Breast augmentation can give women with small or unevenly sized breasts a fuller, firmer, better-proportioned look through the placement of implants. Women may elect to undergo breast augmentation for many different medical and aesthetic reasons, including balancing breast size and compensating for reduced volume due to pregnancy or age. The procedure can be combined with a breast lift if needed for more satisfying results.
The breast implants are saline (salt water filled). Silicone gel filled breast implants are available in special cases of implant replacement, breast reconstruction, and when combined with a breast lift.
Incisions are made in inconspicuous places to minimize scar visibility (around the lower edge of areola, in the fold beneath the breast, or in the under arm area). The incisions are closed with a medical-grade adhesive to avoid stitch marks. The implant is placed behind each breast underneath the chest muscle. Placement under the muscle offers a few advantages over the placement of the implant under the breast tissue only. These include a more natural, softer result, a reduced risk of post-operative firmness due to scar tissue, and less interference with eventual mammogram examinations.
Dr. Wiener minimizes the post-operative discomfort by placing a “pain pump” underneath the breast at the time of surgery. This tiny (1.0-mm in diameter) catheter is attached to a small, noiseless, pump that the patient clips to her clothing for the first 48-hours after the procedure. The pump infuses local anesthesia continuously underneath the breast, essentially numbing the tissues and decreasing the discomfort significantly. After surgery, a soft support bra with a wrap around the chest is worn.
Most patients feel tired and sore after surgery and there is some degree of bruising and swelling. The pain pump catheters are removed painlessly at the first post-operative visit (48-hours). There are no stitches to remove. Most patients return to work after one week. More strenuous activities should be avoided for 4-6 weeks.
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A breast reduction (reduction mammoplasty) removes excess breast tissue and reshapes large, sagging breasts. Excessively large and drooping breasts cause back, neck, shoulder, and breast pain. They can also cause grooving from bra straps, rashes, and problems with posture. They can make it difficult to engage in normal physical activities and can be a source of self-consciousness for the patient.
The procedure involves removing excess breast tissue and skin from the lower portion of the breast as well as elevating and reshaping the remaining breast tissue and nipples. Incisions encircle the areola and extend vertically down the lower one-half of the breast and sometimes horizontally in the fold underneath the breast. always attempts to use the smallest incision possible to minimize scarring. In addition, Dr. Weiner uses a medical grade adhesive rather than sutures in order to minimize the appearance of scars. Dr. Weiner may add liposuction to the breast or to the area near the under arm to create a more contoured look.
After surgery, a soft support bra is used. The breasts will feel sore and there will be some degree of bruising and swelling. This usually resolves in 7-10 days. Most patients return to work in one week. Strenuous activities should be avoided for 4-6 weeks.
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A breast lift, or mastopexy, is performed to return youthful shape and lift to breasts that have sagged as a result of fluctuations in weight, pregnancy, loss of the skin’s natural elasticity, or simply the effects of gravity. The breast tissue is elevated, excess skin is removed, and the nipple and areola is moved to a higher position. The size of the areola can be reduced, and the lift can be combined with a breast implant for added volume and firmness (a very popular procedure).
A variety of incisions are utilized, depending upon the degree of lift needed. Minor lifts are done through incisions around the areola only. More significant lifts require an incision that extends vertically down the lower one-half of the breast beneath the areola and sometimes horizontally in the fold beneath the breast. The addition of a breast implant can fill some of the excess skin and minimize the length of the lift incision needed. Dr. Wiener uses a medical grade adhesive to close most of the lift incisions in order to minimize scar visibility.
After surgery, a soft support bra is worn. There will be some degree of bruising and swelling, and the breasts will feel sore. This usually resolves in 7-10 days. Patients usually return to work within one week. More strenuous activities should be avoided for 4-6 weeks.
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