Breast Cosmetic surgery
Also called 
Mastopexy
Mammoplasty
Breast size reduction
Breast lift
Breast lift with reduction
Breast lift with augmentation

Definition
            Cosmetic breast surgery is a surgical procedure to change the size or shape of the breasts.
Normal anatomy



             The breasts consist of a framework of connective tissue and a system of glands and ducts that produce milk. Fat makes up the majority of the breast tissue. Behind the breast tissue are the Pectoralis muscles.

Description   
             Anesthesia can be general or local for breat cosmetic surgery. For a breast reduction, the surgeon removes some of the breast tissue and may move the nipples higher on the breasts for cosmetic reasons. In general, the operation lasts 3 - 6 hours. During a breast lift, the doctor makes incisions along the natural creases in the breast and around the dark skin surrounding the nipple (areola). A keyhole-shaped incision is made above the areola to define the new location for the nipple. The surgeon removes skin from the lower section of the breast and raises the areola, nipple, and underlying breast tissue. The nipple is moved and incisions are closed with sutures. The procedure can last 3 - 5 hours, depending on the extent of the surgery.

Indications   
              Cosmetic suegeons are supposed to do cosmetic breast surgery, talk to a plastic surgeon. Discuss your expectations about looking and feeling better, keeping in mind that the desired result is improvement, not perfection. Emotional stability is an important factor. Breast surgery can renew your self-confidence and improve your appearance, but the rest is up to you. You may need mammograms or breast x-rays before the surgery. The plastic surgeon will perform a routine breast exam.Mastopexy is typically done to lift sagging, loose breasts. The size of the areola, the dark pink skin surrounding the nipple, can also be reduced.

Breast reduction may be recommended for:

• Colored bra-strap groove
• Cystic breast infections (polycystic mastitis)
• Enlarged breasts (macromastia)
• Pain from the weight of large breasts that is not relieved by a supporting bra
• Arm or finger numbness caused by large breasts
• Back pain, neck pain, or shoulder pain
• Breast pain
• Headache
• Loss of sensation in the breasts
• Poor posture caused by large breasts
• Sleeping problem caused by large breasts
• Scar-like lines (striae) on the breasts

Breast reduction is not recommended if you have one of these conditions:

• Breast cancer
• Cellulitis
• Hardened breast skin

Risks   
In addition to the general risks of surgery and anesthesia, other risks include:

• Inability to nurse a baby after surgery
• Large scars with prolonged healing time
• Uneven position of the nipples
• Sensory loss

The emotional risks may include feeling that the breasts don't look perfect, or that people's reactions are not adequate.

Expectations after surgery   
             Bulky gauze dressing will be wrapped around your breasts and chest after breast lift surgery, or you might wear a surgical bra. You can control your pain with medication. It should subside in 2 - 4 days. After a breast reduction, you'll probably need to stay in the hospital overnight to control pain and nausea. Within the first week, the dressing will be replaced by a soft bra, which you must wear for several weeks. Generally, within a few days, the swelling and discoloration around the incisions will disappear. You may have a temporary loss of sensation in the breast skin and nipples after surgery. This condition will improve with time. Within 2 weeks of surgery, sutures will be removed. You are likely to have a very good outcome from breast reduction surgery. Your appearance and lifestyle activities can be significantly enhanced. Also, the pain or skin symptoms (such as striation) disappear. You may need to wear a special supporting bra for a few months to reshape your breasts.

Recovery period   
             Physical activities are restricted after surgery for some time.  You might be able to do some activity within 1 - 2 days after surgery. The plastic surgeon will recommend a schedule for resuming your usual routine (usually about 8 weeks). To permit proper healing, avoid overhead lifting for 3 - 4 weeks. Scars are permanent and often remain highly visible for a year following surgery, then fade to some degree. The doctor will make every effort to place the incisions so that scars are as hidden as possible. The scars should not be noticeable, even in low-cut clothing (incisions are usually made on the underside of the breast

Breast lift



              Breast lift (mastopexy) is usually performed for drooping breasts, which may occur after a woman has had children. Mammograms (breast X-rays) and a routine breast exam is required before surgery.

             Breast-revision surgery is performed while you are deep asleep and pain-free (using general anesthesia), in either an outpatient facility or in the hospital. Incisions are made along the natural creases in the breast and around the dark pink skin surrounding the nipple (areola). A keyhole-shaped incision above the areola is also made to define the new location of the nipple. Skin is then removed from the lower section of the breast. The areola, nipple, and underlying breast tissue are moved up to a higher position. The nipple is moved and incisions are closed with stitches (sutures).

             After surgery, a bulky gauze dressing is wrapped around the breasts and chest. Sometimes a surgical bra is used. Pain is controlled by medication, and usually subsides in a day or two. Most patients stay in the hospital for two days. The dressing is replaced by a soft bra within the first week, and it must be worn for several weeks. Generally, the swelling and discoloration around the incisions subside within a few days. There may be temporary loss of sensation in the breast skin and nipples after surgery. This condition improves with time. Within two weeks of surgery, stitches (sutures) are removed.

Breast reduction


Breast reduction is usually performed for enlarged breasts (macromastia), but may also be indicated by:

• cystic breast infections (polycystic mastitis)
• back pain, neck pain, shoulder pain, breast pain, or headaches
• loss of sensation in the breasts, arms, or fingers
• sleeping problems or poor posture resulting from large breasts
• pigmented bra-strap groove
• striae (scarlike lines) on the breasts

Mammograms (breast X-rays) and a routine breast exam is required before surgery.

Breast Augmentation


Incision sites are made as inconspicuous as possible, either in the armpit, around the areola, or under the breast.

Breast augmentation by implant


The implant may be placed beneath the breast tissue.
Reference :    MedlinePlus