gel. The implants are placed behind each breast, underneath either breast tissue or the chest wall muscle. The procedure lasts one to two hours and is typically performed with general anesthesia, although local anesthesia combined with a sedative is also possible. After surgery the patient's bustline may be increased by one or more cup sizes.

Incisions are made in inconspicuous places on the breast to minimize scar visibility (in the armpit, in the crease on the underside of the breast, or around the areola, the dark skin around the nipple). The breast is then lifted, creating a pocket into which the implant is inserted.

Placement behind the chest wall muscle offers a few advantages over placement beneath the breast tissue only. These include reduced risk of capsular contracture (post-operative tightening around the implant) and less interference with mammogram examinations. Possible disadvantages include the potential need for drainage tubes, and elevated pain in the first few days following surgery.

After the implants are placed and centered beneath the nipples, incisions are stitched, taped and bandaged, and secured with a surgical bra. Most patients feel tired and sore after surgery, but this usually passes in a day or two and many patients return to work within the week. Stitches/tapes are removed in a week to 10 days and any post-operative pain, swelling and sensitivity will diminish over the first few weeks. Scars will begin to fade in a few months and will continue to fade for months or years.

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Breast Reduction

Large breasts can cause pain, improper posture, rashes, breathing problems, skeletal deformities, and low self-esteem. Breast reduction surgery is usually done to provide relief from these symptoms. Performed under general anesthesia, the three- to four-hour procedure removes fat and glandular tissue and tightens skin to produce smaller, lighter breasts that are in a healthier proportion to the rest of the body.

Breast reduction surgery is not recommended for women who intend to breast-feed, since many of the milk ducts leading to the nipples are removed.

During the procedure an anchor-shaped incision is made from the new location of the nipple down to and around the crease beneath the breast. Dr. Austin removes excess glandular tissue, fat, and skin, relocates the nipple and areola, and reshapes the breast using skin from around the areola before closing the incisions with stitches. Liposuction may be needed to remove excess fat from the armpit area, and in some cases when only fat needs to be removed from the breasts, liposuction alone is used for breast reduction.

For a few days after surgery the breasts are bound with an elastic bandage or a surgical bra and you may be given surgical drainage tubes for fluid removal. Stitches come out in a week and the surgical bra must be worn for about a month.

A little pain is normal after surgery, whether it's mild discomfort, swelling during menstruation, a measure of numbness or sensitivity, or random, shooting pains that may last for a few months. Swelling, bruising, crusting and slight changes in breast size are also common. Most patients return to work in about two weeks, although you should avoid heavy lifting for three to four and only gentle contact with the breasts should occur for six weeks.

Scars fade with time but will not disappear, although they can be hidden with a bra, bathing suit or low-cut top.

Male Breast Reduction (Gynecomastia)

The overdevelopment of male breasts, also known as gynecomastia, affects an estimated 40 to 60 percent of men. This condition may be caused by a hormonal imbalance, side effects from drugs, or may occur for no particular reason at all. But despite the cause, the condition is significant and may pose a serious problem in a man's life.

Men with large or sagging breasts can be both physically and emotionally uncomfortable, often restricting themselves from certain activities because they feel self-conscious about their breast size. Male breast reduction is an excellent way to decrease the size of a man's breast, helping him feel more comfortable and confident.

Male breast reduction surgery is usually performed under general anesthetia on an outpatient basis. The surgery typically takes one to three hours. Several techniques can be utilized in male breast reduction, depending on the extent of the procedure.

If the enlarged breasts are primarily caused by excessive fatty tissue, liposuction can be performed through tiny incisions to remove the excess fat. The incision may be made around the edge of the areola (the area around the nipple) or in the underarm. If excess glandular tissue is the primary cause of the enlarged breast, the tissue will be excised, or cut out, in addition to liposuction.

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