Breast surgery

• Breast reduction
  
• Breast augmentation
  
• Breast lift
• Inverted nipples

Breasts are too large : Breast reduction

This surgery is usually performed when women are troubled by large, sagging breasts.
Breast reduction can be performed once a woman's breast is fully developed (usually at the age of 17).
However, it is advisable to have had the pregnancies before undergoing it.
Breast reduction is not recommended for women who intend to breastfeed as future breastfeeding may not be possible.

Procedure :

The most common procedure involves an anchor-shaped incision that circles the areola, extends downwards and follows the natural curve of the crease beneath the breast.
Breast reduction removes fat, glandular tissue and skin from the breast, making them smaller, lighter and firmer.

Post-surgery :

Your breasts will settle into their definitive shape and volume after 2 to 6 months. During this time, you will need to wear a good athletic bra for support.
Your surgeon will make efforts so that your scars are as unnoticeable as possible.
However, it is important to keep in mind that the scars are permanent.
Still, gradually, they will become less obvious and usually fade into thin white lines.
You can normally get back to work after two weeks, if it's not too strenuous.

Breast augmentation

Breast augmentation is recommended to enhance the body contour of a woman who, for personal reasons, feels that her breast size is too small.

Procedure :

Asmall incision is made and the prosthesis is inserted between the gland and the breast plate and in some cases (delicate skin and no gland), it is positioned under the pectoral muscle. The prosthesis used is a variety of high grade silicon gel or saline filled implants.

Post-surgery :

Within the next 48 hours, you will experience some discomfort, numbness and swelling in the chest area. The first fifteen days, you will feel some temporary pain when moving your arms. You will be completely at ease with the prosthesis after about two months. You will still be able to exercise normally and breastfeed.

Breast Lifting

The breasts often lose their shape, firmness and begin to sag after a pregnancy or a weight loss.
Breast lift is a surgical procedure to raise and to reshape sagging breasts.
The best results are achieved in women with small, sagging breasts.
Breasts of any size can be lifted but the results on heavy breasts may not be as long lasting.
If you are planning future pregnancies, it is advisable to postpone your breast lift. Although this surgery involves no special risks and usually doesn't interfere with breastfeeding, pregnancy is likely to stretch your skin again.

Procedure :

The most common procedure involves an anchor-shaped incision.
Stitches are located around the areola, in a vertical line extending downwards from the nipple area and along the lower crease of the breast.
Although the scars will be permanent, your surgeon will make every effort to make them as unnoticeable as possible and you will be able to wear even low-cut tops.

Post-surgery :

Your breast will be swollen but the pain shouldn't be too severe. You'll wear a surgical bra over gauze dressings and the stitches should be removed after a week. For two to three weeks, you will need to wear a good support bra around the clock. The scars will be red but they will gradually become less obvious and usually fade into thin white lines. After two months, your breast will settle into its definitive and natural shape.

Inverted nipples

As many as 2% of American women have at least one inverted nipple and still the subject of nipple inversion is seldom discussed among friends or in the media. Usually when people discuss breast enhancement, they are talking about enlarging, reducing or lifting their breasts.

Clearly nipples are an integral part of the breast, playing a role in appearance, in sexuality, and in motherhood. And for the women who have inverted nipples, inversion may affect their self-esteem and body image. While several different surgical techniques have existed for inverted nipples, now there is a treatment that has been successful with long-term results.

Most cases of inverted nipples are congenital - some people are just born that way. However, some nipples become inverted after breastfeeding when scar tissue builds in the milk ducts. Nipples that become inverted after birth are usually caused by one of three things: not enough skin at the base of the nipple, constricted milk ducts, or scarring of the milk ducts due to breastfeeding.

Types of Inverted Nipples

There are three "grades" of inversion - which basically means three levels of severity. While some nipples may only be inverted some of the time (and "come out" or become everted in response to cold or physical touch), others are more severely inverted and never come out. Some women can breastfeed normally, while others will never be able to breastfeed.

• Grade 1 : Nipples are inverted but can become everted manually (through stimulation) or in response to cold temperature. They can remain everted for some time. Milk ducts are usually not compromised and breast feeding is possible. These are "shy nipples".
• Grade 2 : Nipples are inverted and are more difficult to evert. The eversion almost never lasts - the nipple returns to the inverted state immediately. Breast feeding could be possible, but this is not a sure thing.
• Grade 3 : Nipples are severely inverted and never evert. Milk ducts are often constricted and breast feeding is impossible. Women with Grade 3 inverted nipples may also struggle with infections, rashes, or problems with nipple hygiene.

Coorestion of Inverted Nipples

Most people who have inverted nipples are happy to hear about surgical corrections and how simple they can be. Inverted nipple repair is performed on nipples that have been inverted since birth or have become inverted due to breast feeding or other trauma. Recurrence of nipple inversion after surgical repair elsewhere is also a reason that nipple repair may be performed.

Dr. B.B unique approach, in the surgery and the after-care (using the Stevens Stent for traction to ensure the nipple retains eversion), repairs the nipple, retains nipple projection, leaves minimal scarring, and gives a natural appearance.

Surgical Correction of Inverted Nipples

Correction for inverted nipples can be done on an out-patient basis. A patient can opt for local anesthesia, intravenous sedation and local anesthesia, or general anesthesia.

The surgery consists of a small incision at the base of the nipple while the nipple is in a protected projected state. Then a gentle spreading of the fibers is performed within the nipple (these fibers are what pulls the nipple inward). Special care is taken : the spreading happens parallel to the milk ducts in order to preserve them.

Once the fibers are spread and the nipple is free and in an outward, normal position, special sutures (stitches) are placed inside the nipple. If you think of a clock, the sutures go from the 12:00 position to the 6:00 position. Another set of sutures go from the 3:00 position to the 9:00 position. A third suture goes around the base of the nipple. This adds stability and strength to the base of the nipple and helps retain its outward projection. All sutures are dissolving so you won't be required to come into the office to have any stitches.

The Stevens Stent

Finally a special stent called the Stevens Stent, is placed over the nipple. This stent actually holds your nipple in place and ensures that the nipple heals in an outward position, retaining the integrity gained through the surgery. Not only does it help with the nipples' projection, it also protects the nipple in the healing stages. This stent is left on for one to three days.

The sutures dissolve within 10 to 14 days and the initial incision will not be noticeable. To date, none of the nipples corrected have reverted.