BREAST SURGERY PROCEDURES
Cosmetic breast surgery is a personal choice that you should do for yourself. Whether you choose augmentation, reduction or a lift, the surgery is safe and well established.* The goal is to enhance your appearance, improve your comfort and renew your self-image.* If you are concerned about the appearance of your breasts, please take a moment to review the information below.
What is a breast augmentation?
Breast augmentation is one of the most popular surgeries that plastic surgeons perform. The purpose of breast augmentation, or enhancement, is to increase the size of your breasts or increase volume lost due to significant weight loss or after pregnancy.* Most commonly this is accomplished by placing an implant within the breast to increase the volume.* Breast augmentation can increase fullness and projection, balance your figure and enhance your self-image.* A breast augmentation is not the same as a breast lift. Augmentation alone will not correct significantly drooping, or ptotic, breasts. To accomplish that you may be a candidate for a breast lift, which can sometimes be done at the same time as an augmentation.*
Breast implants will make your breasts a larger version of their current appearance.* This means that if your nipples are wide apart on your chest before surgery, they will be wide apart after breast augmentation. If one nipple is slightly higher before surgery, then it will likely be slightly higher after surgery. It is important for all patients considering breast augmentation surgery to understand that no one has perfectly symmetrical breasts before surgery, and no one has perfectly symmetrical breasts after surgery. *
SELECT AN IMPLANT
Selecting a Breast Implant
The following is a brief general overview of the decision making process for selecting a breast implant for cosmetic breast augmentation surgery.
Breast Implant Consultation
The choice of a breast implant can, and should, be tailored to each individual patient.* Before the actual exam starts, it is extremely important that Long Beach Plastic Surgeon, Dr. Josh Waltzman speaks with each patient to determine their motivation for breast enhancement surgery and what look they are hoping to accomplish with surgery. It is at this point that Dr. Waltzman can assess if the patients goals are appropriate and realistic for what Dr. Waltzman can safely provide with breast augmentation.* On occasion it can be helpful for the patient to bring photos of women with breasts they consider to be attractive and unattractive. It is relatively easy to make a breast augmentation look good at 1 week or 1 month; but the real question is how will it look at 3 years or 5 years?* Waltzman Plastic Surgery in Long Beach, CA is dedicated to providing long lasting natural results.*
Breast Implant Physical Exam
Dr. Waltzman’s assessment starts by performing a physical exam. Dr. Watlzman looks to see if the patient has one breast that is larger or different in shape than the other breast. Dr. Waltzman also looks for any chest wall asymmetries, and he evaluates their posture to see if they stand straight or if they hold one shoulder is lower than the other. All of these things can affect the choice and size of the implant. Next Dr. Waltzman examines the quality of the breast skin and the amount of tissue between the skin and the chest muscles. It is during this point that the breast is examined for any abnormalities such as concerning masses or nipple discharge.
Breast Implant Measurements
Next come the actual measurements. One of the most important measurements is the width of each breast. This measurement will in large part determine the “largest” implant that can be safely placed. Other important measurements include: the distance from the bony notch at the base of the neck to each nipple, the distance between the nipples, and the distance from each nipple to the fold beneath each breast. It is also important to evaluate where on the chest the breast is positioned. Some women have breasts that sit relatively high on their chest, and other women have breasts that sit lower on their chest.
Saline vs Silocone Breast Implants
It is now time to decide between saline vs silicone, textured or smooth, and round or shaped. Silicone implants are only FDA approved for women 22 years and older. It is most common to use a smooth round implant when placing the implant below the chest muscle. Shaped implants can be beneficial when a very natural look is desired, or when trying to minimize fullness in the upper portion of the breast.* Dr. Waltzman works with all our patients to come up with a plan that both the patient and he feels good about prior to surgery.*
What is a mastopexy?
A breast lift literally lifts the breasts into a more shapely and youthful contour.* This procedure raises the breasts by removing excess skin and tightening and repositioning the underlying breast tissue.*
Over the years, with gravity and life, changes are unavoidable. Pregnancy, breast feeding, weight fluctuations and heredity all play a role in how your breasts age. With time, the breasts lose volume and the skin that holds up the breast tissue loses elasticity. Your breasts lose their perky, youthful shape and firmness, the areolas may enlarge and the breasts droop.
The goal of breast lift surgery is to rejuvenate your figure by reshaping the breasts, restoring breast projection and fullness, reducing the size of the areolas (if needed), and elevating the nipples to a more youthful position.* A breast lift alone will not enlarge your breasts. If you desire larger breasts or more fullness in the cleavage area, breast lift surgery can be combined with breast augmentation.* A breast lift will not reduce the size of your breasts. To reduce the size, a breast lift can be combined with moderate breast reduction surgery.*
The mastopexy surgery
A breast lift can be achieved by various techniques. The right technique will be determined by Dr. Waltzman. This decision is based on the size and shape of your breasts, the size and position of your areolas, how much lift is required, the quality of your skin, and the amount of excess tissue and the elasticity of your skin.
The placement and the extent of incisions is largely determined by the amount of lift required and the quality of the breast skin. It is important to understand that there will be scars that diminish over time.* Dr. Waltzman is adept at closing incisions for a cosmetically pleasing outcome.* Most patients find that the benefits of a breast lift outweigh the appearance of scars. Dr. Waltzman will recommend the right procedure to best match your anatomy and achieve your goals.*
You will see the results immediately after surgery and satisfaction will improve as you recover.* Incision lines will fade over time.* You will continue to age and your breasts will continue to change over time from the effects of gravity and skin aging.
Am I a mastopexy candidate?
Breast lift surgery is highly personalized to address your needs and desires. If you are bothered by sagging breasts, or breasts that have lost their shape and volume, are pendulous and your nipples are not in front of the breast mound, a breast lift with or without implants is the best way to achieve long-lasting results.*
The only way to know what can be accomplished is to make a consultation appointment. Dr. Waltzman will listen to your surgical goals and desires, evaluate your health and your breast tissue and take detailed measurements of your breasts. He will take photos, discuss your options, and make his recommendations. It is important to be honest about your expectations and goals. You will have plenty of time to ask questions and discuss your concerns.
Your decision to have plastic surgery is personal and with Dr. Waltzman’s help you will be able to understand the benefits and risks. Your satisfaction is his top priority. Give us a call today.
Women with overly large breasts can experience emotional problems, poor self-image, physical pain and discomfort. Breast reduction surgery can often times help relieve the pain and discomfort due to large breasts.* Breast reduction surgery can enhance your health and appearance.*
Breast reduction surgery is also called a reduction mammoplasty. This surgery is designed to remove excess breast fat, glandular tissues and skin.* The surgical goal is to achieve a breast size that is in proportion with your body, and alleviate the psychological and physical discomfort associated with overly large breasts.* Patients are typically very happy after surgery and long-term satisfaction rates are high.*
When is breast reduction surgery a good option?
If you suffer from any or all of the following, a reduction mammoplasty may be right for you.*
- You have large, pendulous, heavy and dense breasts that cause chronic neck, back and shoulder pain, mid back pain, back spasms and rashes,
- The weight of your breasts interferes with your ability to be physically active,
- Your nipples rest significantly below the breast crease when unsupported, and
- You have enlarged areolas due to stretched skin
The goal of surgery is to reduce volume while maintaining an esthetically pleasing shape and contour that improves your self-image as well as your physical health and ability to be active.* You should do this for yourself, no one else.
The breast reduction consultation
This is the time to discuss the reasons you want surgery, your expectations and desired outcome. Dr. Waltzman will evaluate your general health, examine your breasts, take detailed measurements, and assess the quality of the breast skin and placement of your nipples and areolas. He will take photos and discuss the risks and benefits of the surgery and your options. He will then recommend a course of treatment that meets your goals.*
Breast reduction considerations
- Women with overly large breasts, who desire to reduce the size of their breasts, are typically advised to postpone surgery until they are finished having children. They should be finished with breast feeding for at least 6 months before considering surgery.
- Women who have had breast reduction surgery have similar success with breast-feeding as those who do not. However, there is the potential for the need to supplement feeding with formula.
- Often larger breast reduction surgery may be covered by insurance.
Can your breast size increase after breast reduction surgery?
Breast tissue is affected by weight loss and weight gain. Aging, pregnancy and menopause all affect your hormones, which naturally affect your breasts. Young women who have breast reduction surgery may experience breast growth due to weight gain, oral contraceptives, pregnancy and breast feeding. In some cases a revision surgery may be needed.
What is gynecomastia?
Gynecomastia is breast enlargement in men. It is a benign condition that is usually due to a hormonal imbalance. However, disorders of the male sex organs, including testicular cancers, can also lead to gynecomastia. It can also be a side effect of certain medications. Enlargement of the breasts is normal in males, especially during puberty, and it usually resolves on its own. While not generally a serious problem, in adult men, it can be embarrassing and emotionally stressful. After excluding medically treatable causes of gynecomastia, surgery can be explored. A variety of surgical options exist, ranging from liposuction to excision of the excess breast tissue.
It is vitally important that you choose a plastic surgeon with the experience and skills you need. Dr. Waltzman has the training and experience to provide you with exceptional care and excellent outcomes.* Importantly, he has an artistic eye, a strong sense of aesthetics, and will honestly and realistically address your needs.
Get the information you need to decide if breast reduction surgery is right for you. Contact us today to schedule a consultation.
Breast cancer is unfortunately a diagnosis that more and more women are forced to face. This can be a scary and emotionally draining time for a woman and the people in her life. Although lifesaving, the surgery to remove the cancer can sometimes be disfiguring. The perception of femininity is often times tied to a feminine form, and breast cancer survivors can be left with altered senses of femininity, sexuality, and sensuality. Additionally, the asymmetry which accompanies breast cancer surgery can be challenging when it comes to wearing bras, fitting in clothing, and being physically active.
As a result, Dr. Waltzman believes it is imperative that all women undergoing breast cancer surgery be educated about their options regarding breast reconstruction. Dr. Waltzman works with a team of highly trained Surgical Oncologists and Breast Surgeons in Long Beach, CA. Together, they formulate an individualized plan for each patient in order to optimize oncologic safety while providing the best aesthetic results.*
Is breast reconstruction right for me?
Having breast reconstruction is a personal decision. Every woman is different, and everyone has different reasons for the decisions they make surrounding breast reconstruction. There are no “correct” answers.
In general terms, you are a good candidate for breast reconstruction if:
- You are healthy enough to undergo general anesthesia and live a moderately active lifestyle that will enable you to recover from the surgeries required to perform breast reconstruction.
- You are emotionally prepared for the fact that sometimes in surgery there can be setbacks. While everything goes right the majority of the time, there are always risks to surgery. It is important you have a support structure that will allow you to handle these potential setbacks.
- You have realistic expectations and goals for your breast reconstruction.
- You understand that breast reconstruction is a process, and not typically complete in one procedure.
What to expect during your consultation
Dr. Waltzman will take a detailed medical history and perform a physical exam that will focus on specific measurements of your chest and breasts. While it is not required, it is a good idea to bring a friend or family member with you on the day of your initial consultation. This person can take notes for you and write down potential questions. Dr. Waltzman will discuss your specific goals for reconstruction and present the available options. The typical initial consultation is about 60-90 minutes. We know that patients have a lot of questions and so we make sure that we have plenty of time to make sure we can address all of them. Additional consultations are common, which serve as additional opportunities to ask questions or go over the reconstructive plan.
Immediate vs. delayed reconstruction
Immediate reconstruction means that the reconstruction is performed on the same day as the mastectomy. Delayed reconstruction means that the reconstruction is performed at some point in the future. A delayed reconstruction can take place several weeks to several years after the initial mastectomy. There are a variety of reasons why your surgeon might decide that a delayed reconstruction is a better option. This is discussed on a case by case basis. Delayed reconstruction can also be performed for a patient who did not have access to reconstruction at the time of mastectomy.
Implant vs. autologous tissue reconstruction
The majority of the breast reconstructions performed in the United States are with a tissue expander and implant. At the time of mastectomy a tissue expander is placed in the chest. Over the coming weeks the expander is slowly filled with fluid that will gradually stretch the skin and provide a shape to the reconstructed breast.* Filling the expander is a simple process that is performed on a weekly basis in Dr. Waltzman’s office. After reaching the desired volume, a second surgery is performed where the expander is removed and a much softer permanent implant is placed.* The same scars are used from the first operation.
The other main category of breast reconstruction is to use the patient’s own tissue (autologous) to reconstruct the breast.* The most common donor sites are the abdomen and the back. This type of reconstruction by definition requires placing an incision on another part of the body with a resulting scar. This type of reconstruction has the advantage of natural skin and fat being used to reconstruct the breast, providing a very natural feel.* The surgery time is often longer when compared to an implant based reconstruction.
Not every women is a candidate for implant based and autologous reconstruction. Depending on a variety of factors, including your body type and the type of therapies needed to treat your cancer, you might not be a suitable candidate for all types of reconstruction.
Stages of breast reconstruction.
Breast reconstruction should be thought of as a process. As a result, it is important that you find a surgeon that is a good fit for you. You will be seeing this surgeon for multiple office visits and likely several surgeries.
Occasionally complete breast reconstruction can be accomplished in one stage at the time of mastectomy. However, the norm after a total mastectomy is for several “stages” of reconstruction. Some of the typical stages involve: tissue expander placement, removal of the expander and placement of an implant, nipple reconstruction, and possible revisions in the future.
Dr. Waltzman works with most major insurance carriers in the area. Contact our office to schedule a consultation if you, or someone you know, are considering breast reconstruction surgery in the Long Beach, CA area.
*Results and patient experience may vary.