Mammoplasty is the surgical procedure of reshaping the breasts. It is performed to reduce or lift large or sagging breasts, to enlarge small breasts, or to reconstruct a breast after the removal of a tumor. Augmentation mammoplasty (also called as breast augmentation) increase the size of the female breast using autologous fat graft or inserting prosthesis in a pocket formed betheath the breast on the chest wall. Breast reconstruction is done after mastectomy as an alternative to achieve a more normal appearance of the breast. It is generally done as one stage in the total plan of treatment for breast cancer.
Breast Enlargement
The surgery of enlarging the breast using implants or auto-graft for those with small breasts.
Who is a Good Candidate for Breast Enlargement?
- For those with no volume due to small breasts
- For those with caved-in breasts
Types of Breast Enlargement Procedure
Cohesive Gel Breast Enlargement
This is the surgical method of enlarging the breast size by selecting between the 2 different types of silicone gel implants. There is the smooth-type and the texture type for the cohesive gels.
Advantages
Since it's softer and prettier in shape in comparison to the saline implants, females of slim physique are able to have breasts with the natural look and feel. The semisolid silicone gel is designed in the form of being wrapped in various peels. Therefore, it controls the exposure of contents into outer areas even if the peel of the implant bursts and has strong durability that blocks it from being ruptured with the strong external pressures.
Minimal Incision Endoscope Breast Enlargement
When performing the surgery with the endoscope, it enables the surgery to be accurately performed with the minimum incision and enables peeling so that the implants can be inserted correctly. Hence, this is the surgery that can make the shape of the breast more beautiful and natural.
Advantages
There are lesser cases of bleeding since the hemostasis is accurately performed since the area of the peeling or bleeding can be observed with the endoscope. Furthermore, this allows the patient not to wear blood bags and also results in less swelling and bruising. Since there is no excessive handling of the area, there is less pain after the surgery and the short time for recovery. There is also less chances of complications such as sense reduction since it doesn't touch the sensory nerves. Moreover, it is best when performing reconstruction since the inner conditions can be accurately observed. The degrees of satisfaction is also high with lesser dangers of various side-effects since the accurate peeling is performed through the endoscope.
Auto-graft Breast Enlargement
This is the surgical method of enlarging the breast size by inserting the pure fat cells that have been purified after collecting the fat from the patient's abdomen or thigh area.
Advantages
It helps to perform the autografting when correcting the partial areas where the skin has grown thin after the breast enlargement surgery by implants. Furthermore, it has a natural shape and feel, without any pain and requires no massage after the surgery. Great effects can be gained when 50~100cc are transplanted in the 1st surgery to repeat the process 2~3 times. This operation does not effect breast-feeding at all.
Post Management of Breast Enlargement
- Avoid immoderate movements or lifting heavy objects for 2~3 days after the surgery. It causes bleeding.
- Avoid laying on stomach for 1 month.
- Showering is allowed from the 2nd week.
- Avoid smoking and drinking alcohol for 1st month.
- Light walks and exercise are allowed from the 2nd week.
- Swimming and golf are allowed from the 3rd month.
Follow-Ups Care Plan After Breast Enlargement
Hospital Visits
- 1st, 2nd, 3rd, 4th 6th and 8th week after operation
- Dates for visitations may differ according to the conditions of each individual.
Exercise
- 3 minute exercises for widening the pectoral muscle 4~5 times a day from the 7th day after the surgery (placing both arms back to open up the chest, spin the arms by drawing circles)
- No particular massages are required.
Medication
- Take only the medications prescribed for you.
- When necessary, accolate may be prescribed to help the prevention of circular construction.
Scars
- For scar management, tape or ointment may be applied and these require prescriptions.
Wearing bra after operation
- It requires that the patient wear the accurate bra according to the term and the form of their breasts
- Wearing regular bras is strictly prohibited until there is a specific order.
KMH recommended Tips
Unlike the other plastic surgeries, the breast enlargement surgeries require strict post-management that are very important. Although it is most important to perform a great surgery, the post-management influences over 20% of the surgical results. The post-management is processed for 1~2 months from the week after removing all sutures.
Breast Reduction
Breast Reduction is the surgical method of reducing the breast with vertical incision or the areola incision when it becomes difficult to perform social activities due to the large size of breasts.
Who is a Good Candidate for Breast Reduction?
- For patients with dissatisfaction due to confidence and psychological factors
- For patients who feel disruption in their social activities due to the size of their breast
- For patients with pain in their neck and back
- For patients with shoulder pains caused by bra straps
- For patients with moist tetter and severe pain during menstruation below the breast
Procedure
- 1. Consultation, reservation and pre-surgery examinations
- 2. Hospitalization on the day of surgery
- 3. 1 day of hospitalization after surgery
- 4. 2~3 visits for 1~2 weeks for dressing and removal of sutures
Types of Breast Reduction Procedure
Areola Incision Breast Reduction
As the method of making the incision on the circumference of the areola, it is like taking out contents from a pocket and tightening the entrance way afterwards.
Advantages
Since it is a simple surgery with less bleeding, the patient is able to leave the hospital on the day of the surgery. It maintains the shape and functions of the breast without leaving any scars. It also has almost no side-effects and brings great results when the condition is not too severe.
Vertical Incision Breast Reduction
This is the surgical method of making the 4~5cm incision in the upside down T-shape from the nipple to the wrinkle underneath the breast. It has complemented the advantages of the existing O-shape incision and the areola incision methods.
Advantages
Great amounts can be reduced and the shape can also be beautifully reconstructed into a cone shape. Since it has a small incision line, the overall time of surgery is reduced and is possible to shape the breast into a circular and ample form. Moreover, it is easy to predict the outcomes and has quicker recovery due to less bleeding during the Surgery.
Post Management of Breast Reduction
- Avoid sauna and intense exercise for about 1 month - Alcohol and smoking is restricted
- Showering is possible from the day after the removal of sutures
(showering is allowed when wearing waterproof tape)
KMH Recommended Tips
This is the case of hypermastia caused by obesity where the breast increases in size due to obesity. As the dietary habits have become Westernized in the recent times, there are more and more cases where the general obesity is the cause.
Breast Reconstruction
Breast Reconstruction is the method for patients that have received mastectomy due to reasons of breast cancer and burns. It uses the patient's own muscles and fats to reconstruct their breast into the similar shape of their original breast. (some cases use artificial implants) This surgery reconstructs the feminine symbol of breast to recover self-confidence for their bodies and is the surgery that is both physically and mentally helpful.
Who is a Good Candidate for Breast Reconstruction?
- Recipients of mastectomy due to breast cancer without relapse can receive the surgery.
- Normally, the reconstruction is received after a year since the mastectomy and during this time, patients may receive radiation therapy, anticancer treatment and hormone treatment.
- Reconstructing the breast does not cause relapse of breast cancer.
Types of Breast Reconstruction Procedure
Using the Abdominal Flap
There is a vertical muscle called the rectus sheath on the inner side of the stomach and inside this muscle, there is a passage of a vessel that supplies blood to the skin. Therefore, moving the skin, hypodermic fat and the muscle all together can cause the safe survival of flap on the breast area. Since the majority of females that require the reconstruction have experiences of child-birth, the skin in their lower abdomen have been stretched, drooping and holding fat. Therefore, using the remaining skin, fat and muscles of this area can newly build the breast in the similar shape of the opposite side. The drooping lower abdomen becomes slimmer with the small scar that can be hidden inside the underwear. After receiving the surgery, the patient lays on the bed for about a week or use the waist support for the wound to heal without any trouble. However, this surgery cannot be used where there are surgical scars or wounds on the stomach.
Using the Back Flap
The skin and fat of the back can also be used for reconstructing the breast. On the outer sides of our back, there is a muscle that occupies almost all of the entire back and when moving a partial amount of this muscle along with the skin, it can fill in the lacking breast tissues. Since the breast is close to the back, the surgery is relatively easy but is difficult to fill in a great volume since there is not much of hypodermic fat.
- Using the Buttock Flap
The female's breast holds many similar points with the buttocks. It's shape, fat tissues of the inner sides and the distribution of muscle tissues are very similar. Using such factors, it is possible to perform the surgery of lifting the buttock flap and moving it to the breast. However, this surgical method requires the microsurgery of connecting the vessels using the microscope since the buttocks and breast are far apart.
Post Management of Breast Reconstruction
- Hospitalization for 1 day can be helpful in stabilization.
- Sutures can be removed 7~10 days after the surgery.
- Showering is possible after removing the sutures.
- It is best to wear a bra during daily activities after the surgery.
- For a certain period of time, the activities of the patient are restricted but it is possible to return to normal daily activities from the 10th day.
- Must avoid activities of lifting heavy objects.
- Surgeries using auto-graft can lengthen the term of hospitalization to 1 week.
- Patients may carry tubes to prevent blood or liquid stagnating in the treated area for 5~7 days.
- Majority of patients are able to complete some daily activities from the 2nd week.
- It is possible to return to normal life after 2 weeks. The surgical scar might seem red for about 2 months but is gradually faded afterwards.
KMH recommended Tips
Breast Reconstruction surgery requires sufficient consultation with the doctor before receiving the surgery. Unlike other breast surgeries, this surgery is a reconstruction where the scale of the surgery can increase due to each condition. Therefore, the in-depth consultation with the doctor must be accomplished before the surgery to accomplish the sufficient communion between the doctor and patient. Testing for general anesthesia such as the blood test, urine test and chest x-rays must be performed in advance. X-rays for the required area, angiography and the doppler tests can be required for surgeries using autograft.
Breast Lift
Breast Lift is done when the breast is drooping by losing its resilience due to pregnancy, breast-feeding and aging. The following is the surgical method of correcting this condition.
Who is a Good Candidate for Breast Lift?
For cases of lost resilience due to pregnancy, breast-feeding and aging.
Procedure of Breast Lift
This is easily confused for the breast reduction surgery but this method stops at removing the remaining skin that has lost its resilience. With this method, the cone shaped breast is built and since it is sutured as if to tighten the opening of a bag, there are no visible scars.There are cases where it is accompanied with the breast enlargement surgery to supplement the contents of breasts that have left due to child-birth or rapid weight reduction.
Post Management of Breast Lift
- Avoid sauna or intense exercise for 1 month
- Alcohol and smoking are restricted for 1 month
- Showering is allowed from the day after the removal of sutures (showering is allowed when wearing waterproof tape)
KMH Recommended Tips
- No food for 8 hours before operation (includes water, gum and candy)
- Must consult with physician when taking medication
- Medication for blood pressure, diabetes and thyroid must be taken in the morning with small amount of water
- Must wear comfortable clothes (tennis shoes)
- Make-up, accessories, manicure and contact lens are restricted
- No driving on the day of surgery
Nipple Correction
This is the surgical method for cases where the nipple is not projecting or where the nipple is too large by controlling and reviving the size through the areola.
Who is a Good Candidate for Nipple Correction?
- For patients who can't breast feed due to sunken nipples
- For patients with large nipples that are not attractive
Types of Nipple Correction Procedure
Nipple Reduction
There are various methods for nipple reduction and amongst them, the proper method must be chosen to effectively reduce the nipple while minimizing the scars. The appropriate size of the nipple is left to cut the partial area before suturing. This process leaves almost no scars and the patient is able to gain satisfactory results.
Advantages
Nipple reduction surgery approaches with the 3-dimensional approach minimal incision surgery to leave no scars and streamline damages. Therefore, it is possible to breast feed and maintain the senses of the nipples.
Inverted Nipple
Inverted Nipple speaks of the condition where the nipple is not projecting or is sunk more than the surrounding tissues. It is a rare condition for 3 out of 100 women to carry and occurs more frequently amongst Korean women. Due to the difficulties for maintaining cleanliness for the inverted nipple, infections or inflammations can easily occur and has the possibilities of becoming thelitis to raise health problems and also causes problems for breast feeding. To have beautiful breasts, the overall shape and size is important but the shape of the nipple is also important. When the nipple is inverted, it badly influences the overall image of the breast. Due to severe complexities and shame caused by the inverted nipple, patients may avoid exposing their bodies in the public facilities such as swimming pools and gyms.
Post Management of Nipple Correction
- Avoid sauna or intense exercise for 1 month
- Alcohol and smoking are restricted for 1 month
- Showering is allowed from the day after the removal of sutures
(showering is allowed when wearing waterproof tape)
KMH Recommended Tips
- No food for 8 hours before operation (includes water, gum and candy)
- Must consult with physician when taking medication
- Medication for blood pressure, diabetes and thyroid must be taken in the morning with small amount of water
- Must wear comfortable clothes (tennis shoes)
- Make-up, accessories, manicure and contact lens are restricted
- No driving on the day of surgery
