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Breast
Assymetry
A small degree of breast asymmetry is quite normal. Surgical intervention
may be indicated when the differences in volume or shape lead to
physical discomfort. Through breast augmentation or breast reduction,
the appearance of full, balanced and even breasts with even nipples
may be accomplished.
How
is a breast asymmetry procedure performed?
Asymmetrical
breasts can be made more even either by augmentation of the smaller
breast, or by reduction of the larger one:
Augmentation:
In this procedure, the surgeon makes an incision either under the
armpit, in the crease under the breast, around the areola (the pigmented
tissue around the nipple), or through the navel. The surgeon then
lifts the breast tissue, creates a pocket in the chest area - either
above or below the muscle, and then places the implant inside the
pocket. Almost all implants used today are filled with a saline
solution.
Reduction:
In this procedure, an anchor-shaped incision is made on the breast
itself. The excess fat tissue removed in a liposuction-type procedure,
and then the incision is closed, creating a breast contour closer
in size and shape to the other one. If less tissue will be removed,
a doughnut-shaped area of skin may be removed just around the nipple.
An advantage to this procedure is that the incision and stitches
may be less visible.
How
long does breast asymmetry procedure take?
The
length of the surgery depends on the type of procedure you choose,
your anatomy, the incision technique, and type of anesthesia.
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What
type of anesthesia is used?
The
breast asymmetry procedure is most often performed under general
anesthesia. In some cases, you may choose to be sedated instead.
(This will make you sleepy and comfortable without being completely
asleep).
Where
is the procedure performed?
The
location chosen for the surgery depends on the procedure performed
and the extent of the work being performed. Most breast augmentation
and reduction surgeries are performed in a surgical suite as an
outpatient procedure.
When
can I return home and resume normal activities?
If
surgeries are performed in a surgical suite as an outpatient procedure
then you'll be able to return home within a few hours of the surgery.
However, if large amounts of tissue are removed during a reduction
procedure, your doctor may want you to stay overnight in the hospital
where medical personnel can monitor your initial recovery.
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How
do I prepare for a breast asymmetry procedure?
During
your initial consultation, your surgeon will discuss the changes
that you would like to make to your appearance. Since the appearance
of your breasts is a matter of personal perception and preference,
you will need to discuss your concerns in detail so your surgeon
can determine the appropriate alternatives. Your surgeon will explain
how your age, the size and shape of your breasts, and the condition
of your skin may affect the results of this procedure. You also
should make arrangements ahead of time for someone to drive you
to and from your procedure and to assist you with your daily activities
during your recovery period.
Prior
to your surgical procedure, the surgeon will perform a complete
health history and physical. This will include examining and measuring
your breasts, as well as photographing them as a frame of reference
during the surgery and afterwards. Your surgeon may also require
you to have a mammogram (breast x-ray). Knowledge of your allergies,
medications and previous surgeries should be brought to your surgeon's
attention at this time. Specific instructions to assist you in preparing
for this procedure will be given to you after the health history
and physical is complete. Depending on your individual health status,
the instructions may include guidelines regarding your diet, alcohol
intake, smoking and which medications to take or avoid. Your experience
will be much smoother if you remain compliant with your surgeon's
instructions.
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What
precautions are necessary during recovery?
You
will receive instructions about changing the gauze and keeping the
incisions clean, positions for sleep and rest, raising your arms,
breathing exercises and breast massage. Whether you choose augmentation
or reduction, you should:
Expect
to feel tired and tender for the first 24 to 48 hours. Your breasts
will be bruised and sore, therefore, an adequate amount of rest
is advised.
Drink plenty of fluids and be sure to follow your medication schedule.
Allow enough time for recovery. If your job is not too physically
demanding, you'll probably be able to go back to work in a week
or so.
Avoid vigorous or strenuous exercise for six weeks.
Know what to expect. Your stitches will be removed in a week to
ten days. The incision scars will be firm and pink for at least
six weeks, and then will begin to fade. Your breasts will remain
swollen for three to four weeks following surgery. They will be
tender to touch and movement.
Avoid lifting and pushing for two weeks, and no heavy lifting or
pushing for four weeks.
Allow about two months for complete recovery.
Discomfort following surgery (which reduces and disappears over
time) is expected; however, be sure to tell your doctor if:
There is an increase in pain, swelling, redness, drainage or bleeding
in the surgical area.
You develop headache, muscle aches, dizziness or a general ill feeling
and fever, nausea or vomiting.
These can be symptoms of infection, and may require medical attention.
The usual follow ups after surgery are at one week, one month, three
and/or six months, and thereafter at annual exams.
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What
are the possible complications after a breast asymmetry procedure?
Breast
Augmentation: Even though the implant is well tolerated, your
body's natural reaction to a foreign material is to surround it
with a thin membrane called a "capsule" in order to stay
in the desired pocket. The formation of this capsule is not a problem
and occurs in every patient. In some cases, for reasons that are
as yet not completely understood, this capsule can shrink around
one or both implants, compressing the implant and making it round
and firm. This is called capsular contracture and can occur in varying
degrees. Although some women may consider some firmness desirable,
the capsule can cause the breast to become unnaturally firm, misshapen
or uncomfortable. Capsular contracture may occur from a few weeks
to several years after the initial procedure. There is no way to
predict your body's reaction and if you will develop capsular contracture.
Placing the implant under the muscle, in some cases, can reduce
the incidence of this condition. If a patient does develop capsular
contracture, surgical intervention may be required.
The
opposite of capsular contracture can also occur when breast implants
are in a satisfactory position but several months later there is
spontaneous expansion of the capsule. This is described medically
as an inferior and lateral migration of the implants. If this happens,
the patient will require closure of the breast pocket to reposition
the implant either through the original incision or through a small
inframammary incision.
While
there is no evidence that the saline breast implant causes breast
cancer, it is recommended that the patient have a preoperative mammogram
as a baseline. Thereafter, when having a mammogram be sure to go
to a radiology center where the radiologist is experienced in the
(Eklund) special technique required for an accurate x-ray of a patient
with breast implants.
It
is emphasized that regular breast examination and mammograms are
the best way to detect early cancers. It is always important to
be informed about the possible complications before any surgery.
Be sure to discuss any concerns you may have with your surgeon.
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Breast
Reduction: The scars in breast reduction procedures are placed
in natural skin demarcation lines around the areola, down the breast,
and across the bottom of the breast. In most women, the scars from
the incisions will be pink for about six months and gradually fade
thereafter. It is important to know that all scars are permanent
and their height, width and final color are never completely predictable.
As
with any surgical procedure, small nerves to the skin are interrupted
during surgery. Portions of the nipple area may feel numb or have
less than full feeling. Sensitivity returns over several weeks,
but some diminished feeling may last indefinitely. This does not
usually interfere with erotic sensation and many women even report
an increased erotic sensitivity with their new breasts.
No
procedure is without risks; however, the majority of complications
known to be associated with a breast reduction are minor when the
procedure is performed by an experienced board certified plastic
surgeon. It is always important to be informed about the possible
complications before any surgery. Be sure to discuss any concerns
you may have with your surgeon.
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What
results can I expect after a breast asymmetry procedure?
Your
breasts will be wrapped with gauze bandage, plus a tighter bandage
for protection and support. You also may have small drainage tubes
coming out of the incisions, to help drain some of the excess fluid.
It is important to take the medication prescribed to you by your
doctor. Someone will need to drive you home, and you may need assistance
at home over the next couple of days.
If
your breast skin is very dry following surgery, you can apply a
moisturizer, but be sure to keep the sutures (stitches) area dry.
Breast
asymmetry can help clothes to fit better as well as improve the
overall contour by balancing the breasts. Remember, though, that
as with breasts in general, the pull of gravity will affect a surgically
corrected breast over time. However, since the breasts are now more
equal in size and weight, they may undergo such changes more evenly.
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Choosing
the right surgeon
To
obtain further information regarding breast asymmetry, we advise
you to consult with a qualified and experienced board-certified
plastic surgeon. Regardless of the type of procedure you are considering,
it is crucial to choose the right surgeon for your individual goals.
To receive a complimentary consultation with a specialist in your
area, simply fill out our Online Referral Form or call Toll Free 800.434.6760.
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