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Mammoplasty

Plastic surgery of the breast; called also mammoplasty.

Augmentation mammaplasty plastic surgery to increase the size of the female breast, or sometimes to uplift pendulous breasts. It can be done for purely cosmetic purposes, as when a woman wants larger breasts, or following mastectomy to replace surgically removed tissue (see reconstructive mammaplasty).

Reconstructive mammaplasty breast reconstruction after mastectomy, done as an alternative to breast forms and specially designed brassieres to achieve a more normal appearance of the breast. If this procedure is chosen, it is usually considered to be just one stage in the total plan of treatment for breast cancer. It has both a psychologic and physiologic impact on the patient. Criteria used to determine whether reconstructive surgery is appropriate postmastectomy include the amount of tissue remaining after mastectomy, e.g., pectoral muscles, skin, and nipple; the probability of recurrent metastatic disease; appearance and size of the unoperated breast; and size and angle of the mastectomy scar. Adjuvant cancer therapy with radiation does not necessarily preclude additional plastic breast surgery.

Reduction mammaplasty plastic surgery to reduce the size of the female breast. Physical and psychological problems that may be amenable to this include fatigue or a dragging sensation caused by the weight of the breasts, breast tenderness and discomfort, and difficulty obtaining adequate support even with a sturdy brassiere. Psychological stress can result from embarrassment over deep grooves created by the shoulder straps of brassieres, fear of ridicule, and difficulty in finding suitable clothing. Reduction mammaplasty usually involves removal of excess breast tissue by way of a curved incision under the breast. The skin is pulled taut and the nipple transplanted to its normal position in the center of the newly formed breast. After surgery the patient may need help in adjusting to a new body image. If she is of childbearing age she should be informed that normal lactation is no longer possible after this procedure.

Risks

Breast reduction surgery has the same risks as any other type of major surgery — bleeding, infection and an adverse reaction to the anesthesia. Other possible risks include:

  • Scarring
  • Loss of sensation in the nipples and skin surrounding the nipples (areolae)
  • Difficulty or inability to breast-feed
  • Differences in the size, shape and symmetry (asymmetry) of the surgically altered left and right breasts, which might lead to further surgery to improve appearance.

The risk of poor wound healing seems to increase with the amount of breast tissue removed. However, it isn't clear that women with a higher body mass index are at greater risk of complications from breast reduction surgery.

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