Various parts of the body can be reduced, augmented or lifted. Reduction and elevation of the breasts, or augmentation, are popular and highly successful procedures. In general they give considerable satisfaction and have a small complication rate. Similarly, liposuction is very successful, particularly for areas that are resistant to weight loss. Calf, buttock, chin and cheek augmentation similarly can give great pleasure in suitable cases.
Where the breasts are too heavy it may cause the bra straps to cut in across the shoulders, upper thoracic back pain and sweating and irritation beneath the breast in summer. The weight of the breast may draw them downwards making it difficult for ladies to find suitable clothing and also embarrassment in beachwear.
The principle of breast reduction is to reduce the volume of the breast and elevate the nipple into the correct position. Surprisingly the operation is pain free and the complications will be carefully explained to you by your specialist but are very infrequent. The scars take a year to eighteen months to settle and although sensation to the nipple is at risk it is unusual to lose sensation with modern techniques. Usually a night in hospital is required, sutures removed at two weeks. It is a procedure which gives a very considerable degree of satisfaction for ladies.
This is very similar to a breast reduction but is used where no breast tissue needs to be removed. Where the breasts have merely become droopy it is possible to elevate the nipple and tighten the breast envelope. If extra volume is required then a prosthesis can be inserted at the same time providing improved position and volume.
Breast augmentation is a very popular procedure enhancing the bosoms in circumstances where the development has been perceived as being somewhat restricted or where volume has been lost following childbirth. The content of the prosthesis can either be salt water or silicone. Silicone is usually preferred as it generally has a better feel and shape. Some 10-15 years ago there was concern as to whether absorbed silicone might have a deleterious effect on the body but large series in different countries have shown no evidence of this. The envelopes around the prostheses are much thicker than they were in time gone by and leaks therefore reduced. It is advised however that the prostheses should be scanned at 10-15 years to confirm that the envelopes are intact. False negatives and false positives do exist however. Texturing on the surface of the prosthesis has greatly reduced capsular contractures to maintain the soft feel of the prosthesis and a natural shape. Breast prostheses can be placed either above the muscle of the chest directly behind the breast or beneath the muscle. The decision as to the correct placement would depend on the individual's shape and the position of the nipples. Prostheses can be inserted via an incision in the inframammary fold or via the armpit. These usually measure approximately 4.5cm and settle over the course of a year. The size of the prosthesis to be inserted is largely an individual choice and will be discussed with you. It is preferable to be in hospital overnight but it is not absolutely necessary if the prosthesis is placed above the chest muscle. If placed below it is more painful and an overnight stay desirable to allow help with analgesia. You will need to be fully advised of the advantages and disadvantages of breast prostheses but in general most are delighted with the result.
Increase in the size of male breasts can be very embarrassing, particularly in those who wish to spend time on the beach. The excess tissue behind the breast can either be fat or actual breast tissue immediately behind the areola. Excess fatty tissue can be successfully removed using liposuction, in which case there is minimal scarring. If the reason for the breast swelling relates to excess breast tissue behind the areola, it needs excision via a hemi-areolar incision. Both methods are very successful and provide considerable relief from embarrassment.
Douglas Harrison is one of the best plastic surgeons in the world. His dedication to his work, his kindness, and his caring nature make you feel completely at ease and reassured that you are with one of the best. He is a true pioneer in this industry and a nurturer of his craft. Douglas is truly inspiring and gifted at what he does, and long may it continue.
C J Mitchell, Journalist, London