Plastic and Cosmetic Surgery - Cosmetic breast surgery
Breasts that sag even though they are not too large can be lifted to a more attractive contour by an operation that consolidates the tissue. The surgical procedure, called mastopexy , consists of removing strips of skin from the base of the breasts and bringing the rest of the skin together under tension so that it is tight enough to support the tissue in an upward position. The nipple is moved to a higher position.
In spite of all the publicity given to breast augmentation, most cosmetic surgery involving the breasts is concerned with reducing rather than enlarging them. Breast reduction is frequently undertaken not only to improve appearance but also for purposes of health and comfort.
The operation, called a reduction mammoplasty , is performed under either local or general anesthesia, depending on the extent of the reduction. The surgeon cuts out fatty tissue and skin and repositions the nipple to a higher placement. The incisions are positioned so that the scars will be hidden when the patient is wearing normal clothing.
The techniques used in this operation, called augmentation mammoplasty , have changed over the years. Early operations to augment the size of the breasts involved the injection of paraffin, but this was soon abandoned as unsatisfactory. Experimentation with the use of various synthetic substances and of fatty tissue taken from the buttocks also gave poor results.
Breast implants containing silicone gel and inserted under the breast tissue were once the norm in augmentation surgery, but concerns developed regarding leakage of the gel into surrounding tissue and its subsequent migration to other parts of the body. Although no health complications were definitively linked to silicone implants, lawsuits against the manufacturers and public concern led to their being taken off the market almost entirely. Saline implants—salt water in a jacket made of silicone in a rubber-like form—are now the only kind available for cosmetic breast enlargement.