The procedure, also known as reduction mammoplasty, saw an 11 percent increase in popularity in 2017, following a 4 percent decline in 2016.
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Breast augmentation and augmentation mammoplasty (colloquially: "boob job") is a cosmetic surgery technique using breast-implants and fat-graft mammoplasty techniques to increase the size, change the shape, and alter the texture of the breasts of a woman. Augmentation mammoplasty is applied to correct congenital defects of the breasts and the chest wall. As an elective cosmetic surgery, primary augmentation changes the aestheticsof size, shape, and textureof healthy breasts. The surgical implantation approach creates a spherical augmentation of the breast hemisphere, using a breast implant filled with either saline solution or silicone gel; the fat-graft transfer approach augments the size and corrects contour defects of the breast hemisphere with grafts of the adipocyte fat tissue, drawn from the person's body.
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Mokbel's clinical interests in the field of breast surgery include the early detection of breast cancer, breast ductoscopy, minimally-invasive breast surgery, sentinel node biopsy, skin-sparing mastectomy, breast reconstruction, cosmetic breast surgery, prevention of breast cancer, genetic predisposition, integrative oncology and the management of benign conditions including breast cysts, mastalgia and fibroadenomas. Mokbel has extensive experience in the field of reconstructive and aesthetic breast surgery including augmentation mammoplasty (replacement of implants and correction of contracture), reduction mammoplasty and mastopexy.
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The surgical scars of a breast augmentation mammoplasty heal at 6-weeks post- operative, and fade within several months, according to the skin type of the woman. Depending upon the daily physical activity the woman might require, the augmentation mammoplasty patient usually resumes her normal life activities at about 1-week post-operative. The woman who underwent submuscular implantation (beneath the pectoralis major muscles) usually has a longer post–operative convalescence, and experiences more pain, because of the healing of the deep- tissue cuts into the chest muscles for the breast augmentation. The patient usually does not exercise or engage in strenuous physical activities for about six weeks.
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Reduction mammoplasty (also breast reduction and reduction mammaplasty) is the plastic surgery procedure for reducing the size of large breasts. In a breast reduction surgery for re-establishing a functional bust that is proportionate to the woman's body, the critical corrective consideration is the tissue viability of the nipple–areola complex (NAC), to ensure the functional sensitivity and lactational capability of the breasts. The indications for breast reduction surgery are three-fold – physical, aesthetic, and psychological – the restoration of the bust, of the woman's self-image, and of her mental health. In corrective practice, the surgical techniques and praxis for reduction mammoplasty also are applied to mastopexy (breast lift).
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The reliability of the lipectomy procedure was confirmed in two studies. The first, Tumescent Technique, Tumescent Anesthesia & Microcannular Liposuction (2000) reported that tumescent liposuction is a reliable reduction mammoplasty procedure, which yields consistent results of size, appearance, and texture of the reduced-volume breasts.Dryden RM, American Academy of Cosmetic Surgery Conference, Florida, February 2000. The second study by Daniel Lanzer, Breast Reduction with Liposuction (2002), about a 250-woman cohort, reported that the application of tumescent liposuction, as the sole reduction-mammoplasty procedure, yielded consistent results wherein none of the patients had loose breast-skin envelopes, irregular breast-shape, permanent loss of sensation (either glandular, dermal, or of the NAC), scars, tissue necrosis, or infection.
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Lab tests of her blood for hormones and biochemical substances showed normal values, though tests revealed that it might have been caused by hypersensitivity to estrogen. She underwent a bilateral reduction mammoplasty. Surgeons removed of tissue from her right breast and from her left breast. She was administered tamoxifen afterward to suppress breast regrowth.
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Moreover, mastopexy surgery techniques also are applied to reduction mammoplasty, which is the correction of oversized breasts. Psychologically, a mastopexy procedure to correct breast ptosis is not indicated by medical cause or physical reason, but by the self-image of the woman; that is, the combination of physical, aesthetic, and mental health requirements of her Self.
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As a medical device technology, there are five generations of silicone breast implant, each defined by common model- manufacturing techniques. The modern prosthetic breast was invented in 1961 by the American plastic surgeons Thomas Cronin and Frank Gerow, and manufactured by the Dow Corning Corporation; in due course, the first augmentation mammoplasty was performed in 1962.
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Breast reduction by liposuction only cannot be performed upon a woman whose mammogram indicates that the oversized breast is principally composed of hypertrophied milk glands. Furthermore, liposuction mammoplasty also is contraindicated for any woman whose mammograms indicate the presence of unevaluated neoplasms; likewise, the presence of a great degree of breast ptosis, and an inelastic skin envelope.
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These surgeries include vaginoplasty, feminizing augmentation mammoplasty, orchiectomy, facial feminization surgery, reduction thyrochondroplasty (tracheal shave), and voice feminization surgery among others. Masculinization surgeries are surgeries that result in anatomy that is typically gendered male. These surgeries include chest masculinization surgery (top surgery), metoidioplasty, phalloplasty, scrotoplasty, and hysterectomy. In addition to SRS, patients may need to follow a lifelong course of masculinizing or feminizing hormone replacement therapy.
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It is a common procedure performed for people who have undergone major weight loss. It may be performed in both men and women. Breast reduction, or reduction mammoplasty, is the cosmetic surgery used in resizing the breast, in women with oversized breasts and men who suffer from gynecomastia. This type of surgery is performed to treat a breast condition known as hypertrophy, which refers to oversized breasts.
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The modern prosthetic breast was invented in 1961, by the American plastic surgeons Thomas Cronin and Frank Gerow, and manufactured by the Dow Corning Corporation; in due course, the first augmentation mammoplasty was performed in 1962. There are five generations of medical device technology for the breast-implant models filled with silicone gel; each generation of breast prosthesis is defined by common model-manufacturing techniques.
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Insurance companies in the United States typically require the physician to provide evidence that a woman's large breasts cause headaches or back and neck pain before they will pay for reduction mammoplasty. Insurance companies also mandate a woman who is overweight, which is often the case with gigantomastia, to first lose a certain amount of weight. They also commonly require the patient to try alternative treatments like physical therapy for a year or more.
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Breast reduction: the pre-operative (l.) and post-operative (r.) aspects of the correction of macromastia and breast ptosis in a young woman. Reduction mammoplasty: The keyhole incision plan for correcting macromastia; the sagging, hypertrophied breast (l.), the surgical reduction procedure (c.), the reduced, elevated breast (r.). Breast reduction: foremost is the tissue viability of the NAC; it also hides a periareolar scar in the skin-color transition at the areolar periphery. breast lift surgery.
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Cross-section scheme of the mammary gland. The presence of breast implants currently presents no contraindication to breast feeding, and no evidence to support that the practice may present health issues to a breast feeding infant is recognized by the USFDA. Women with breast implants may have functional breast-feeding difficulties; mammoplasty procedures that feature periareolar incisions are especially likely to cause breast-feeding difficulties. Surgery may also damage the lactiferous ducts and the nerves in the nipple-areola area.
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Kefah Mokbel's main research interest lies in the field of molecular biology and the clinical management of breast cancer. Furthermore, he has published several papers in the field of aesthetic breast surgery including breast reconstruction following mastectomy and augmentation mammoplasty using implants and fat transfer. His prolific research output includes over 300 published papers in medical literature. According to Google Scholar Kefah Mokbel has 350 publications which have been cited more than 7000 times with a H-index of 50 and an i10-index of 167.
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Breast augmentation: The post-operative aspect of a right- breast cancer mastectomy; the woman is a candidate for a primary breast reconstruction with a breast implant. An augmentation mammoplasty for emplacing breast implants has three therapeutic purposes: # Primary reconstruction: to replace breast tissues damaged by trauma (blunt, penetrating, blast), disease (breast cancer), and failed anatomic development (tuberous breast deformity). # Revision and reconstruction: to revise (correct) the outcome of a previous breast reconstruction surgery. # Primary augmentation: to aesthetically augment the size, form, and feel of the breasts.
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The surgical scars of a breast augmentation mammoplasty develop approximately at 6-weeks post-operative, and fade within months. Depending upon the daily-life physical activities required of the woman, the breast augmentation patient usually resumes her normal life at 1-week post-operative. Moreover, women whose breast implants were emplaced beneath the chest muscles (submuscular placement) usually have a longer, slightly more painful convalescence, because of the healing of the incisions to the chest muscles. Usually, she does not exercise or engage in strenuous physical activities for approximately 6 weeks.
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SPAIR (short-scar periareolar inferior pedicle reduction) is a short-scar breast surgery technique developed by Dennis C. Hammond, assistant professor of surgery at Michigan State University. The technique was designed to allow a better-shaped breast, a limited amount of scarring, and a more accelerated healing process, by eliminating the lateral scar beneath the breast found in conventional breast reduction surgery. The technique is considered to be a good alternative to vertical mammoplasty. Short-scar refers to the smaller, shorter (when compared to conventional breast reduction methods), vertical- only scar.
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A person with breast implants is usually able to breast-feed an infant; yet implants can cause functional breast-feeding difficulties, especially with mammoplasty procedures that involve cutting around the areola, and implant placement directly beneath the breast, which tend to cause greater breast-feeding difficulties. Patients are advised to select a procedure which causes the least damage to the lactiferous ducts and the nerves of the nipple- areola complex (NAC).Breastfeeding after Breast Surgery , La Leche League (2009-09-05).Breastfeeding and Breast Implants , Selected Bibliography April 2003, LLLI Center for Breastfeeding Information.
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The traditional, surgical techniques for breast reduction remodel the breast mound using a skin and glandular (breast tissue) pedicle (inferior, superior, central), and then trim and re- drape the skin envelope into a new breast of natural size, shape, and contour; yet it produces long surgical scars upon the breast hemisphere. In response, L. Benelli, in 1990, presented the round block mammoplasty, a minimal-scar periareolar incision technique that produces only a periareolar scar – around the NAC, where the dark-to-light skin-color transition hides the surgical scar.
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A mammoplasty procedure for the placement of breast implant devices has three (3) purposes: # primary reconstruction: the replacement of breast tissues damaged by trauma (blunt, penetrating, blast), disease (breast cancer), and failed anatomic development (tuberous breast deformity). # revision and reconstruction: to revise (correct) the outcome of a previous breast reconstruction surgery. # primary augmentation: to aesthetically augment the size, form, and feel of the breasts. The operating room (OR) time of post–mastectomy breast reconstruction, and of breast augmentation surgery is determined by the procedure employed, the type of incisions, the breast implant (type and materials), and the pectoral locale of the implant pocket.
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In a study conducted in the United Kingdom of 103 women seeking mammoplasty, researchers found a strong link between obesity and inaccurate back measurement. They concluded that "obesity, breast hypertrophy, fashion and bra-fitting practices combine to make those women who most need supportive bras the least likely to get accurately fitted bras." One issue that complicates finding a correctly fitting bra is that band and cup sizes are not standardized, but vary considerably from one manufacturer to another, resulting in sizes that only provide an approximate fit. Women cannot rely on labeled bra sizes to identify a bra that fits properly.
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She also was a fellow of the American College of Surgeons. During her career, Stephenson authored dozens of articles and lectures on a wide range of plastic and reconstructive surgery subjects, including aesthetic plastic surgery, burns, mammoplasty, rhytidectomy, and the history of plastic surgery. She co-authored a medical textbook, "Plastic and Reconstructive Surgery," in 1948, and was co- editor and then editor of the journal Plastic and Reconstructive Surgery from 1963–67, the first woman to do so. From 1967-75, she also was co-editor and then editor of the Plastic and Reconstructive Surgery Yearbook.
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A reduction mammoplasty to re-size enlarged breasts and to correct breast ptosis resects (cuts and removes) excess tissues (glandular, adipose, skin), overstretched suspensory ligaments, and transposes the NAC higher upon the breast hemisphere. At puberty, the breast grows in consequence to the influences of the hormones estrogen and progesterone; as a mammary gland the breast is composed of lobules of glandular tissue, each of which is drained by a lactiferous duct that empties to the nipple. Most of the volume (ca. 90%) and rounded contour of the breasts are conferred by the adipose fat interspersed amongst the lobules – except during pregnancy and lactation, when breast milk constitutes most of the breast volume.
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Breast implant emplacement is performed with five (5) types of surgical incisions: # Inframammary: an incision made to the inframammary fold (natural crease under the breast), which affords maximal access for precise dissection of the tissues and emplacement of the breast implants. It is the preferred surgical technique for emplacing silicone-gel implants, because it better exposes the breast tissue–pectoralis muscle interface; yet, IMF implantation can produce thicker, slightly more visible surgical scars. # Periareolar: a border-line incision along the periphery of the areola, which provides an optimal approach when adjustments to the IMF position are required, or when a mastopexy (breast lift) is included to the primary mammoplasty procedure. In periareolar emplacement, the incision is around the medial-half (inferior half) of the areola's circumference.
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The emplacement of a breast implant device is performed with five types of surgical incisions: # Inframammary: an incision made below the breast, in the infra-mammary fold (IMF), which affords maximal access for precise dissection and emplacement of the breast implant devices. It is the preferred surgical technique for emplacing silicone-gel implants, because of the longer incisions required; yet, IMF implantation can produce thicker, slightly more visible surgical scars. # Periareolar: an incision made along the areolar periphery (border), which provides an optimal approach when adjustments to the IMF position are required, or when a mastopexy (breast lift) is included to the primary mammoplasty procedure. In the periareolar emplacement method, the incision is around the medial-half (inferior half) of the areola's circumference.
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The breast reduction performed with the vertical-scar technique usually produces a well-projected bust featuring breasts with short incision scars and a NAC elevated by means of a pedicle (superior, medial, lateral) that maintains the biologic and functional viability of the NAC. The increased projection of the reduced bust is achieved by medially gathering the folds of the skin-envelope and suturing the inner and outer portions of the remaining breast gland to provide a support pillar, and upward projection of the NAC . The vertical-scar reduction mammoplasty is best suited for removing small areas of the skin envelope and small volumes of internal tissues (glandular, adipose) from the lateral and the inferior portions of the breast hemisphere; thus the short incision scars.
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When the patient is unsatisfied with the outcome of the augmentation mammoplasty; or when technical or medical complications occur; or because of the breast implants’ limited product life, it is likely she might require replacing the breast implants. Common revision surgery indications include major and minor medical complications, capsular contracture, shell rupture, and device deflation. Revision incidence rates were greater for breast reconstruction patients, because of the post-mastectomy changes to the soft-tissues and to the skin envelope of the breast, and to the anatomical borders of the breast, especially in women who received adjuvant external radiation therapy. Moreover, besides breast reconstruction, breast cancer patients usually undergo revision surgery of the nipple-areola complex (NAC), and symmetry procedures upon the opposite breast, to create a bust of natural appearance, size, form, and feel.
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" The presented cover art showed plastic surgeon Jan Adams who performed a liposuction and mammoplasty operation on West's mother, Donda West, which led to complications and eventually her death a day after. Within the texts, Kanye West explained that he wanted to "forgive and stop hating," implying that West was ready to forgive the plastic surgeon for the situation regarding his mother's death. On April 30, Adams responded to the news of the cover in the form of an open letter, asking West to "cease and desist using my photo or any image of me to promote your album or any of your work," while noting his willingness to sit down with West for a face to face conversation. West responded to the letter on his Twitter saying, "This is amazing.
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The woman is instructed to resume her normal life activities, and to eat a light diet, post-operative, on the day of the breast reduction surgery; to resume washing in a shower at 1-day post-operative; to avoid strenuous physical activity, and to wear a sports brassière; the convalescence regimen is for 3-months post- operative. She is also informed that the wrinkles at the bottom of the vertical limb of the scar usually resolve and fade within 1–6 months post- operative; yet some cases might require surgical revision of the vertical scar. Scheduled follow-up consultations ensure a satisfactory outcome to the breast reduction surgery, and facilitate the early identification and management of medical complications. There is limited evidence in showing wound drains have no significant benefit after reduction mammoplasty.
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The reduction of oversized breasts by liposuction only (lipectomy) is indicated when a minor-to-moderate volume-reduction is required, and there is no breast ptosis to correct. However, in a 2001 study of 250 patients, nipple and breast elevation of between 3 cm and 15 cm was reported. Further indications for lipectomy are presented by: (i) the woman who requires a large-volume reduction, and wants un-scarred, sensate breasts, yet will accept a degree of ptosis; (ii) the woman who requires a secondary mammoplasty to correct an asymmetric breast, by up to one (1) brassière cup- size; and (iii) the girl afflicted with virginal breast hypertrophy, as a temporary procedure performed before the conclusion of her thelarche (the pubertal breast-growth phase), given the hypertrophy's high rate of recurrence.
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The measures of the bust: a liposuction mammoplasty procedure does not feature a surgical-incision plan delineated upon the woman's breasts, chest, and torso. Yet the measures of the bust are established in order to determine the required degree(s) of correction; thus, with the patient sitting erect, for each breast, the surgeon records the jugular-notch-to-nipple distances, the nipple-to-inframammary-fold distances, and any asymmetries. Afterwards, the anaesthetized patient is laid supine upon the operating table, with her arms laterally extended (abducted) in order to fully expose the breasts. Anaesthestic preparation: to limit bleeding during the liposuction, the proper degree of vasoconstriction of the breast's circulatory system is established with an anaesthetic solution (lidocaine + epinephrine in saline solution) that is infiltrated to the deep and the superficial plains of each breast.
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Mastopexy (Greek μαστός mastos "breast" + -pēxiā "affix") is the plastic surgery mammoplasty procedure for raising sagging breasts upon the chest of the woman, by changing and modifying the size, contour, and elevation of the breasts. In a breast-lift surgery to re-establish an aesthetically proportionate bust for the woman, the critical corrective consideration is the tissue viability of the nipple-areola complex (NAC), to ensure the functional sensitivity of the breasts for lactation and breast-feeding. The breast-lift correction of a sagging bust is a surgical operation that cuts and removes excess tissues (glandular, adipose, skin), overstretched suspensory ligaments, excess skin from the skin-envelope, and transposes the nipple-areola complex higher upon the breast hemisphere. In surgical practice, mastopexy can be performed as a discrete breast-lift procedure, and as a subordinate surgery within a combined mastopexy–breast augmentation procedure.
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When the woman is unsatisfied with the outcome of the augmentation mammoplasty; or when technical or medical complications occur; or because of the breast implants' limited product life (Class III medical device, in the U.S.), it is likely she might require replacing the breast implants. The common revision surgery indications include major and minor medical complications, capsular contracture, shell rupture, and device deflation. Revision incidence rates were greater for breast reconstruction patients, because of the post-mastectomy changes to the soft-tissues and to the skin envelope of the breast, and to the anatomical borders of the breast, especially in women who received adjuvant external radiation therapy. Moreover, besides breast reconstruction, breast cancer patients usually undergo revision surgery of the nipple-areola complex (NAC), and symmetry procedures upon the opposite breast, to create a bust of natural appearance, size, form, and feel.
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Free-flap breast reconstruction is a type of autologous-tissue breast reconstruction applied after mastectomy for breast cancer, without the emplacement of a breast implant prosthesis. As a type of plastic surgery, the free-flap procedure for breast reconstruction employs tissues, harvested from another part of the woman's body, to create a vascularised flap, which is equipped with its own blood vessels. Breast-reconstruction mammoplasty can sometimes be realised with the application of a pedicled flap of tissue that has been harvested from the latissimus dorsi muscle, which is the broadest muscle of the back, to which the pedicle (“foot”) of the tissue flap remains attached until it successfully grafts to the recipient site, the mastectomy wound. Moreover, if the volume of breast-tissue excised was of relatively small mass, breast augmentation procedures, such as autologous-fat grafting, also can be applied to reconstruct the breast lost to mastectomy.
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The medical treatment records for the reduction mammoplasty are established with pre-operative, multi-perspective photographs of the oversized breasts, the sternal-notch–to-nipple distances, and the nipple-to–inframammary-fold distances. The woman is instructed about the purposes of the breast reduction surgery, the achievable corrections, the expected final size, shape, and contour of the reduced breasts, the expected final appearance of the breast reduction scars; possible changes in the sensation of the NAC, possible changes in her breast-feeding capability, and possible medical complications. The woman also is instructed about post-operative matters such as convalescence and the proper care of the surgical wounds to the breasts. Incision-plan delineation: to the breasts of the standing patient, the plastic surgeon delineates the mosque dome skin-incision plan, and the area representing the superior pedicle (composed of skin and glandular tissues), the breast midline, the inframammary fold (IMF), and the vertical axis of the breast, beneath the IMF.
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Although seven studies have statistically connected a woman's breast augmentation to a greater suicide- rate, the research indicates that breast augmentation surgery does not increase the death rate; and that, in the first instance, it is the psychopathologically-inclined woman who is more likely to undergo a breast augmentation procedure.National Plastic Surgery Procedural Statistics, 2006. Arlington Heights, Illinois, American Society of Plastic Surgeons, 2007 The study Effect of Breast Augmentation Mammoplasty on Self-Esteem and Sexuality: A Quantitative Analysis (2007), reported that the women attributed their improved self image, self-esteem, and increased, satisfactory sexual functioning to having undergone breast augmentation; the cohort, aged 21–57 years, averaged post-operative self-esteem increases that ranged from 20.7 to 24.9 points on the 30-point Rosenberg self-esteem scale, which data supported the 78.6 per cent increase in the woman's libido, relative to her pre- operative level of libido. Therefore, before agreeing to any surgery, the plastic surgeon evaluates and considers the woman's mental health to determine if breast implants can positively affect her self-esteem and sexual functioning.
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A mammograph of a normal breast (left);a mammograph of a cancerous breast (right). The presence of radiologically opaque breast implants (either saline or silicone) might interfere with the radiographic sensitivity of the mammograph, that is, the image might not show any tumor(s) present. In this case, an Eklund view mammogram is required to ascertain either the presence or the absence of a cancerous tumor, wherein the breast implant is manually displaced against the chest wall and the breast is pulled forward, so that the mammograph can visualize a greater volume of the internal tissues; nonetheless, approximately one-third of the breast tissue remains inadequately visualized, resulting in an increased incidence of mammograms with false-negative results. The breast cancer studies Cancer in the Augmented Breast: Diagnosis and Prognosis (1993) and Breast Cancer after Augmentation Mammoplasty (2001) of women with breast implant prostheses reported no significant differences in disease-stage at the time of the diagnosis of cancer; prognoses are similar in both groups of women, with augmented patients at a lower risk for subsequent cancer recurrence or death.
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From the first half of the twentieth century, physicians used other substances as breast implant fillers—ivory, glass balls, ground rubber, ox cartilage, Terylene wool, gutta-percha, Dicora, polyethylene chips, Ivalon (polyvinyl alcohol—formaldehyde polymer sponge), a polyethylene sac with Ivalon, polyether foam sponge (Etheron), polyethylene tape (Polystan) strips wound into a ball, polyester (polyurethane foam sponge) Silastic rubber, and teflon-silicone prostheses. In the mid-twentieth century, Morton I. Berson, in 1945, and Jacques Maliniac, in 1950, each performed flap- based breast augmentations by rotating the patient's chest wall tissue into the breast to increase its volume. Furthermore, throughout the 1950s and the 1960s, plastic surgeons used synthetic fillers—including silicone injections received by some 50,000 women, from which developed silicone granulomas and breast hardening that required treatment by mastectomy. In 1961, the American plastic surgeons Thomas Cronin and Frank Gerow, and the Dow Corning Corporation, developed the first silicone breast prosthesis, filled with silicone gel; in due course, the first augmentation mammoplasty was performed in 1962 using the Cronin–Gerow Implant, prosthesis model 1963.
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