osmetic surgery of the breast can be divided into four categories: - Breast augmentation - Breast lift - Breast reduction - Correction of gynecomastia (male breast reduction) With very few exceptions, these operations are performed under general anesthesia. However, due to the fact that they are relatively short procedures (1-2 hours) and involve little discomfort, they can almost always be performed on an out-patient basis. Recent technological advancements have allowed us to perform these surgeries more safely and with fewer post-operative side effects and a shorter convalescence period. This translates into better scars, better breast reshaping and consequently, a happier patient population.
#1.Breast augmentation
With the recent advent of endoscopic techniques, the field of cosmetic surgery has undergone dramatic changes. Endoscopy utilizes highly sophisticated mini-camera systems introduced through tiny incisions to accomplish esthetic improvements which previously would have required bigger incisions and scars. One of the most common operations using the endoscope is breast augmentation. Previously, the standard technique required incisions directly on the breasts themselves, thus resulting in permanent scars. In contrast, endoscopic breast augmentation requires a tiny incision in the underarm through which the entire operation is performed and also through which the implant is introduced. The most obvious advantage is the fact that the scars are kept to an absolute minimum. In addition, due to the fact that the scars are small, the operating time is kept to a minimum, thereby reducing post-operative discomfort, swelling and convalescence time. Only a fully certified plastic surgeon, having had additional training in the utilization of endoscopic technique can perform endoscopic surgery. Twenty percent (20%) of the implants used today are saline-filled (salt water). The remaining 80% of implants are cohesive gel implants. The decision to opt for either implant should be taken conjointly between the patient and Dr. Papanastasiou depending on the patient’s chest anatomy and thickness of tissues. Specifically, a patient with little or no breast tissue may want to consider a cohesive gel implant simply because it would give her a more natural feel and better breast enhancement and at the same time, minimize the chances of implant rippling which can be sometimes visible with the saline implants in a patient with this type of chest. Post-operative discomfort following this procedure is generally categorized as moderate for the first several days. However, by the end of the first week, the patient is able to return to fairly normal activities, except for strenuous use of arms and chest muscles. Exercises must be avoided for 4 weeks. Bruising usually disappears within the first two weeks. Slight swelling of the breasts may last for up to three months.   # 2. Breast reduction Large, heavy breasts are usually a developmental problem which occurs in adolescence but may also occur later in life, either due to pregnancy or weight gain. This may cause the patient neck and back discomfort and may severely restrict her physical activities. This operation usually is done under general anesthesia and takes approximately two hours to complete. It is done as a out-patient procedure and associated discomfort is minimal. Not only does the patient get a reduction in volume of breast but also a lift so that the nipple and areola are relocated to their appropriate level. Generally, bruising and discoloration last no more than two weeks. There may be a slight swelling of the breasts for up to three months. The convalescence is usually two-three weeks.
# 3. Breast lift Patients presenting for this type of surgery usually have breasts which are sagging and loose. The causes of this condition may include post-pregnancy loss of breast firmness, long-term effects of gravity and sudden weight loss. The solution to the problem is called a mastopexy (breast lift) and this is usually performed under general anesthesia. The operation takes approximately two hours. It is done as an out-patient procedure and the discomfort experienced with this type of surgery is usually categorized as mild. In carrying out a mastopexy, Dr. Papanastasiou will not only raise the nipple and areola to their proper locations but he will also tighten the breast and re-shape it to give it a natural, esthetic appearance. In certain cases, when there is also a lack of adequate breast tissue, one can also perform a breast augmentation by inserting an implant at the same time as the breast lift. Generally, bruising and discoloration last approximately two weeks. There may be slight swelling of the breasts for up to three months. The patient is usually functional after two-three weeks
# 4. Correction of gynecomastia (male breast reduction) Before After Gynecomastia is a condition whereby the male breast enlarges either due to an increase in the fat of the breast or the glandular tissue. This is usually a benign condition and quite often develops during adolescence as the effect of the hormones causes the breasts to enlarge. It may sometimes be seen in competitive weight lifters who are taking anabolic steroids. Using tumescent liposuction technique, in the majority of cases, we are able to reduce the size of the patient’s breasts without any direct incisions on the breasts themselves. This allows for a satisfactory reduction and re-contouring of the breasts without any resultant scars. In cases where the breast tissue is too thick and glandular and cannot be suctioned entirely, we may have to make a small incision on the lower part of the areola in order to directly excise the remaining tissue. This operation is done under general anesthesia, usually takes 1-2 hours and is performed as an out-patient procedure. There should be minimal discomfort post-operatively but bruising may persist for several weeks. There might be swelling for two to three months. The patient is instructed not to do any heavy lifting for at least the first four weeks.

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