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BREAST AUGMENTATION
I most commonly use smooth, round, silicone or saline breast implants placed under the muscle. The key to a successful outcome is precisely creating the space for the implant to sit. Underdissection results in implants positioned too high and too lateral. Overdissection results in implants too low or rippling medially. I release the muscle inferiorly and partially medially to yield excellent positioning immediately. I do not rely on the implant to “Fall with time”. Sometimes a breast lift must be performed at the same time if the breasts are droopy (ptotic).
-Dr. Reagan
| Procedure: | Enhance the size of breast using silicone gel or saline implants. |
| Length: | 1 to 2 hours. |
| Anesthesia: | General. |
| In/Outpatient: | Usually outpatient. |
| Side Effects: | Temporary soreness, swelling, change in nipple sensation, bruising. Breast sensitive to stimulation for a few weeks. |
| Risks: | Lack of implant permanence — surgical removal or replacement of the implants may be required to treat problems, including: deflation; the formation of scar tissue around the implant (capsular contracture), which may cause the breast to feel tight or hard; bleeding or infection. Increase or decrease in sensitivity of nipples or breast skin, occasionally permanent. Mammography requires a special technique. (Note: Some women have reported symptoms similar to those of immune disorders. Ask your doctor about these and other FDA concerns.) |
| Recovery: | Back to work: a few days. Physical contact with breasts: 3 to 4 weeks. Fading of scars: several months to a year or more. |
| Duration of Results: | Variable. Implants may require removal or replacement. |
BREAST REDUCTION
New techniques can reduce incisions (vertical breast reduction). Final shape should be round, and symmetic. Review photos.
- Dr. Reagan
| Procedure: | Reducing breast size and lifting nipple-areolar complex. |
| Length: | 2 to 3 hours. |
| Anesthesia: | General. |
| In/Outpatient: | Outpatient. |
| Side Effects: | Bruising, swelling, scars, numbness. |
| Risks: | Delayed healing, asymmetry, loss of nipple sensation. |
| Recovery: | 2-3 weeks. Return to work in 2 weeks. Exercise 6 weeks. |
BREAST LIFT
There are three types of breast lifts depending on the degree of repositioning. The periareolar lift hides the scar around the areolar, while the vertical lift adds a vertical scar and the full mastopexy leaves an “anchor scar.” An implant is sometimes added (see breast augmentation) to yield long-lasting superior fullness. The final result may take several months while the tissue relaxes.
- Dr. Reagan
| Procedure: | Raise and reshape sagging breasts by removing excess skin and repositioning remaining tissue and nipples. |
| Length: | 1 to 3 hours. |
| Anesthesia: | Local with sedation, or general. |
| In/Outpatient: | Usually outpatient. Sometimes inpatient. |
| Side Effects: | Temporary bruising, swelling, discomfort, numbness, dry breast skin. Permanent scars. |
| Risks: | Thick, wide scars; skin loss; infection. Unevenly positioned nipples. Permanent loss of feeling in nipples or breast. |
| Recovery: | Back to work: 1 week or more. Strenuous activities: 1 month. Fading of scars: several months to a year. |
| Duration of Results: | Variable; gravity, pregnancy, aging, and weight changes may cause new sagging. Results may last longer or be enhanced when breast implants are inserted as part of the procedure. |
BREAST RECONSTRUCTION
I typically reconstruct the breast using an expander placed under the muscle at the time of mastectomy. A permanent implant is exchanged at a later date. In some patients, I can place teh implant immediately (one-stage reconstruction). Latissmus Dorsi and TRAM flaps are utilized occasionally.
– Dr. Reagan
| Procedure: | Reconstructing breast after mastectomy for cancer. |
| Length: | 2 to 4 hours. |
| Anesthesia: | General. |
| In/Outpatient: | Inpatient. |
| Risks: | Delayed healing of skin. |
| Recovery: | 2-3 weeks. |
