Breast Procedures

Breast Asymmetry
Breasts are almost never perfectly symmetrical. All women have some degree of asymmetry, or difference in size or shape or location of the breast on the chest. The point at which the breast asymmetry becomes a problem necessitating plastic surgery is when the degree of asymmetry is such that the woman has a day-to-day issue with camouflaging the asymmetry with padding or other such measures. This is embarrassing and a nuisance. It is not uncommon to see a patient who uses a D cup bra on one side, but could wear a B cup on the opposite side.

The exact nature of the asymmetry is not always readily apparent. The patient usually realizes there is a different volume, or amount, of breast tissue. But what is often not so obvious is that this is usually accompanied by more skin on the larger side, possibly a larger diameter areola, a difference in the relative position of the nipple and areola, a difference in the location of the crease beneath the breast, and sometimes even a different configuration of the underlying rib cage. Not all of these facets of the asymmetry may be present and not all need be addressed to achieve an acceptable degree of symmetry.

All Surgery Carries Some Uncertainty and Risk

The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard. Capsular contracture can be treated in several ways, and sometimes requires either removal or "scoring" of the scar tissue, or perhaps removal or replacement of the implant.

As with any surgical procedure, excessive bleeding following the operation may cause some swelling and pain. If excessive bleeding continues, another operation may be needed to control the bleeding and remove the accumulated blood.

A small percentage of women develop an infection around an implant. This may occur at any time, but is most often seen within a week after surgery. In some cases, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted.

Some women report that their nipples become oversensitive, under sensitive, or even numb. You may also notice small patches of numbness near your incisions. These symptoms usually disappear within time, but may be permanent in some patients.

Breast implants do not generally interfere with a woman's ability to breast feed, or present a health hazard during pregnancy to a woman or her baby. However, pregnancy and the associated changes to a woman's body may alter the results of any breast surgery, including surgery to place breast implants. Therefore, it is important to discuss the options of breast implant surgery with your plastic surgeon if you are interested in becoming pregnant and breast feeding in the future.

The Surgery

The method of inserting and positioning your implant will depend on your anatomy and your surgeon's recommendation. The incision can be made either in the crease where the breast meets the chest, around the areola (the dark skin surrounding the nipple), or in the armpit. In addition, a saline implant may be placed through an incision at the navel. Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible.

Working through the incision, the surgeon will lift your breast tissue and skin to create a pocket, either directly behind the breast tissue (submammary or subglandular placement) or may be placed beneath the pectoral muscle and on top of the chest wall (submuscular placement). Once the implant is positioned within this pocket, the incisions are closed with sutures, skin adhesive and/or surgical tape. A gauze bandage may be applied over your breasts to help with healing.

The surgery usually takes one to two hours to complete. You'll want to discuss the pros and cons of these alternatives with your doctor before surgery to make sure you fully understand the implications of the procedure he or she recommends for you.

View breast surgery videos.

Content courtesy of PlasticSurgery.org