Aesthetic Medicine

Large breasts can cause problems in many stages of a woman’s life. When they are larger than the usual standards of attractiveness in our society, the breasts are considered aesthetically displeasing. There can be a feeling of uncomfortable fullness, neck or back pain, and shoulder grooving. The goal of reduction mammoplasty is to reduce, re-contour and reshape the breasts. The breasts are made smaller and nipple areola complex is re-positioned upward, and if indicated, reduced in size. Excess skin and breast tissue is removed from the lower and outer portions of the breast.

Incisions are made in the lower breast resulting in usually two scars: one around the nipple, which usually heals very nicely and a vertical incision from the nipple to beneath the breast, which remains somewhat visible. Breast tissue is sculpted using a combination of sharp dissection and liposuction. The nipple remains attached to the deeper breast tissue. Care is taken to close these incisions as carefully as possible. Nevertheless, patients must realize that resultant scarring is as much a factor of tissue response as it is surgical skill, and occasionally wide scars can form despite a nice overall breast shape. Most often, with time, these scars do tend to blend into the normal skin, becoming less noticeable.

A preoperative plan is decided upon which allows both the surgeon and the patient to share in the decision as to the proposed size of the breast after surgery. The surgeon will attempt to make the breasts as identical as possible, but some asymmetry may remain. Furthermore, it is not possible to predict exactly how large the breast will finally be after reduction surgery. The healing process results in some progressive change in breast size for several months following surgery.

Mastopexy (or breast lift) is performed because over the years breasts can lose their shape and firmness due to pregnancy, nursing and loss of skin elasticity, causing them to descend. Pregnancy and nursing often result in stretched skin and therefore decreased volume. Breast lift surgery restores a more youthful appearance to a woman’s breasts by raising and reshaping the breast thus slowing the effects of aging and gravity. If the breasts have sufficient volume then a simple lift of the nipple-areola complex is all that may be needed. If however the volume is lost, then mastopexy is commonly performed in conjunction with breast augmentation (implants or fat transfer from any unwanted area) to increase breast firmness, volume and cleavage.

This procedure can also reduce the size of the areola (the darker skin surrounding the nipple) and at the same time raise the nipple to the normal position. This may appeal to women who have lost breast volume after pregnancy and breast feeding. As with all cosmetic surgery, realistic expectations and emotional stability are important.

These procedures are performed at Rinnova Med-Surgical and Laser Institute using local anesthesia, which provides a more rapid recovery with minimal discomfort post operatively. Most patients return to work in 2 to 4 days.