Breast Procedures

Most women feel that their breasts are a vital part of who they are. While having the breasts of a movie star is not, nor should it be, the goal of every woman, it is important that a woman’s breasts are in proportion with the rest of her body and at harmony with her overall self-image. At his state-of-the-art surgical facilities, Dr. Graivier offers:

• Breast Reduction
• Breast Augmentation
• Breast Lift

Breast Reduction

Breast reduction surgery, also called reduction mammaplasty, is a procedure that removes skin and fatty tissue from excessively large breasts. Many women who have large breasts complain of medical problems such as back and neck pain, shoulder pain, skin irritation, breathing difficulties and numbness in the hands. Because breast reduction is performed as a remedy for these significant health problems, it is often considered a reconstructive procedure. As such, it is sometimes covered under the patient's insurance plan.

Overly large breasts cause many young women emotional distress. Developing extremely large breasts at a very young age — when a girl is especially self-conscious about her body — can cause severe emotional issues. For many women, extremely large breasts can cause considerable physical discomfort and functional problems, as well as embarrassment. The majority of women who seek reduction surgery do so for physical relief rather than for cosmetic improvement. In addition, many women find that when excess skin is removed, old stretch marks are eliminated.

Consultation

During your consultation your surgeon will perform a breast examination and discuss the benefits and risks of the reduction surgery. He will explain that breast reduction surgery leaves an anchor-shaped scar that is permanent, though it may vary from being inconspicuous to very prominent depending on how you heal. The scar does not bother most women, who consider it a reasonable sacrifice for a more proportional body, clothes that clothes fit better, and relief from the physical discomfort caused by overly large breasts.

The Procedure

The operation may be done either in an outpatient operating room or a hospital setting; you may stay one night in the hospital. Breast Reduction can take from two to four hours, depending on the size of your breasts and the method used. Breast reduction is performed under general anesthesia.

Your surgeon will create a keyhole-shaped cut that circles the areola and extends down to the crease of the breast so that the nipple can be moved into its new position. In most cases, your nipple remains attached to its blood supply, but occasionally it is necessary to completely remove the nipples and areola and place them in a higher position as a graft.

Excess breast tissue, skin and fat are removed from around the areola and from the sides and bottom of the breast. Your surgeon will use stitches to secure the areola and remaining skin into its new location. You will have stitches that go around the areola, come down the curve of the breast in a straight line, and then follow the breast crease. Liposuction is sometimes used to remove excess fat from the armpit area. When surgery is completed, your incisions will be bandaged and you will be dressed in a surgical bra.

Recovery

You will experience discomfort for the first 24 to 48 hours after your breast reduction, and you may find it difficult to lift your arms. However, pain medication will be prescribed to lessen discomfort for the first couple of weeks. You will be asked to wear a surgical bra at all times other than when you shower, which you may do approximately two days after your surgery. The surgical bra will protect your breasts and the dressings over your incisions for several weeks.

You may experience random shooting pains and numbness in your breasts for several months, and your breasts may feel sore during the first menstruation following surgery because the hormonal stimulation will cause them to swell, pulling the incisions. Since sexual arousal can cause also cause the incisions to swell, you should avoid sex for about three weeks. After that time, you should be careful to avoid direct contact with your breasts for another two to three weeks. Most women can return to work, social activities and some mild exercise in about two weeks. When you resume vigorous exercise you should wear a good athletic bra for support (though you should wait at least six weeks to purchase new bras, after the swelling has subsided.)

Dr. Graivier will see you several times during the healing period. Though most of the stitches involved in breast reduction are placed under the skin and will dissolve, this surgery does leave permanent scars. The scares might remain pink and lumpy for several weeks, or they may begin to fade immediately. It takes a year to 18 months for scars to fully mature and fade to pale pink, brown, or white.

If you would like more information about breast reduction surgery or any of our spa services, contact the North Atlanta Plastic Surgery & Day Spa today!

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Breast Augmentation

Breast augmentation surgery involves placement of an implant either behind the muscle or just behind the breast tissue. At the present time, the implants used in breast augmentation have a solid silicone outer shell and are filled with saline, the same solution used in IV fluid. The procedure is offered to women (usually 17 years or older) whose breasts have finished developing. It can be performed on women either before or after having children but is particularly effective for women who have lost fullness in their breasts after childbearing.

Breast augmentation can be performed in combination with a breast lift to increase fullness in the breasts and elevate the position of the breast tissue and nipple. The main goal of breast augmentation surgery is to create a natural appearing and feeling breast. Many women have breast asymmetry prior to surgery, and while this can be improved, it may not be completely corrected.

Consultation

Because bra sizes vary, it is beneficial to bring to your consultation pictures of women with breast sizes that you feel would look good on you. Dr. Graivier will discuss your desired size and shape with you, and talk to you about the placement of the implant and incisions that will be used. He will perform a breast examination during your consultation and note at least three different size implants that may achieve your desired size.

During the consultation, Dr. Graivier will discuss the risks and goals of your surgery. The main risks include hardening of the tissue around the implant (capsular contracture), implant rupture, and implant malposition. Companies that make the implants offer a lifetime warranty on their products. In the event that an implant deflates, a replacement will be provided.

Before Surgery

You will be asked to stop taking aspirin and anti-inflammatory medications 10 days prior to surgery. If you smoke, you should stop three weeks before and after surgery.

Before surgery, the doctor will mark your breasts in the upright position. He will once again go over your size expectations before proceeding to the operating room.

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The Procedure

The operation will be performed in an outpatient surgery center. The surgery itself can take one to two hours, and you will be kept in the recovery room for at least one hour after the surgery. At the time of surgery, an incision is made and the breast pocket formed. The patient is placed in an upright position while temporary breast implant sizers are positioned. The sizers are filled to a variety of volumes, until the breast size for the patient's desires is determined. At that point, the implant sizers are removed and replaced with the appropriately sized permanent implants. This technique has been an excellent method of obtaining the desired breast size.

Dr. Graivier most commonly uses an approach through the armpit, making an incision less than one inch in length. He uses a fiberoptic endoscope to assist in the placement of the breast implants. He most commonly uses smooth saline implants place behind the chest muscle, but the approaches may vary depending on the patient's anatomy as well as the presence of breast sagging

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Recovery

You will experience discomfort for the first 24-48 hours after your breast augmentation. You will have pain medication and antibiotics prescribed to lessen discomfort and decrease the risk of infection. A surgical bra will be placed after the surgery. If the procedure has been done through the armpits with the endoscope, an upper bra strap will also be placed. Ice should be applied to your sides for approximately 15 minutes every three hours over the first day and then for 15 minutes every four hours for the second day.

On the second day after surgery, you will be asked to remove the bra and use the bra strap alone to allow gravity to assist in the settling of the implants. You will be asked to massage your breasts at that stage of your recovery, gently rubbing the tissue in a downward and inward direction. You may also shower on the second day after surgery.

It takes approximately three to four weeks for the breast implants to settle into the proper position. Much of the swelling on the sides and in the breasts themselves will diminish in approximately 10 days to two weeks Stitches that are placed under the skin will dissolve, and the rest of the sutures will be removed during the first week after surgery.

Dr. Graivier will see you several times during the healing period. Your breasts may feel sore, and you may have burning or tingling sensations in the nipples for approximately six weeks following the procedure. This is because the nerves to the nipple are stretched with the placement of implants. Nipple sensation should eventually return, however, as well as the patient's ability to breastfeed. You should avoid strenuous activity for three to four weeks following surgery. Most women can return to work, social activities, and some mild exercise in about five days. When you resume vigorous exercise, you should wear a good athletic bra for support. Still, we recommend that you wait at least six weeks to purchase new bras, after the swelling has completely subsided.

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Breast Lift

Also known as mastopexy, breast lift surgery restores the shape and firmness of droopy breasts. As women age, skin and breast tissue begin to sag, making breasts appear deflated. Breast lift surgery removes excess skin and breast tissue, giving breasts a firmer texture and lifting them higher on the body to restore youthful perkiness. A breast lift procedure may be performed in conjunction with breast augmentation in order to lift the breasts and increase breast volume simultaneously.

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Consultation

There are different types of breast lift procedures that may be utilized in breast lift surgery. Dr. Graivier will explain what procedure will work best with your breast shape and body type. Most breast lift patients will undergo the standard breast lift surgery technique, which can correct sagging breasts of all sizes. This technique will leave an anchor-shaped scar on the breast, around the areola, descending from the nipple and across the breast crease. If you have small breasts and only moderate sagging, you may be a candidate for a less invasive form of breast lift surgery called a doughnut mastopexy. Contact Dr. Graivier’s office to discuss whether you may be a candidate for this procedure.

During the consultation, Dr. Graivier will also discuss the possible risks and complications of breast lift surgery. Breast lift risks include the loss of sensation around the nipple and breast, difficulty breastfeeding, and the possibility of significant scarring. The degree of scarring will depend on how your body and skin heals; however, most women find that scars decrease significantly over time regardless of their initial severity. Complications after breast lift surgery are generally rare, and most patients are pleased with the more youthful appearance of their breasts after surgery despite scarring.

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Before Surgery

As with other surgeries, Dr. Graivier asks that breast lift patients stop taking aspirin and anti-inflammatory medications 10 days prior to surgery. Patients should also stop smoking for three weeks before and after surgery.

On the day of your surgery, a companion should drive you to your appointment. Because breast lift surgery requires the use of general anesthesia, you will not be able to drive yourself home after the procedure.

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The Procedure

Breast lift surgery is performed on an outpatient basis while the patient is under general anesthesia. During a standard breast lift surgery, three separate incisions are made: around the nipple, vertically from the nipple to the breast crease, and horizontally along the breast crease. Skin and tissue below the nipple is removed, and the nipple is repositioned higher on the breast. After reshaping the breast with the remaining skin, Dr. Graivier will carefully close the incision with sutures.

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Recovery

After breast lift surgery, you may experience initial discomfort and swelling during the first two weeks. Dr. Graivier will prescribe pain medication and antibiotics for you during this time to make sure you are comfortable and to decrease the risk of infection. After surgery, you will wear a surgical bra for several weeks to protect your sutures and support your newly lifted breasts.

Over the next weeks and months, you will return to our office several times so we can make sure your recovery goes smoothly. Most patients return to work after about a week, and sutures are removed between one and two weeks. It is important to remember that scars will fade more and more after surgery; however, they will be permanent. If you do not experience major weight fluctuations or pregnancy, a breast lift procedure should create breasts that maintain their youthful perkiness for many years to come. Occasionally, breasts will begin to sag again as gravity and aging take their toll; however, it is possible to have more than one breast lift procedure to maintain the youthful results you desire.

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Contact North Atlanta Plastic Surgery & Day Spa

If you would like more information about any of our breast augmentation, reduction, or lift procedures, contact the North Atlanta Plastic Surgery & Day Spa today!