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Breast Reduction and Breast Augmentation

James C. Grotting, M.D., F.A.C.S.

article courtesy James C. Grotting, M.D., F.A.C.S.

CLICK HERE to visit the website of James C. Grotting, M.D., F.A.C.S.

Most women seeking breast reduction are referred by their family doctor, gynecologist, or even their chiropractor. These women have had chronic back pain and general discomfort because of their exceptionally large breasts. Oftentimes they have been using medications in an effort to relieve their pain.

A breast reduction is usually a relatively safe outpatient or overnight procedure. It reduces the size of the breasts and lifts them up on the chest. Women in their childbearing years are often concerned that breast reduction will interfere with their ability to breast-feed. Breast reduction will not mechanically interfere if they already have the ability to breast-feed. In other words, not every woman naturally possesses the ability to breast-feed.

Recuperation from the surgery usually takes a couple of weeks. Many patients feel comfortable enough to return to work while they are still recuperating. If, however, the patient has a very physically demanding job, then the recuperation period is usually a little longer.

The procedure does leave the patient with visible scars. Some of the scars are hidden in the folds beneath the breast. The latest technology and techniques are used so as to minimize the length and breadth of all scars. There is also a possibility of some numbness, but only a small percentage of women experience it.

Because it relieves back pain, many insurance companies cover the expense of breast reduction surgery. For many women, breast reduction improves their quality of life. It relieves their back pain, relieves the need for pain medication, and enables them to dress in styles and fashions in which they never before felt comfortable or attractive.

Breast augmentation is the exact opposite of a breast reduction. With augmentation the physician lifts and enlarges the breast using either saline filled or silicone-gel filled implants. The procedure can be performed in a surgery center or hospital. Although considered a relatively safe and simple procedure, as with any surgical procedure there is a degree of risk involved with breast augmentation. Potential risks include deflation of the implant (10 percent chance over 10 years), hardening due to surrounding scar tissue, bleeding, or infection. All of these complications are uncommon.

Regarding implants, both saline-filled and silicone gel-filled are safe and effective ways of augmenting the breast. Saline-filled implants offer the advantage of being totally absorbable if the implant leaks. However, visible wrinkling or rippling is a little more common with saline-filled implants than with silicone gel-filled implants. Also, silicone gel-filled implants feel a little more like breast tissue than saline-filled implants. The American Society of Plastic Surgeons has invested over $5 million to find the answers regarding the safety and effectiveness of silicone implants, and the studies are ongoing. At this time, we can say that silicone-filled implants are not causing disease, that the silicone is not transmitted in breast milk, and that any effects of silicone breast implants are confined to the breasts.

Both saline-filled and silicone-filled implants are man-made objects and cannot be expected to last forever. Even though there are patients who have had the same implants for 29 years, as a patient you should be aware that the risk of deflation is 10 percent over a 10-year period. In time, you may need another procedure to replace your implants.

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