Mammaplasty

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Mammoplasty
Mammoplasty morozov.jpg
Before and after mammaplasty
ICD-9-CM 85.31-85.32, 85.5
MeSH D016462

Mammaplasty (also called mammoplasty [1] or mastoplasty) refers to a group of surgical procedures, the goal of which is to reshape or otherwise modify the appearance of the breast. There are three main types of mammoplasty: [2] [3]

Contents

  1. Augmentation mammaplasty is commonly performed to increase the size, change the shape, and/or alter the texture of the breasts. This usually involves the surgical implantation of breast implants.
  2. Reduction mammaplasty is commonly performed to reduce the size, change the shape, and/or alter the texture of the breasts. This involves the removal of breast tissue.
  3. Reconstructive mammoplasty is breast reconstruction that is done after mastectomy to give the breasts an appearance that is more normal/familiar.

Social context

Mammaplasty started a surgical procedure to help relieve women of the excess weight of their breasts; it was only later that it was used for cosmetic purposes. [4] There is social pressure on women to subscribe to socially prescribed beauty standards of how their bodies must be, and one part of this is the pressure on women to have 'perfect breasts'. [5] [6] Earlier records of such surgery were either for medical purposes or to make a person fit in more easily with a certain social group. It was in the beginning of the 20th century that Hippolyte Morestin and Eugene Hollander started breast reduction (reduction mammoplasty) for beauty purposes only. By the 1930s though, breast reduction had become more of aesthetic surgery than reconstructive surgery. [7]

It is still however used for medical purposes and female celebrities vocally getting such surgery has allowed for more to undertake it and speak up openly about it, a recent example of it being Ariel Winter, who plays Alex in Modern Family, undergoing breast reduction surgery after years of back and neck pain. [8]

Augmentation mammaplasty

Breast augmentation , sometimes referred to as a "boob job" by patients, involves using breast implants or fat transfer to increase the size of one's breasts. This procedure can also restore breast volume lost after weight reduction or pregnancy, achieve a more rounded breast shape or improve natural breast size asymmetry. For some women, breast augmentation is a way to feel more confident. For others, it is part of rebuilding the breast for various conditions.[ citation needed ] [9] [10]

Breast augmentation is performed with implants (see below) that can be placed under a chest muscle or over a chest muscle. [11] In general, all breast augmentations are minimally invasive procedures, involving incisions that are usually between 3 and 5 cm in length. [12] Breast augmentation is a relatively straightforward procedure. As with any surgery, some uncertainty and risk are associated with breast augmentation surgery. [13]

What breast augmentation surgery can do

Risks

Breast augmentation poses various risks, including: [14]

Reduction mammaplasty

Breast reduction surgery is also known as reduction mammaplasty or mammoplasty. It is a cosmetic surgical procedure aimed at reducing large or sagging breasts to a more comfortable size and shape. [15] Large ptotic (sagging) breasts can become troublesome for patients, leading to potentially debilitating symptoms and a poor quality of life. [16] Patients seeking breast reduction commonly present with complaints of migraines, back pain, neck pain, severe discomfort, unwanted harassment, poor self-image and anxiety among other symptoms. [17] [18] These patients can benefit greatly from a reduction in breast size, as most symptoms are relieved by reduction mammaplasty. [19]

Reasons for treatment

Many women with large breasts experience varying degrees of physical and psychological distress, often including:

The goal of the surgery is to reduce the breast size so that they are more comfortable and proportional to the woman's physique. [15]

Benefits

Thousands of mammaplasties are performed every year, and most women are happy with the results. A study of 66 women who had undergone breast reduction reported that the women showed a 94% satisfaction with the results of the procedure (in terms of size, shape, nipple position, and sensation in the breast). [20] This study also reported great improvement in self-esteem, and problems with appearance, exercise and embarrassment over breast size were substantially reduced.

Overall, this and other studies have shown that breast reduction improves function, wellbeing and quality of life for women with excessively large or sagging breasts. [15]

Risks

Specific risks of breast reduction surgery include:

Breast cancer and reconstructive mammaplasty

Research has indicated that breast reduction surgery, for women who are at high risk for breast cancer, may serve as an effective primary prevention strategy for tackling breast cancer and is not shown to increase chances of the breast cancer coming back or making it harder to check this through a mammography. [21] As opposed to mastectomy, therapeutic mammoplasty has emerged as a way to address breast cancer in women with larger breasts and where early breast cancer is detected, this helps align with the cosmetic needs of the person in question and has positive health benefits as well. [22]

Many reports have also addressed the relationship between breast cancer and augmentation mammaplasty using implants. Most of them report that there is no increased rate of breast cancer in patients with augmentation mammaplasty. [23] On the contrary, several studies have reported that the rate of breast cancer is actually lower in patients with augmentation mammaplasty. These studies argue that the lower incidence rate of breast cancer is probably due to the lower calorie intake of patients who wish to have augmentation mammaplasty. These patients, being on the thinner side, do not have a tendency toward breast cancer. [24]

A concern for breast cancer survivors can be the physical appearance of their breasts after the surgical procedures required to cure breast cancer in several cases. Reconstructive mammaplasty is breast reconstruction that is done after mastectomy to give the breasts an appearance that is more normal/familiar. Some factors that are considered before deciding whether such surgery would be apt are the size and shape of the breasts before operation, the amount of tissue remaining after the mastectomy, chance of the cancer returning, and what the mastectomy scar looks like and where it is. [25] Mammoplasty has also evolved as a way for women to address physical changes that mastectomy brings about to their bodies. Surgery to reconstruct the breasts can be started along with the mastectomy or after the body has healed from the mastectomy. [26]

Mammograms in general are not performed on reconstructed breasts that have had implants, it is recommended that a woman who has had a breast implant let the radiology technician know of it, before a mammogram, as special steps may be necessary for ensuring correct results and not causing harm to the implant. [21]

Related Research Articles

<span class="mw-page-title-main">Breast reconstruction</span> Surgical rebuilding of a breast

Breast reconstruction is the surgical process of rebuilding the shape and look of a breast, most commonly in women who have had surgery to treat breast cancer. It involves using autologous tissue, prosthetic implants, or a combination of both with the goal of reconstructing a natural-looking breast. This process often also includes the rebuilding of the nipple and areola, known as nipple-areola complex (NAC) reconstruction, as one of the final stages.

<span class="mw-page-title-main">Mastectomy</span> Surgical removal of one or both breasts

Mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. A mastectomy is usually carried out to treat breast cancer. In some cases, women believed to be at high risk of breast cancer have the operation as a preventive measure. Alternatively, some women can choose to have a wide local excision, also known as a lumpectomy, an operation in which a small volume of breast tissue containing the tumor and a surrounding margin of healthy tissue is removed to conserve the breast. Both mastectomy and lumpectomy are referred to as "local therapies" for breast cancer, targeting the area of the tumor, as opposed to systemic therapies, such as chemotherapy, hormonal therapy, or immunotherapy.

<span class="mw-page-title-main">Plastic surgery</span> Medical surgical specialty

Plastic surgery is a surgical specialty involving the restoration, reconstruction, or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery covers a wide range of specialties, including craniofacial surgery, hand surgery, microsurgery, and the treatment of burns. This category of surgery focuses on restoring a body part or improving its function. In contrast, cosmetic surgery focuses solely on improving the physical appearance of the body. A comprehensive definition of plastic surgery has never been established, because it has no distinct anatomical object and thus overlaps with practically all other surgical specialties. An essential feature of plastic surgery is that it involves the treatment of conditions that require or may require tissue relocation skills.

Gender-affirming surgery for female-to-male transgender people includes a variety of surgical procedures that alter anatomical traits to provide physical traits more comfortable to the trans man's male identity and functioning.

<span class="mw-page-title-main">Breast augmentation</span> Surgical procedure

Breast augmentation and augmentation mammoplasty is a cosmetic surgery procedure, which uses breast-implants and/ or fat-graft mammoplasty technique to increase the size, change the shape, and alter the texture of the breasts. Although in some cases augmentation mammoplasty is applied to correct congenital defects of the breasts and the chest wall in other cases it is performed purely for cosmetic reasons.

<span class="mw-page-title-main">Breast reduction</span> Plastic surgery procedure

Reduction mammoplasty 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 patient'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 patient's self-image, and of the patient's mental health.

<span class="mw-page-title-main">Reconstructive surgery</span> Surgery to restore form and function

Reconstructive surgery is surgery performed to restore normal appearance and function to body parts malformed by a disease or medical condition.

<span class="mw-page-title-main">Chest reconstruction</span> Surgical procedure

Chest reconstruction refers to any of various surgical procedures to reconstruct the chest by removing breast tissue or altering the nipples and areolae in order to mitigate gender dysphoria. Chest reconstruction may be performed in cases of gynecomastia and gender dysphoria. People may pursue chest reconstruction, also known as top surgery, as part of transitioning.

<span class="mw-page-title-main">Breast implant</span> Prosthesis used to change the size, shape, and contour of a persons breast

A breast implant is a prosthesis used to change the size, shape, and contour of a person's breast. In reconstructive plastic surgery, breast implants can be placed to restore a natural looking breast following a mastectomy, to correct congenital defects and deformities of the chest wall or, cosmetically, to enlarge the appearance of the breast through breast augmentation surgery.

Mastopexy 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.

A DIEP flap is type of breast reconstruction where blood vessels, fat, and skin from the lower belly are relocated to the chest to rebuild breasts after mastectomy. DIEP stands for the deep inferior epigastric perforator artery, which runs through the abdomen. This is a type of autologous reconstruction, meaning one's own tissue is used.

Breast surgery is a form of surgery performed on the breast.

Symmastia is a condition defined as a confluence of the breast tissue of both breasts across the intermammary cleft that normally divides them. It can be surgically corrected by a plastic surgeon through symmastia revision.

SPAIR 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.

Trans-umbilical breast augmentation (TUBA) is a type of breast augmentation in which breast implants are placed through an incision at the navel rather than the chest.

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.

A preventive mastectomy or prophylactic mastectomy or risk-reducing mastectomy (RRM) is an elective operation to remove the breasts so that the risk of breast cancer is reduced.

Fat transfer, also known as fat graft, lipomodelling, or fat injections, is a surgical process in which a person's own fat is transferred from one area of the body to another area. The major aim of this procedure is to improve or augment the area that has irregularities and grooves. Carried out under either general anesthesia or local anesthesia, the technique involves 3 main stages: fat harvesting, fat processing and fat injection.

<span class="mw-page-title-main">Nipple reconstruction surgery</span>

Nipple reconstruction, specifically nipple-areola complex (NAC) reconstruction, is a procedure commonly done for patients who had part or all of their nipple removed for medical reasons. For example, NAC reconstruction can apply to breast cancer patients who underwent a mastectomy, the surgical removal of a breast. NAC reconstruction can also be applied to patients with trauma, burn injuries, and congenital or pathological abnormalities in nipple development.

<span class="mw-page-title-main">Nipple-sparing mastectomy</span> Breast cancer treating method

Nipple-sparing mastectomy (NSM), also known as nipple delay, is one of the surgical approaches for treating or preventing breast cancer. It involves the removal of all breast tissue, except the nipple-areolar complex (NAC), and the creation of new circulatory connections from the breast skin to NAC. By preserving the NAC, NSM has provided patients with higher cosmetic expectations and the opportunity to undergo a mastectomy while maintaining a more natural appearance.

References

  1. ↑ "mammoplasty". The Free Dictionary. Retrieved 10 February 2015.
  2. ↑ Horndeski, Gary. "mammaplasty (mammoplasty) surgical procedures". Horndeski Method. Archived from the original on 10 February 2015. Retrieved 10 February 2015.
  3. ↑ "Breast Procedures". Wake Forest School of Medicine. Retrieved 10 February 2015.
  4. ↑ Lalardrie, J. P.; Mouly, R. (December 1978). "History of mammaplasty". Aesthetic Plastic Surgery. 2 (1): 167–176. doi:10.1007/bf01577951. ISSN   0364-216X. PMID   24173845. S2CID   708542.
  5. ↑ "This is the perfect breast shape | The Times of India". The Times of India. 2017-08-09. Retrieved 2018-10-27.
  6. ↑ "The Pressure to Be Perfect". HuffPost UK. 2015-02-17. Retrieved 2018-10-27.
  7. ↑ Purohit, Shrirang (October 2008). "Reduction mammoplasty". Indian Journal of Plastic Surgery. 41 (Suppl): S64–S79. ISSN   0970-0358. PMC   2825129 . PMID   20174545.
  8. ↑ Sanghani, Radhika (2015-08-13). "Ariel Winter: Three bottles of wine strapped to your chest? No wonder breast reductions are on the rise". Daily Telegraph. ISSN   0307-1235 . Retrieved 2018-10-27.
  9. ↑ Davis, Jeanie Lerche. "How Can Breast Implants Affect Your Life?". WebMD. Retrieved 2022-10-09.
  10. ↑ "Breast augmentation - Mayo Clinic". www.mayoclinic.org. Retrieved 2022-10-09.
  11. ↑ Lane Smith, MD | Las Vegas; Tuesday, January 28. "Where will your breast implants be placed?". American Society of Plastic Surgeons. Retrieved 2022-10-09.{{cite web}}: CS1 maint: numeric names: authors list (link)
  12. ↑ Fanous, Nabil; Tawilé, Caroline; Brousseau, Valérie J (2008). "Minimal inframammary incision for breast augmentation". The Canadian Journal of Plastic Surgery. 16 (1): 14–17. doi:10.1177/229255030801600109. ISSN   1195-2199. PMC   2690624 . PMID   19554159.
  13. ↑ "Mammoplasty (Plastic Surgery for the Breasts)". OnHealth. Retrieved 2022-10-09.
  14. ↑ "Breast augmentation - Mayo Clinic". Mayo Clinic .
  15. 1 2 3 4 "Breast Reduction (Reduction Mammaplasty or Mammoplasty)". 2008-05-14.
  16. ↑ Gale, Chloe (2020-10-09). "Large Breasts can cause neck and shoulder problems". Medbelle. Retrieved 2022-10-09.
  17. ↑ Ducic, Ivica; Iorio, Matthew L.; Al-Attar, Ali (January 2010). "Chronic Headaches/Migraines: Extending Indications for Breast Reduction". Plastic and Reconstructive Surgery. 125 (1): 44–49. doi:10.1097/PRS.0b013e3181c2a63f. ISSN   0032-1052. PMID   20048598. S2CID   40612330.
  18. ↑ Bhowad, Akash (2022-08-08). "Is Reduction Mammoplasty Cost Effective?". Health Works Collective. Retrieved 2022-10-09.
  19. ↑ Chopra K, Tadisina KK, Singh DP (2013). "Breast reduction mammaplasty". ePlasty. 13: ic59. PMC   3782143 . PMID   24106568.
  20. ↑ "Breast Reduction (Reduction Mammaplasty or Mammoplasty)". HealthEngine Blog. 2008-05-14. Retrieved 2022-10-09.
  21. 1 2 "Breast Reconstruction After Mastectomy". National Cancer Institute. 2016-10-17. Retrieved 2018-10-27.
  22. ↑ "Therapeutic mammaplasty Information for patients" (PDF). www.ouh.nhs.uk.
  23. ↑ Deapen, Dennis (December 2007). "Breast implants and breast cancer: a review of incidence, detection, mortality, and survival". Plastic and Reconstructive Surgery. 120 (7 Suppl 1): 70S–80S. doi:10.1097/01.prs.0000286577.70026.5d. ISSN   1529-4242. PMID   18090816. S2CID   2758292.
  24. ↑ Takayanagi S (September 2012). "Augmentation mammaplasty using implants: a review". Arch Plast Surg. 39 (5): 448–51. doi:10.5999/aps.2012.39.5.448. PMC   3474399 . PMID   23094237.
  25. ↑ "mammaplasty". TheFreeDictionary.com. Retrieved 2018-10-27.
  26. ↑ "Breast Reconstruction After Mastectomy". National Cancer Institute. 2016-10-17. Retrieved 2018-10-27.
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