Procedures :: Breast
Breast Augmentation
Breast augmentation is one of the most frequently performed cosmetic surgery procedures in the U.S. It 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 either saline (salt water) or silicone gel (recently approved by the FDA). They 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 under local anesthesia with sedation given by a board-certified anesthesiologist, making the patient totally unaware of the procedure without the need for general anesthesia, while providing post-operative pain control with a long-lasting local anesthetic. After surgery the patient’s bustline may be increased by one or more cup sizes and minor drooping will also be improved.
Breast Lift
A woman's breasts may droop as a result of the natural effects of aging, heredity, gravity, pregnancy, breastfeeding, or weight loss. A breast lift, also called a mastopexy, is performed to return youthful shape and lift to breasts that have sagged or lost volume and firmness.
Breast lifts rejuvenate the breasts by trimming excess skin and tightening supporting tissues to achieve an uplifted, youthful contour. After a mastopexy, the breasts are higher on the chest and firmer to the touch. Breast lifts can also reposition and reduce the size of the areola-the dark skin surrounding the nipple-which may have stretched or drooped.
Mastopexy is usually performed on an outpatient basis under under local anesthesia with sedation given by a board-certified anesthesiologist while providing post-operative pain control with a long-lasting local anesthetic and lasts from 1 to 3 hours. In addition, for those women needing both a lift and an enlargement, the mastopexy can be combined with an augmentation at the same time. They may return to work after a few days, although sports are prohibited for 2-3 weeks.
Breast Reduction
Large breasts can cause pain in the breasts, neck, upper or lower back along with 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 or local anesthesia with sedation, depending on the preferences of the patient,
the two- 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 usually not recommended for women who intend to breast-feed, since many of the milk ducts leading to the nipples are removed. The method of breast reduction Dr. Reiffel performs actually maintains many of the milk ducts, frequently allowing patients to experience breast-feeding after surgery, although the amount of milk may be somewhat limited. This method also helps preserve sensibility to the nipple.
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. Reiffel 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. Scars fade with time but will not disappear, although they can be hidden with a bra, bathing suit or low-cut top.
Breast Reconstruction
Modern surgical technology makes it possible to construct a natural-looking breast after mastectomy (breast removal) for cancer or other diseases. The procedure is commonly begun and sometimes completed immediately following mastectomy, so that the patient wakes with a new breast mound instead of no breast at all. Alternatively, reconstruction may begin years after mastectomy.
Women whose cancer seems to have been eradicated with mastectomy are the best candidates for breast reconstruction. Those with health problems such as obesity and high blood pressure and those who smoke are advised to wait. Others prefer to postpone surgery as they come to terms with having cancer, consider the extent of the procedure, or explore alternatives.
The reconstruction itself consists of multiple operations, the first of which involves creation of the breast mound and is performed during or after mastectomy in a hospital under general anesthesia. Later surgeries, if necessary, may be done in the hospital or an outpatient facility, with either general or local anesthesia.
There are several ways to reconstruct the breast, both with and without implants; Dr. Reiffel will work together with you in deciding which is the best for you.
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