Cosmetic Surgery - Breast

 
Breast Augmentation (Enlargement)  - Now DRAIN-FREE

Implant Exchange - Now DRAIN-FREE

Breast Reduction and Mastopexy (Uplift)
 - Now DRAIN-FREE
Gynaecomastia (Male Breast Tissue)  - Now DRAIN-FREE
Cosmetic Surgery Breast Hampshire

Online 3d simulations by Crisalix


Breast Augmentation (Enlargement)
 
Why undergo breast augmentation?

Breast augmentation is a surgical procedure to enhance the size and/or shape of a woman’s breasts. There are several reasons as to why a woman might consider breast augmentation surgery:

1)    She feels that her breasts are too small and would like to enhance her body contour
2)    She might like to balance breasts that are of a different size
3)    There may be a loss of volume following pregnancy that she would like addressed
4)    There may be varying degrees of breast loss following cancer surgery

How is it done?

The surgery itself consists of placing an implant beneath the breast tissue in order to increase the overall breast volume. These implants consist of a silicone shell surrounding either a saline (salt water) or silicone gel filling. My preference is to use silicone-filled implants as I believe these provide a more predictable and natural result in terms of both look and feel. The safety of silicone implants has been extensively investigated and there is no evidence to suggest that they are harmful. If you would like more information, please visit the government website on breast implants that can be found here .

The surgical incision is usually made in the crease under the breast. The implants may then be placed either underneath the pectoralis major muscle (the main chest muscle), or on top of it (see images). In thinner women, the skin of the breast and chest may not be thick enough to disguise the implant and the edge of the implant may be more obvious. One way to avoid this is to place the implant underneath the pectoralis muscle as the thickness of the muscle itself will cover the top edge of the implant. For women with adequate thickness of skin over the breast area, the implant can simply be placed beneath the existing breast tissue, above the underlying muscle.
Breast Augmentation Enlargement Hampshire
Schematic of breast implants under the breast tissue (left) and under the muscle (right)

The decision as to which incision to use and where to place the implant is made during the first consultation. I will evaluate your overall health and make a surgical plan based on your breasts and skin type. At the initial consultation we will also decide on the size of implant to use by placing trial implants into the bra until the correct size is achieved. Occasionally, implants alone will not give you the result you want and a breast uplift may also be recommended.

At this stage a photograph is taken which forms part of your medical record. There is no identifiable information on the photograph and it will not be used for publication or teaching purposes without your express written consent .

What are the risks?

Breast augmentation is fairly straightforward surgery. However, as with all surgery, there are certain risks associated with it. All surgery involves a degree of bleeding. In the vast majority of cases, this is minimal and easily controlled during the procedure itself. In a small percentage of patients, there may be a more significant collection of blood that may even require a return to the operating theatre to remove it.

Meticulous steps are taken before, during and after the surgery to ensure that the risk of infection is minimal. However, the risk of infection can never be completely eradicated. In a few cases, the incision can become red and inflamed. This usually settles down with simple antibiotics. However, in a very small number of patients, the implant itself can become infected. If this is the case, the implant would have to be removed while the infection is cleared up and would need to be replaced several weeks later.

All surgery involves the formation of scars. The incision scar will be raised and pink for the first few months, but will usually settle into a fine white line after several months. In some cases the scar can remain raised and pink. There is also scar formation inside the breast around the implant. We call this a ‘capsule’. A capsule is the body’s normal reaction to foreign material (in this case, the implant). In most cases, the capsule remains soft for many years. However, if the capsule tightens around the implant it can cause the breast to feel hard and, sometimes, painful. In these cases it may be necessary to surgically release the tight capsule and replace the implant.

It is safe to say that the sensation to the nipple after the surgery will definitely change. In some women it will become more sensitive, but in some women it will become less sensitive or even numb. In the great majority of patients this settles down after a few months. In very few, however, the change can be permanent.

The Surgery

Prior to the surgery, you will be given all the information you need in terms of how best to prepare for the operation. The surgery itself is performed under a general anaesthetic (with you asleep). It takes about 2 hours to complete. A drain is placed on each side to minimise any collections of fluid within the breast and these are removed the next day. The incisions are closed with sutures and covered with several layers of tape.

After the Surgery

After a general anaesthetic it is normal to feel tired and out of sorts, but this is temporary and you will be up and ready to leave the hospital after a single overnight stay. You will need someone to drive you home. You will need to wear a sports bra without underwiring for the first 6 weeks after the surgery. You will feel a little sore for a few days following the surgery, but this is usually well controlled with normal painkillers.

You will be able to bathe normally from the first week after the operation.
A week after your surgery you will visit the dressing clinic. Here, the dressings are removed. The sutures are dissolvable and do not need to be removed.

The breasts will remain swollen for a few weeks and you may even notice that they settle down at different rates. However, after a two to three months the swelling should have resolved and the breasts will have settled into their final position.

Returning to work and play

Most people can return to work after 2 weeks. More active occupations may require longer, but this will be discussed fully with you. The breasts will remain tender for up to 3 weeks, so you should avoid too much physical contact during this time.

If you are in the appropriate age group for routine mammograms, these can recommence. You will need to inform the technician that you have had breast augmentation surgery as they will use a different technique to properly examine the breast tissue.

After a final review with your surgeon at 3 months, it is not usually necessary to be seen again. However, regular appointments with your surgeon are recommended so that if any complications do occur, they can be picked up and addressed early.

Breast Augmentation Breast Augmentation Boob Job Enlargement
Breast enlargement Augmentation Boob Job

 



Implant Exchange


Who needs to exchange their implants?

Breast implants have a limited lifespan in your body. You may lose the cosmetic benefit of the implants if, for example, the implant ruptures or you form a tight capsule of scar tissue around the implant (see Breast Augmentation  for further detail)

How is it done?

The old implant is accessed through the existing scar under the breast and removed. If the implant was ruptured, it may be necessary  to remove any free silicone from the cavity. In most cases, it is also necessary to score the scar capsule in order to soften it up to accept another implant in the same place. Occasionally, it is necessary to change the 'plane' of the implant. For example, it may be necessary to place a previously superficial implant underneath the chest wall muscle.

During our initial consultation, I will evaluate your overall health and make a surgical plan based on your breasts and skin type

At this stage a photograph is taken which forms part of your medical record. There is no identifiable information on the photograph and it will not be used for publication or teaching purposes without your express written consent .

What are the risks?

The risks are the same as for Breast Augmentation. However, since we are accessing the implant through a pre-existing scar, there should be no further scarring as long as the new wound heals satisfactorily.

The Surgery

As for Breast Augmentation

After the Surgery

As for Breast Augmentation

Returning to work and play

As for Breast Augmentation
Breast Reduction and Mastopexy (Uplift)


Why undergo breast reduction?

Large or pendulous breasts can be associated with several problems:


    1) Difficulty in finding clothes or underwear that fits
    2) Painful indentations from bra straps
    3) Irritation of the skin beneath the breast
    4) Back and neck pain
    5) Difficulty breathing and exercising

In fact reduction mammaplasty, as breast reduction is technically known, is rarely a cosmetic procedure and is much more often undertaken to improve function.

How is it done?

There are 3 main issues that need to be addressed when considering a breast reduction:


    1) An excess of breast tissue
    2) An excess of breast skin
    3) A nipple that is too low

A careful surgical plan is needed that will solve all of these issues. In the first instance, careful measurements are taken to decide on the new position of the nipple - not too low and not too high. Following this, and depending on how much of a reduction is required, a pattern is drawn on the breast to guide the amount of skin that needs to be taken away. This is usually in the form of an anchor (see diagram), although with smaller reductions only the vertical incisions may be necessary. Once the desired amount of tissue is removed, the nipple is moved up to its new position and the remaining skin is sutured back together to form a scar that goes around the nipple and continues downwards to form an upside down 'T'.
Breast Reduction Mastoplexy Uplift Hampshire
During our initial consultation, I will evaluate your overall health and make a surgical plan based on your breasts and skin type. If you are of an age where you would have regular mammograms, I would like there to be an up to date mammogram prior to embarking on the surgery.

At this stage a photograph is taken which forms part of your medical record. There is no identifiable information on the photograph and it will not be used for publication or teaching purposes without your express written consent .

What are the risks?

Breast reduction is not straightforward surgery. It should be performed by a qualified plastic surgeon. As with all surgery, there are certain risks associated with it. All surgery involves a degree of bleeding. In the vast majority of cases, this is minimal and easily controlled during the procedure itself. In a small percentage of patients, there may be a more significant collection of blood that may even require a return to the operating theatre to remove it.

Meticulous steps are taken before, during and after the surgery to ensure that the risk of infection is minimal. However, the risk of infection can never be completely eradicated. In a few cases, the incision can become red and inflamed. This usually settles down with simple antibiotics.
All surgery involves the formation of scars. The incision scars will be raised and pink for the first few months, but will usually settle into fine white lines after several months. In some cases the scars can remain raised and pink.

It is safe to say that the sensation to the nipple after the surgery will definitely change. In some women it will become more sensitive, but in some women it will become less sensitive or even numb. In the great majority of patients this settles down after a few months. In very few, however, the change can be permanent. In extremely rare cases, the nipple or skin of the breast can lose its blood supply and die, requiring reconstruction in the future.

Since the surgery involves cutting into the breast tissue itself, women who wish to breast feed following breast reduction surgery are more likely to need formula supplementation.

The Surgery

Prior to the surgery, you will be given all the information you need in terms of how best to prepare for the operation. The surgery itself is performed under a general anaesthetic (with you asleep). It takes about 2 hours to complete. The incisions are closed with sutures and asterile dressing.

After the Surgery

After a general anaesthetic it is normal to feel tired and out of sorts, but this is temporary and you can expect to be in hospital for 1 night. You will need someone to drive you home. You will need to wear a sports bra without underwiring for the first 6 weeks after the surgery. You will feel a little sore for a few days following the surgery, but this is usually well controlled with normal painkillers.
You will be able to bathe normally from the first week after the operation.

A week after your surgery you will visit the dressing clinic. Here, the dressing is removed. The sutures are dissolvable and do not need to be removed.

The breasts will remain swollen for a few weeks and you may even notice that they settle down at different rates. However, after a couple of months the swelling should have resolved and the breasts will have settled into their final position.

Returning to work and play

Most people can return to work after 2 weeks. More active occupations may require longer, but this will be discussed fully with you. The breasts will remain tender for up to 6 weeks, so you should avoid too much physical contact during this time.

After a final review with your surgeon at 3 months, it is not usually necessary to be seen again. However, regular appointments with your surgeon are recommended so that if any complications do occur, they can be picked up and addressed early.

Although it is significant surgery, with permanent scarring, breast reduction surgery consistently scores highly in patient satisfaction surveys due to the functional benefits it confers.

Breast Reduction pre-op Breast Reduction Post-Op
breast reduction breast reduction
Mastopexy Breast Uplift Pre-Op Mastopexy Breast Uplift Post-Op
 



 

Gynaecomastia (Male Breast Tissue)


What is gynaecomastia?

Gynaecomastia is the presence of excessive breast tissue in a man. The cause for this may be physiological (a normal part of development) as seen in newborns, adolescents, and the elderly due to imbalances in circulating hormones. The cause may also be pathological (part of a disease process), due to a reaction to certain drugs and the presence of particular tumours. For this reason, any man who has gynaecomastia should see their doctor for a simple examination and blood tests to rule out any serious causes for the problem before seeking corrective surgery.

Whatever the cause, gynaecomastia is much more common than most people think and up to 60% of males will suffer from it to some degree during their lifetime. It can be an embarrassing and socially debilitating condition as sufferers may seek to hide it by wearing unseasonably thick shirts and avoiding all activities that might involve exposing the chest area.

What can be done?

Broadly speaking, there are 4 types of gynaecomastia, depending on the amount of excess tissue and the degree of excess skin:

    1) A small amount of excess breast tissue without any excess skin
    2) A moderate amount of excess breast tissue without any excess skin
    3) A moderate amount of excess breast tissue with excess skin
    4) A large amount of excess breast tissue with excess skin

In the first 2 cases, there is no need to excise any skin and any surgical procedure is aimed at removing the excess breast tissue. If the breast tissue is soft and fatty, then simply liposuction alone may suffice. This involves introducing a suction tube through a tiny incision and literally vacuuming fat out of the breast. If the tissue is more glandular, tough and fibrous, then it may be necessary to surgically remove the tissue through a small incision around the lower half of the nipple.

In the second 2 examples, it is not only necessary to remove the breast tissue, but also to excise the excess skin to restore the masculine shape of the chest wall. The technique depends on the amount of excess skin and varies from a simple 'donut' excision of skin from around the nipple to a full 'mastectomy' procedure in severe cases that might need the nipples detached and replaced as grafts.

Before the Surgery

During our initial consultation, I will evaluate your overall health and make a surgical plan based on your skin type and the degree of gynaecomastia

At this stage a photograph is taken which forms part of your medical record. There is no identifiable information on the photograph and it will not be used for publication or teaching purposes without your express written consent .

What are the risks?

Gynaecomastia surgery is relatively straightforward. To minimise the risks, it should be performed by a qualified plastic surgeon. However, as with all surgery, there are certain risks associated with it. All surgery involves a degree of bleeding. In the vast majority of cases, this is minimal and easily controlled during the procedure itself. In a small percentage of patients, there may be a more significant collection of blood that may even require a return to the operating theatre to remove it.

Meticulous steps are taken before, during and after the surgery to ensure that the risk of infection is minimal. However, the risk of infection can never be completely eradicated. In a few cases, the incision can become red and inflamed. This usually settles down with simple antibiotics.

All surgery involves the formation of scars. The incision scars will be raised and pink for the first few months, but will usually settle into fine white lines after several months. In some cases the scars can remain raised and pink.
The sensation to the nipple after the surgery may change. Although this is more relevant for female breast surgery, it can prove troublesome for the very small percentage of men for whom the change is permanent.

The Surgery

Prior to the surgery, you will be given all the information you need in terms of how best to prepare for the operation. The surgery itself is performed under a general anaesthetic (with you asleep). It takes about 2 hours to complete. Any incisions are closed with sutures and covered with a sterile dressing. A snug tube dressing is placed around the chest to help reduce the swelling in the breasts afterwards.

After the Surgery

After a general anaesthetic it is normal to feel tired and out of sorts, but this is temporary and you can expect to be in hospital for 1 night. You will need someone to drive you home. You will need to wear a tight-fitting sports top for the first 6 weeks after the surgery. You will feel a little sore for a few days following the surgery, but this is usually well controlled with normal painkillers.
You will be able to bathe normally from the first week after the operation.

A week after your surgery you will visit the dressing clinic. Here, the dressing is removed. The sutures are dissolvable and do not need to be removed.

The chest may remain swollen for a few weeks and you may even notice that each side settles down at a different rate. However, after a couple of months the swelling should have resolved and the chest should maintain its masculine contour.

Returning to work and play

Most people can return to work after 2 weeks. More active occupations may require longer, but this will be discussed fully with you. The chest will remain tender for up to 6 weeks, so you should avoid too much physical contact during this time.

After a final review with your surgeon at 3 months, it is not usually necessary to be seen again. However, regular appointments with your surgeon are recommended so that if any complications do occur, they can be picked up and addressed early.

 
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