Finding a suitable surgeon to perform
breast enhancement or reconstructive surgery is not an easy task. The Internet and hard copy publications are full of advertorial and paid advertisements extolling the virtues of the surgeon with the biggest advertising budget.
Women seeking cosmetic surgery to the breasts fall into three main groups:
1.Under Development of the Breasts
To achieve enlargement in a naturally small breast one must insert a device behind the breast which enlarges its volume. This device is known as a breast implant or prosthesis and virtually all of the devices today are made of high quality medical grade silicone which has been demonstrated over many years to be a very safe material.
Breast augmentation is achieved by making a small incision to insert the device which can be placed either in front of or behind the pectoral muscle which is the major muscle that clothes the chest. There are several possible locations for this incision. Dr Olbournes preference is to make an incision high up in the armpit where the scar invariably heals up to be almost invisible. With this approach there are no scars at all on the breast to remind the patient in years to come that she had this procedure. The operation is usually straightforward and is performed under general anaesthetic in a hospital usually with an overnight stay.
2.Large Breasts
For treatment of very large breasts a reduction mammaplasty is the preferred option. In this operation a cut is made around the nipple which is then relocated to a predetermined position higher on the breast. The nipple is not removed from the breast, but remains attached to the breast at all times, thereby maximising the possibility that sensation and breast-feeding can be retained for the future. The excess breast is then excised and the wound closed. The size of the reduction determines the length of the scar. Dr Olbournes preference is to perform a vertical mammaplasty which leaves a scar running from the nipple to the fold beneath the breast, but no scar running from side to side in the submammary area. It is his conviction that this gives the best shape long term with the minimal amount of scarring.
3. Droopy (Ptotic Breasts)
Some ladies have droopy breasts, but are not unhappy with the volume when they are in their brassiere. For these ladies breast uplift (mastopexy) is the preferred operation. This operation is very similar to a breast reduction procedure, but only skin is removed, the breast is repositioned and no breast tissue is excised. In ladies with droopy or ptotic breasts an increase in volume can be achieved by inserting a prosthesis or implant at the same time as performing the breast uplift.
