Cosmetic breast surgery
Breast surgery encompasses two types of surgeries:
1. Cosmetic breast surgery, which implies a breast reduction or augmentation as well as the treatment of drooping breasts. The appropriate term for these surgical procedures would be “Augmentation Mammoplasty”, “Reduction Mammoplasty” and “Mastopexy”, respectively.
2. Reconstructive breast surgery, which is aimed at restoring the volume, shape and size of one or both breasts affected, whether partially or totally, by a tumor or any other reason (burnings, traumatism, etc.).
Augmentation mammoplasty
This is a common surgical procedure, since the so called breast hypoplasia or agnesis (small-sized breast) mainly affects women, insofar as this is an element of lack of sensuality and bodily aesthetics. The breast size can be restored through the incretion of an implant. The silicone implant is, by far, the element of best quality and similitude with the breast. As this issue has been widely discussed in the media, it is important to have an interview with the surgeon, since it is him who must clarify all the patient’s doubts, worries and “myths” related to silicone breast implants.
The operation is done under neurolepto-anesthesia (local anesthesia and sedatives). Patients are “sedated” during the operation and can return home that same day, a few hours after their recovery.
There are three common incision sites for the insertion of the implant: periareolar or transareoral (under or through the areola), inframammary (within the breast fold) or axillary (under the arm). Patients undergoing an augmentation mammoplasty return to work really soon (in 48 or 72 hours) and may resume physical activities 20 days after the operation.
Reduction mammoplasty
When breasts have an excessive size and weight (breast hypertrophy or macromastia, depending on the breast enlargement) it can be a real “burden” for the patient, who experiences a variety of physical and mental problems over the years.
Generally, patients suffer from back pain, skin irritations in the breast fold, cosmetic discomfort or problems with the clothing due to the excessive size of their breasts. The reduction mammoplasty surgery is performed under general anesthesia (it is of greater importance than the augmentation mammoplasty). Technically, this surgical procedure consists in adapting the breast volume to the skin and, therefore, incisions must be inevitably made in areas outside the areola, but always hidden by women underwear. Patients undergoing a breast reduction surgery experience a noticeable relief and an amazing improvement in the body contour.
Reconstructive breast surgery
Loss of a breast is a real amputation of an important organ for women’s bodily aspect. Breasts can be rebuilt regardless of the cause originating their loss (cancer, serious burnings or traumatisms).
Technically, there are two main types of breast reconstruction available:
1. Placement of a tissue expander and an implant. This type of breast reconstruction is a two-part process. The fist implant operation involves placing a tissue expander (a kind of balloon that is filled with salt water) in the intended breast area. Then, the surgeon will replace the tissue expander with a permanent silicone implant. Nowadays, there are definite tissue expanders, which simplify the operation.
2. Muscle flap reconstruction, which involves using a patient’s own tissue (autogenous tissue) to rebuild the contour of the breast. Tissue may be taken from different parts of the body, but it is most frequently taken from the stomach (skin and fat. This is called TRAM - Transverse Rectus Abdominis Muscle - flap procedure) or from the back (skin, fat and muscle. Back tissue (latissimus dorsi) reconstructive flap). The nipple and areola are rebuilt on a surgical procedure subsequent to the reconstruction of the contour and size of the breast (this operation is made approximately two to six moths later). The technique used must be tailored to each particular case, and the surgeon must be able to recognize which of the different alternatives that can be offered to the patient is the one that will produce the best cosmetic result.
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