Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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Breast augmentation, or augmentation mammoplasty, is the surgical enhancement of breast volume and shape. This procedure is typically performed using prosthetic implants filled with either silicone gel or sterile saline. The primary goal is to increase fullness, projection, and symmetry.
The procedure involves creating a pocket behind the natural breast tissue or beneath the pectoral muscle. The placement choice depends on the patient’s existing tissue coverage and aesthetic goals. Submuscular placement generally offers a more natural transition and lower risk of visible rippling in thin patients.
Modern augmentation also utilizes fat transfer, either alone or in combination with implants (composite augmentation). This allows for subtle volume increases and precise contouring of the cleavage or upper breast, smoothing out the edges of an implant for a seamless look.
Mastopexy is designed to address ptosis, or sagging, by removing excess skin and reshaping the breast tissue to a higher, more youthful position. This procedure does not significantly change the breast’s size but revitalizes its profile and firmness.
Different incision patterns are used based on the degree of sagging. The periareolar (donut) lift is for mild ptosis, the vertical (lollipop) lift for moderate cases, and the anchor (inverted T) lift for severe sagging. The goal is to tighten the skin envelope and elevate the nipple areola complex.
Mastopexy is often combined with augmentation (augmentation mastopexy) for patients who have both deflation and sagging. This combination restores both the volume lost after pregnancy or weight loss and the youthful lifted position.
Breast reduction, or reduction mammoplasty, removes excess breast fat, glandular tissue, and skin to achieve a breast size that is more proportionate to the patient’s body. It is often a functional procedure as much as an aesthetic one, relieving the physical burden of heavy breasts.
The procedure alleviates chronic back, neck, and shoulder pain, as well as skin irritation under the breast crease. It also allows for greater freedom of movement and the ability to exercise without discomfort.
Aesthetically, breast reduction lifts the breast and reduces the size of the areola if it has been stretched. The result is a smaller, lighter, and firmer breast that is lifted on the chest wall. The surgical techniques are similar to those of a breast lift but involve the removal of significant tissue mass.
Gynecomastia surgery is the correction of overdeveloped or enlarged breasts in men. Hormonal imbalances, genetics, or medication use can cause this condition. The surgery aims to flatten and enhance the chest contours for a more masculine appearance.
The procedure typically involves liposuction to remove excess fatty tissue and surgical excision to remove glandular breast tissue. In severe cases with excess skin, skin removal may also be necessary to achieve a taut chest wall.
This surgery can have a profound impact on a man’s self-confidence, allowing him to feel comfortable going shirtless or wearing fitted clothing. It is one of the most common cosmetic procedures performed on men.
Revision surgery is performed to correct complications or unsatisfactory results from a previous breast augmentation. Common reasons for revision include capsular contracture (hardening of scar tissue around the implant), implant rupture, or displacement (bottoming out or lateral drift).
It also addresses aesthetic changes over time. Patients may wish to change the size or type of their implants or require a lift as their skin stretches with age. Revision surgery is often more complex than the primary surgery due to the presence of scar tissue.
Explantation, or the permanent removal of breast implants, is another form of revision. This is chosen by women who no longer desire implants or who are concerned about breast implant illness. It is often combined with a lift to manage the loose skin left behind.
Tuberous breast deformity is a congenital condition where the breasts fail to develop normally. They may appear constricted, tubular, or pointed, often with a high inframammary fold and herniated areolas (puffy nipples).
Correction involves a specialized approach to release the constricted tissue internally, allowing the breast to expand. This is almost always combined with breast augmentation to provide the missing volume and structure required to create a round, natural shape.
This reconstructive aesthetic procedure requires careful planning. Fat grafting is often used in conjunction with implants to fill out the lower pole of the breast, which is typically underdeveloped in these patients.
Procedures to correct the nipple and areola can be performed as standalone surgeries or as part of a larger breast surgery. Inverted nipple correction releases the short ducts that tether the nipple inward, allowing it to project naturally.
Areola reduction decreases the diameter of the areola, which may have stretched due to breastfeeding or genetics. This is often done during a breast lift or reduction, but can be performed under local anesthesia as a minor procedure.
These procedures are generally minor with quick recovery times but offer significant aesthetic improvement. They address specific concerns that can affect a woman’s confidence in her naked appearance.
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Saline implants are filled with sterile salt water. They are inserted empty and filled during surgery, allowing for a smaller incision. If they rupture, they deflate quickly, and the water is absorbed. Silicone implants are pre-filled with a cohesive gel that feels more like natural breast tissue. If they rupture, the gel usually stays within the shell or the scar tissue capsule.
If your nipples are positioned below the crease under your breast (inframammary fold), you likely need a lift. Implants alone add volume but cannot significantly raise the nipple position. Adding a large implant to a sagging breast can sometimes worsen the drooping appearance, creating a “snoopy nose” deformity.
Fat transfer typically provides a modest increase, usually about one-half to one full cup size per session. It relies on the survival of the transferred fat cells. If you desire a significant increase in size, implants are usually the more reliable option, or you may require multiple fat transfer sessions.
“Gummy bear” refers to form-stable, highly cohesive silicone implants. The gel inside is thicker and holds its shape, much like a gummy candy. This allows the implant to maintain a specific shape (such as a teardrop) and reduces the risk of gel migration if the shell were to break.
Breast reduction is often covered by insurance if it is deemed medically necessary. This usually requires documentation of physical symptoms like back pain, shoulder grooving, and rashes that have not responded to conservative treatments like physical therapy. Cosmetic reductions are not covered.
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