Breast correction
    for women

 

To the photo album

Breast corrections

Breast corrections are breast reductions, breast lifts, breast enlargements and breast implant changes. Women in different stages in their lives undergo breast corrections. The reason is often cosmetic and also to cure health issues or to correct congenital size differences.  The procedure leads almost without exception to more confidence and solves eventual neck, shoulder and back aches.

In some cases combinations are necessary like a lift and an enlargement. Often the nipples are corrected to a smaller size.

Breast corrections are substantial treatments and it is of importance to have a clear understanding of the wishes and possibilities. Mammography might be part of the checks prior to surgery.

 

Breast lift

1. Age

The common rule is a minimum age of 18 years old, however, an exception can be made for breast reduction, enlargement or to correct congenital deformities. In that case, we will make an extra careful consideration, involving the parents, the general practitioner and in some cases a psychologist. It is conditional that parents are present at the first consult when the patient is of very young age.

There is no maximum age, however, the risk of complications slightly increases with age. The vitality of the patient is the decisive factor. Breast corrections for women above 60 years old are no longer an exception in my practice.

2. A natural result

I strive for a natural result; however, this result will only be visible after the first weeks/months after surgery. This is the case for all types of breast correction. The breast will be slight swollen at first and the scars have to recover. Family and friends do not always recognise that. They might, therefore, make well-meant, premature, critical remarks. Read more about this in the article 'comments from family and friends'. A well-shaped bra supports the breasts and will slow the process of sagging.

Underneath the breast lies the pectoral muscle. With exercise this muscle can increase in volume, but that will not change the shape of the breasts in a positive way, it will rather decrease the underlying fat tissue and make the breasts look more deflated.

3. Use of implants

With breast enlargements and in some cases with breast lifts silicone implants are used. Again I will strive for a natural result. A breast lift including implants requires an alignment between the intensity of the lift and the size and shape of the implant; this is complex and requires experience.

A natural result is not defined by the shape of the implant (round or anatomical) but is a combination of 1) the shape and volume of the own breast, 2) the volume en the diameter of the breast implant and 3) placement of the implant over or under the pectoral muscle.

With young women with little breast growth the implant will be usually placed under the muscle. Where breasts have decreased in volume after pregnancy the implants are placed over the muscle to be able to fill the breasts completely. The volume, diameter of the implant and the position versus the muscle will be set individually for the best result. For the aesthetic breast correction the round implants are mostly used.

4. Before surgery

For all breast corrections it is conditional to stop smoking in the period around surgery, because it increases the risk of complications substantially. Temporarily stop using anticoagulants like Ascal and aspirin.

5. Surgery


Breast lift

The techniques used with breast lift surgery are quite similar to breast reduction surgery and will leave similar scars: the “anchor-shaped incision”, the “keyhole method” and a combination of the two. All techniques will leave a scare around the nipple. The keyhole method, with a vertical coupe line in the lower part of the breast and of course around the nipple, is only suitable for the breast lift. No breast tissue will be removed with the breast lift, the tissue is used to shape the breast and increase its firmness.

A simple breast lift will take about one hour, a more complex one, with or withou the use of implants, 2 to 2½ hours.


Breast enlargement

Surgery and the Dual-plane technique

The silicon breast implant will be placed over or under the muscle through a 4 cm wide incision in the fold under the breast. In case the own breast is larger and possibly drooping (see also under breast lift), than it is preferable to place the implant over the muscle to also make a firmer breast. When the implant is placed under the muscle than I will use the Dual-plane technique. In this case the pectoral muscle is partially detached so that the upper half of the implant lies over the muscle and the bottom half directly behind the chest. Both techniques can give a good and natural result. In both cases the operating time is about two hours and the skin will be closed using dissolvable stiches.


Breast reduction

Prior to the intervention I will make markings on each breast with a black marking pen outlining the place of the new nipple and the amount of skin that I will remove. Don’t use body lotion or crème so that my drawing will not rub off.

There are different techniques that I use: the “anchor-shaped incision”, the “keyhole method” and a combination of the two. All techniques will leave a scare around the nipple. The keyhole method, with a vertical coupe line in the lower part of the breast and of course around the nipple, is only suitable for breasts which aren’t too large and for the breast lift.

During the procedure the nipple is moved upwards on a thick pedicle. Then, the tissue from the breast gland underneath the breast is loosened from the pectoral muscle, after which the excess tissue is removed to the extent necessary. Thereafter the remaining tissue will be shaped into the new, smaller breast.

6. After surgery

Tape has been applied to the breasts or you are wearing a compression vest. Tubes come out from both sides as drains, which are used to suction excessive blood and tissue fluid during the first two hours. The drains will be removed before you go home.

Depending on the type of breast correction you will stay in hospital for a few hours to a full night. With breast enlargement you usually will be able to go home on the day of surgery. After a breast lift or breast reduction you usually stay for one night.

7. The first weeks

The morning after surgery the tape or vest can be removed. From that moment on it is recommendable to take a daily shower. It is no problem to use soap and shampoo.

With breast enlargement when de implants are under the pectoral muscle that is more painful than under the muscle. You will receive painkillers after surgery and a prescription for pain medication during the first few days. In general breast corrections are considered non painful procedures. Take the painkillers when needed.

During the first 2 weeks you will wear a (sports) bra without underwire, preferably with pre-shaped cups. After 2 weeks you can gradually resume most activities. After a breast enlargement it is best not to do any pectoral muscle exercises during the first few weeks and after this period to build up gradually. These are all general rules; you will receive broader and tailor-made instructions after surgery.

8. The final result


Well meant comments

As written, almost without exception women are pleased with the results of a breast correction. More self-confidence, easier to find the right clothes en no more back, neck and shoulder complaints. The final result and scars need time. It takes several weeks befor the breasts have their natural look and some months to a year before the scars fade. Friends and family might not always understand that and might, therefore, make well-meant, premature, critical remarks. Read more about this in the article 'comments from family and friends'.


Scars

Depending on the type of breast correction you will have larger or smaller scars. Examples are a scar around the nipple, a verticalscar with a breast lift and an anchor shaped scar with a breast reduction. Because the breast will gradually drop, it will cover the scar. With more extensive lifts and the breast reduction I will place the scar in the crease under the breast. As with other scars this will fade in time. With a breast enlargement there is only a small scar (about 4 cm long) in the crease under the breast.

A scar will always remain, it will never disappear completely. From the feedback from my patients I know that most women find that the positive effect of the procedure by far exceeds this relatively small negative point.


Complications en risks

A bruise is a possible complication, but is easily treatable. Moving the breast tissue takes a toll on the blood flow which may cause in a longer healing process. Therefore it is highly recommendable not to smoke. Rest and support by a well-fitting bra will have a positive effect on a good recovery.

Sometimes the wounds under the breasts will widen, which causes wound leakage for 1 or 2 weeks. Paraffin gauze and a shower twice a day will solve the problem. Smoking and overweight increases the risk of these complications.

Complications with implants:

Breast implants are modernized. The density of the fluid used has increased so that the gel does not drain, not even in the hypothetical case of a rupture of the implant. The shell of the implant is so solid that rupturing is virtually impossible.

Capsular contracture can be a reason to replace the implants, but is in itself no medical ground. In rare cases of external trauma, like a car accident, the implant van rupture en silicone gel can leak to the chest area. Obviously this will be medical ground to remove the damaged implant en to replace it.

Most manufacturers will give some form of guarantee on the implants. As is the case with all medical implants a hundred percent guarantee cannot be given. See my article about guarantee.