Breast surgery: Options

Overview

Breast surgery can modify the appearance or function of breasts in individuals of both genders. For men, procedures may address conditions like gynecomastia (enlarged breasts) or breast cancer. These surgeries serve various purposes, including cosmetic enhancements such as rejuvenation or augmentation, as well as medical interventions like reducing breast size to relieve back pain or removing cancerous tissue.

Types

There are various types of breast surgeries, performed for either medical or cosmetic reasons.

Breast surgery for cosmetic purposes include:

• Breast reduction: This is performed to decrease breast size.
• Breast reconstruction: Often performed following breast cancer surgery.
• Breast augmentation: Performed to increase breast size.

Breast surgery for medical purposes include:

• Breast reduction: This is performed to reduce breast size.
• Removal of breast lumps that are non-cancerous: Removal of certain non-cancerous breast masses may be necessary.
• Surgery for breast cancer: To eradicate the malignancy, all or a portion of the breast as well as any adjacent lymph nodes may be removed. Common surgery include mastectomy and lumpectomy.
• Mastectomy: To avoid breast cancer, breasts are removed.

Reasons for undergoing the procedure

Breast surgery is done for two main reasons:

• Medical: It may include treating breast cancer, removing non-cancerous lumps, or reducing breast size to alleviate back pain.
• Cosmetic: Surgery can be done to change the size, appearance, or shape of the breasts to meet personal preferences.

Risk

Breast surgery involves inherent risks. For instance, breast implants can complicate the detection of breast cancer, a significant health concern. Additionally, implants may not be permanent, necessitating future surgical interventions.

Potential risk include:

• Discomfort, or intense pain
• Scarring
• Leakage or rupture of the implant
• Anesthesia
• Excessive bleeding
• Infection
• Modifications to breast or nipple feeling
• Requiring corrective surgery

Before the procedure

Before breast augmentation, reduction, or reconstruction, the following is required:

• Consultation to determine candidacy: Assessing suitability for the procedure typically involves a comprehensive consultation. This includes discussing the reasons for surgery, any allergies to medications, past medical treatments, current medications, use of vitamins or supplements, alcohol, tobacco, or drug consumption, family history of breast cancer, existing health conditions, and prior surgeries. During consultation, it’s also important to inquire about the healthcare provider’s credentials, expected recovery time, potential risks and side effects, likelihood of future surgeries, impact on breastfeeding, long-term appearance of the breasts, and options available if the patient is dissatisfied with the surgical outcome.
• Physical examination and measurement: The healthcare provider will measure the patient’s breasts, discuss the desired size, and take photographs for before-and-after comparisons. It also includes identifying the size and location of the cancer to determine whether a lumpectomy or mastectomy is required.

Eligibility for optional cosmetic breast surgery typically requires being in good physical health, not pregnant or breastfeeding, having fully developed breasts, and making the decision for personal reasons rather than external pressures, which is an important consideration in cosmetic procedures.

Prior surgery, necessary preparations may include:

• Undergoing a blood test
• Taking recommended vitamins
• Avoiding or adjusting intake of certain medications
• Refraining from recreational drug use
• Ceasing smoking and nicotine use

During the procedure

Breast surgeries involve several steps tailored to the specific procedure.

• Breast reconstruction surgery: This involves using implants or one’s own tissue, like from the abdominal wall, for the reconstruction process. This is often considered for trauma or to alter nipple appearance. However, it does not restore breastfeeding ability or nipple sensation.
• Breast reduction surgery: During the procedure, one will be under general anesthesia. The healthcare provider makes incisions around the nipple and downward, removes excess skin, tissue, and fat, relocates the nipple, and closes the incisions, possibly with drainage tubes and dressings.
• Breast augmentation surgery: In this procedure, often performed under intravenous sedation or general anesthesia, incisions are made depending on implant type and placement preference (areola, breast fold, or armpit). The implants are inserted either under the muscle or behind breast tissue. The incisions are closed with sutures and adhesive, and results are visible immediately post-surgery.

After the procedure

Following breast surgery, comprehensive post-operative instructions will be provided, and a follow-up appointment will be arranged. Healthcare providers will closely monitor the patient’s recovery. Pain medication will be prescribed to alleviate discomfort. Gauze dressings, along with a support bra or elastic bandage, will be provided to reduce swelling and support the healing process of the breasts.

Outcome

Recovery time after breast surgery typically ranges from one week to six weeks or more, depending on the specific type of surgery. Soreness can persist for weeks afterward, although it varies case by case.

Recovery time depends on the type of breast surgery:

• Lumpectomy: One may return to work around two weeks
• Mastectomy: Recovery takes four to six weeks.
• Breast reduction or augmentation: One may return to work/school in about one week

Bruising, numbness, or tingling around the surgical site, upper arm, and armpit is also commonly felt after breast cancer surgery. Scar tissue from breast reduction surgery can sometimes lead to discomfort or pain as well.

Pain can be managed with pain relievers, warm showers after a week, and gentle exercises. Applying vitamin E lotion or pure lanolin to the incisions can aid in reducing scarring.

It is also important to be on look out for potential complications, such as:

• Persistent coughing or breathlessness
• Digestive issues
• Damaged sutures
• Headaches, blurred vision, or dizziness
• Increased drainage
• Pain that is unresponsive to standard painkillers.
• Appetite loss
• A fever that reaches 101 degrees Fahrenheit or above

Regular blood tests, physical exams, and mammograms are essential for ongoing health monitoring. Future surgeries may be required due to cancer recurrence or the need to replace implants.