Asymmetric breasts can be corrected through surgery that either enlarges the smaller breast or reduces the larger one. Implants can be placed in smaller breasts or a breast reduction can be performed on larger breasts. If the nipples appear at different heights, surgery can relocate one or both of the nipples.
All of these options produce breasts that are more similar in appearance, working with each woman’s unique body to achieve the best possible results. Creating a more balanced appearance can help improve physical balance, self-confidence and body image.
Women whose cancer seems to have been eradicated with mastectomy are the best candidates for breast reconstruction. Those with health problems such as obesity and high blood pressure and those who smoke are advised to wait. Others prefer to postpone surgery as they come to terms with having cancer, consider the extent of the procedure, or explore alternatives.
The reconstruction itself consists of multiple operations, the first of which involves creation of the breast mound and is performed during or after mastectomy in a hospital under general anesthesia. Later surgeries, if necessary, may be done in the hospital or an outpatient facility, with either general or local anesthesia.
There are several ways to reconstruct the breast, both with and without implants; your breast surgeon and plastic surgeon should work together with you in deciding which approach is best for you.
Breast reconstruction has not been proven to affect the recurrence of cancer or other diseases, chemotherapy or radiation treatment.
Nevertheless, in addition to the complications possible from any surgical procedure (bleeding, fluid collection, excessive scar tissue, or difficulties with anesthesia), there are some risks inherent in breast reconstruction, including infection around the implant, if an implant is used, and capsular contracture, when the scar (capsule) around the implant tightens, causing the breast to feel hard. Treatment for capsular contracture varies from “scoring” the scar tissue to removing or replacing the implant. Some patients may need time to come to terms emotionally with their new breasts.
During the breast reduction procedure, the surgeon makes either a circular incision around the nipple then downwards or an anchor incision that circles the nipple and extends down the breast and along the breast crease. Fat and glandular tissue is then removed, while excess skin is tightened to produce a smaller, natural-looking breast. The nipple and areola are not removed but are usually repositioned higher on the breast.
The results of a breast reduction are visible right away and will continue to improve as swelling and bruising subside. Scars will continue to fade over time, becoming less and less noticeable.
Male Breast Reduction (Gynecomastia)
Male breast reduction may be performed using liposuction, surgery or a combination of the two, depending on the amount and type of tissue found in the breasts. If the breasts consist of mostly fatty tissue, liposuction may be used to suction out fat from an incision in the nipple or underarm areas. For breasts with an excessive amount of glandular tissue, excision surgery may be performed, which requires cutting away the excess fat, skin and tissue through a larger incision. Your surgeon will determine which technique is best for you based on your individual goals for surgery.
After breast reduction surgery, patients will usually be able to return home the very same day. Post-operative symptoms may include swelling and discomfort, which can be managed through pain medication and compression garments worn for the first few days after surgery. Patients will be able to return to work once they feel well enough, but should avoid sexual activity and strenuous exercise for a week or two while the chest heals. For most patients, breast reduction surgery produces a flatter, more well-defined chest that can last for many years, as long as patients maintain a stable weight.
The Male Breast Reduction