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These plastic surgery procedures are a growing business and arguably a media obsession for both women and men. In both the USA & UK it is one of the top five popular cosmetic surgeries.

UK

In the UK, breast surgeries have been steadily increasing in popularity in recent years. The British Association of Aesthetic Plastic Surgeons, London, UK released its annual audit figures on 26 January 2009 (1). 34,000 cosmetic surgery procedures were carried out, a threefold increase since 2003. 91% of patients were women, with breast augmentation the most popular treatment, increasing by 30% on the previous year. Breast reductions also increased by 13%.

Male breast reduction had increased from 22 operations in 2003 to 323 last year, highlighting the exponential increase in popularity for this surgery.

Stateside

In the USA, however, 2008 figures from The American Society of Plastic Surgeons bucked the trend (2).  Breast augmentation surgeries were reported be down by 12%, breast reduction down by 16 percent and breast uplift surgeries down by 11% on 2008. In the same year, a staggering   17,902 male patients had breast reduction surgeries. But overall breast surgeries remained one of the five most popular cosmetic surgical procedures.

For women, cosmetic surgery offers three major choices:

Breast augmentation (the classic ‘boob job’) aims to enlarge the breast size by

inserting silicone or saline implants into the breast tissues via incisions generally made in the curved crease underneath each breast.

Breast reduction procedures reduce the quantity of breast tissue and simultaneously uplift the remaining tissue. The nipple and areola may also be repositioned if the shape of the breast changes due to the reduction in a way that would leave the ‘normal’ position looking ‘unnatural’.

Breast uplifting aims to change the position of the breasts where the tissues have lost a desirable shape. This is usually performed without changing the size of the breast and simply repositions breasts that have lost firmness and/or become flatter.

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For men – the new ‘male boob job’

The medical term for the male breast which is overdeveloped or enlarged is gynecomastia. This is a commonly occurring stage in adolescent young men with 90% of cases resolving within months as hormonal changes occur. In adult men, the most common age for this condition is the middle to later years, occurring with perhaps 40-60% of men. Surgery to reduce excess chest fat eliminating gynaecomastia is the second fastest growing cosmetic surgery for men in the UK. Liposuction techniques or excision (surgical removal of tissue) may be used alone or combined with each other, depending on the individual patients needs.

DISCLAIMER: No information here can be used as medical advice or used to make healthcare decision!  Please only consult professional physicians for advice.

RS Brown

1.   British Association of Aesthetic Plastic Surgeons. 2009. Cosmetic rates of inflation: male, female breast ops on the rise. [online]. London: British Association of Aesthetic Plastic Surgeons. Available at:

http://www.baaps.org.uk/content/view/453/62/

1. American Society of Plastic Surgeons. 2009. 2008 Female Plastic Surgery Statistics. [online] Illinois:  American Society of Plastic Surgeons. Available at:

http://www.plasticsurgery.org/Media/stats/2008-cosmetic-reconstructive-plastic-surgery-minimally-invasive-statistics.pdf

Photo Credits:

1 http://www.sxc.hu/profile/beesnail

2 http://www.sxc.hu/profile/lusi

• to enlarge under developed breasts

• to enlarge the breasts to create a more proportionate figure

• to enlarge the size of one breast which is particularly smaller than the other (all breasts are slightly asymmetrical)

• after pregnancy to enlarge breasts which have lost some size

• other individual reasons for breast enhancement for more self confidence

The procedure

Patients meet with their surgeon and discuss the exact procedure that is recommended for them. So the information here is very much ‘generally speaking’:

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The operation uses a general anaesthetic, and lasts approximately an hour to an hour and a half. Small incisions tend to be made in the crease underneath the breasts, or sometimes the armpit or lower edge of the areola (the darker circle around the nipple). Then a pocket is created to house the breast implant, either beneath the muscle or beneath breast tissues. Breast implants have a firm silicone elastimer shell, filled with either silicone gel or saline.

Silicone is most commonly used as it is felt to give a softer contour and feel to the new breasts.

Post-surgery, pain relief medication and antibiotics may be required. There may be drainage tubes inserted during the surgery to collect extravasated blood. Generally, the stay in hospital is overnight, and any such tubes are removed the following morning.

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Discomfort is a definite feature, and women are generally advised to take 1 to 2 weeks off work. Women with children are generally advised to have some help for at least one week with household chores. Bathing and showering is contraindicated for 7 to 14 days, and patients must sleep on their back. Underwire bras are also not allowed for a certain time. Surgeons usually give specific advice on the recovery care for each patient.

Long-term commitment

One major feature of breast enlargement surgery is commitment – this is a long-term commitment rather than a one off surgery.

The lifespan of an implant varies from patient to patient, so a good aftercare relationship with the surgery team is essential (3).

Take impartial expert advice - the more skilled surgeons routinely operate to correct previous cosmetic surgery (3 )

‘Plastic surgery gone wrong’ stories

The media often carries sensationalist stories of unsuccessful surgeries and risks posed. The truth is, all surgery carries risks, the result are variable by surgeon and by patient. The UK ‘s Department of Health provides a comprehensive guide for women considering breast implant surgery (3), which is a must-read for facts, considerations and advice. The guide contains safety data and information on procedures and materials used and known outcomes. Professional bodies for cosmetic surgery could also offer advice on which qualifications and training the more experienced surgeons should have in your location. Incredibly, worldwide, not all surgeons who practice plastic surgery actually have specialised training in it and some have little experience of certain procedures.

DISCLAIMER: No information here can be used as medical advice or used to make healthcare decision!  Please only consult qualified physicians for advice.

Kath Smith

References:

1. American Society of Plastic Surgeons. 2009. 2008 Female Plastic Surgery Statistics. [online] Illinois:  American Society of Plastic Surgeons. Available at:

http://www.plasticsurgery.org/Media/stats/2008-cosmetic-reconstructive-plastic-surgery-minimally-invasive-statistics.pdf

2. British Association of Aesthetic Plastic Surgeons. 2009. Cosmetic rates of inflation: male, female breast ops on the rise. [online]. London: British Association of Aesthetic Plastic Surgeons. Available at:

http://www.baaps.org.uk/content/view/453/62/

3. Medicines and Healthcare products Regulatory Agency. 2006. Breast Implants: Information for women considering breast implants. London: Department of Health. Available at:

http://www.mhra.gov.uk/Publications/Postersandleaflets/CON2022635

Photo credits:

1 Asterisc21 http://www.sxc.hu/browse.phtml?f=profile&l=asterisc21

2 Dimshik http://www.sxc.hu/profile/dimshik

3 Lusi http://www.sxc.hu/profile/lusi

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Breast uplifts (medical name ‘maxoplasty’) aims to enhance the contour of breast which have lost their natural shape and/or firmness.    Causes may include substantial weight loss from slimming; pregnancy; or premature loss  of elastic tone to the skin, creating a more sagging shape. Women may choose breast uplift surgery to improve self confidence and feel better in a bikini on holiday. The operation is breast plastic surgery aimed at enhancing shape, not increasing size – but it can be performed with a simultaneous  breast augmentation if required, during the same surgery. Maxoplasty always uses general anaesthetic and the operation may last between 1 to 3hrs. The way the operation is then performed depends on the individual patient’s breast shape and the opinion of the surgeon for the best results.

The procedure

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Generally, though, small incisions are made at sites on the breast which allow for a higher position of the nipple and areole (darker circle around it). A crescent shaped incision is commonly used to remove excess skin from an incision above the areola, although it can be performed lower down on the breast. Once the excess skin has gone, the nipple should rest in a higher place, hence the name ‘uplift surgery’. This taughter skin should result in more pert breasts.

Recovery

Cosmetic surgery needs recovery time like any other operation. It may be necessary for antibiotics and pain relief medication to be given following the surgery.

Drainage tubes may also need to be inserted into the breasts during the operation and remain in place for a short time afterwards, to remove any leaked blood. Once any tubing is removed, stitches are later removed between 7 to 14 days. Patients generally  spend 1 to 2 nights in hospital, followed by attendance at appointments to monitor wound healing. A supportive bra is needed and strenuous physical activity must not be done for some time. Several weeks are needed off work to recover and exercise should be reintroduced with care over the next 4 to 6 weeks, following explicitly the individual advice of the surgeon.

Some Important Considerations

The procedure always involves a degree of scarring. The lasting extent of scarring can depend on the degree to which the breast had lost their shape. Initially, the scars are pink, and then generally speaking over time fade to faint white lines. It is possible that the sensitivity in the nipple can decrease. It is also possible that patients may not be able to breast feed following this surgery. All concerns must be fully discussed with the surgeon before committing, so that fully informed choices can be made.

DISCLAIMER: No information here can be used as medical advice or used to make any healthcare decision!  Please only consult qualified physicians for advice.

Julia Smith

Photo Credits

1 http://www.sxc.hu/profile/Blinc

2 http://www.sxc.hu/profile/lusi

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While many women with bigger breasts receive wistful compliments from their less endowed girlfriends, for some it can actually be a source of many problems.

Reasons for choosing it can include discomfort due to heavier breasts; aching back muscles due to supporting the heavier breasts and breast pain. Clothing can be a problem: bra straps ‘cutting in’ to the shoulders, tops can feel they hang awkwardly; it can be difficult to find pleasing underwear or strappy tops to fit. Sports and beachwear may feel like an absolute ‘no go’ area due to breast discomfort or clothing anxieties.

The procedure

Surgeons generally hold a consultation with prospective patients to discuss the best surgical procedures for the operation, so what follows is of course, a general outline. Advice on buying a suitable supportive bra for the post-operative period is essential before the operation.

The operation usually lasts around 3 hours, under general anaesthetic and aims to remove breast tissue and ‘uplift’ the remainder. Incisions are commonly like an upside down anchor-shape, around the nipple and then down the breast to the crease underneath. Excess fat and skin is removed and the nipple and areola (dark circle around it) are repositioned higher to create a natural looking appearance to the new shaped breasts. Sutures seal the incisions and remain in place for around 7 to 14 days.

Recovery

Patients normally stay in hospital 1 or 2 days after surgery and pain medication is routinely offered as needed. The surgeon may need to insert drainage tubes into each breast to collect any

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blood leakage, so patients may wake up from the aesthetic with these in place. Generally, those are removed before you can go home from hospital. Advice on how long to wear the chosen support bra for is very important (and of course underwired bras are a definitely not allowed until given a medical ‘go-ahead’).  A guideline for the time needed off work is 2 to 4 weeks dependant on both the occupation and each patient’s medical needs.  Strenuous exercise must be restricted for some weeks. There are also important appointments to check healing progress.

Expert Advice

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Although breast surgeries are some of the most widely practiced and well documented cosmetic procedures, any surgery carries certain degrees of risk. Expert advice from surgeons with specialist training and experience is essential. Many professional cosmetic surgery bodies raise the point that you should never choose a surgeon by the price-tag alone and offer advice to find competent surgeons. Potential risks, implications and realistic estimates of how the end results could look should be thoroughly discussed to your complete satisfaction before any commitment is made. Cosmetic surgery is a sizeable industry, so if you are unsatisfied with the consultation, there will be plenty of other surgical facilities to choose from.

DISCLAIMER: No information here can be used as medical advice or used to make any healthcare decision!  Please only consult qualified physicians for advice.

RS Brown

Photo Credits:

1 http://www.sxc.hu/profile/kwinton

2 http://www.sxc.hu/profile/forwardcom

3. http://www.sxc.hu/profile/lusi

Some professional bodies for plastic surgery UK/ USA/ Canada – please note we do not ‘endorse’ or recieve sponsorship from them:

1.   British Association of Aesthetic Plastic Surgeons.

http://www.baaps.org.uk

2. American Society of Plastic Surgeons.

http://www.plasticsurgery.org/

3. Canadian Society of Plastic Surgeons/ Societe Canadienne Des Churugiens Plasticiens

http://www.plasticsurgery.ca/

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Gynecomastia is the medical term for over-developed or enlarged male chests. The topic has become common in the media, sometimes featuring in (somewhat insensitive) jokes or comedies, bandied about as ‘moobs’, ‘man boobs’, etc.  Against this background however, innovative male breast reduction surgeries for men are an increasing trend in cosmetic surgery.

The procedure

Men having breast reduction surgery should meet with their physician to discuss the operation before scheduling as

-         there are a number of causes for the condition – DO SEE YOUR DOCTOR TO EXPLORE THESE FIRST

-         techniques and results vary from patient to patient

So whilst many internet sites may detail ‘procedures’, again the only true advice for patient is that of the physician! Generally speaking though:

Where the chest is enlarged due to fatty tissue, liposuction is used. Various techniques exist for liposuction, chosen according to the patient’s individual needs. In general, the patient is given a general anaesthetic and a cannula, a narrow hollow tube shaped instrument is inserted through small surgical incisions. The cannula is manoeuvred backwards and forward to loosen the fatty tissue for removal by suction.

Removal of glandular breast tissue or excess skin is generally with excision techniques, where incisions are made to enable surgical cutting away of the unwanted materials before suturing to reseal the chest.

The surgery may involve a combination of techniques, and if the nipple or areola needs repositioning due to the ‘new’ chest shape created by liposuction this will involve excision.

Reasons for choosing breast reduction surgery

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Common reasons for choosing this surgery are regions of fat that don’t respond to training marketed as ”get rid man boobs’ diets and exercise; rapid weight loss leading to sagging skin giving a more defined look to the breast than is comfortable for the man and feelings of embarrassment around the physique.

Some men may have difficulty finding clothes which they feel hang correctly over the enlarged chest. Social factors, such as ‘jokes’ or insensitive comments may also contribute to the desire for surgery. For some men the condition can provoke deeply uncomfortable emotions. Some men can feel embarrassed, ashamed, anxious and unfortunately shameful about their physique. Others may feel perhaps not such a range of negative emotion but have a desire to look younger.

Considerations

Advice from various professional cosmetic surgeons associations emphasises time and again the need for qualified and experienced surgical teams who have specialist training in the procedure. One common theme is that while for many patients, cost can be a huge factor in choosing a surgeon; it is advised that a surgeon is never chosen simply for the cheapest price tag. Another common caution is any surgical procedure carries elements of risk and these should be fully explained and explored with the surgeon before committing to any procedure.

There are many other considerations; consult your physician and try the professional body for cosmetic (aesthetic, plastic) surgeons in your country for more information. There is a rising trend for male cosmetic procedures, including hair transplant surgery, male breast reduction, male tummy tucks and male ‘facelift’ procedures. As with any new trend in plastic surgery, the most important element should always be saftey and consulting only expert, legally qualified and specialised surgical teams for unpressured, no-obligation advice. Never put your health at risk for a seemingly lower price without finding out all the facts first.

DISCLAIMER: No information here can be used as medical advice or used to make any healthcare decision!  Please only consult qualified physicians for advice.

Julia Smith

Photo Credits

1. http://www.sxc.hu/profile/lusi

2. http://www.sxc.hu/profile/nazreth

Professional bodies – please note, this list is not exhaustive and we do not ‘endorse’ them or get paid to carry this information:

UK-  British Association of Aesthetic Plastic Surgeons.

http://www.baaps.org.uk

USA – American Society of Plastic Surgeons.

http://www.plasticsurgery.org/

Canada-  Canadian Society of Plastic Surgeons/ Societe Canadienne Des Churugiens Plasticiens

http://www.plasticsurgery.ca/