How it works
Everything begins with a consultation with a specialist in plastic and aesthetic surgery. The safety and the outcome of your surgery depend a great deal on how clearly, fully, and honestly you share your history. You will be asked about your reasons for wanting surgery and your expectations, your general health, your medical history, the medications and herbal supplements you take, any past surgeries, and your family history of breast cancer.
Your surgeon will examine your breasts, take detailed measurements of their size and shape, assess your skin quality and the position of your nipples and areolae, and take photographs for your medical record. From there, your surgeon discusses your options, recommends a treatment plan, and explains both the results that may be possible and the risks of surgery.
During the operation, you will be given medication to keep you comfortable. Anesthesia (medication that keeps you from feeling pain) may be intravenous sedation or general anesthesia; your surgeon will advise you on the choice that suits you. The incision can take several forms depending on your situation: a circular incision around the areola, a keyhole pattern with an incision around the areola and a vertical line down to the breast crease, or an inverted-T pattern.
After the incision is made, your surgeon removes excess skin, fatty tissue, and breast gland tissue, reduces the areola if needed, and moves the nipple and areola to a higher position. With very large and heavily sagging breasts, the nipple and areola are sometimes removed completely and then grafted back into a new position. In some cases, liposuction is combined with surgery to draw out extra fatty tissue; if your breast size is mostly due to fat and there is little excess skin, liposuction may be used on its own. Finally, the incisions are closed and shaped into a smaller, higher breast, using dissolvable sutures on the inside and non-dissolvable sutures on the outside, and sometimes surgical glue or special tape.