Breast cosmetic surgery procedures.

Breasts

Breasts can be small, large, saggy, or may have been subjected to some type of trauma, such as burns or a mastectomy for breast cancer. In any case, the volume and shape of breasts, if unsightly, can be bothersome, and plastic surgery counts on various and modern resources to offer the best ways improve the appearance of the breasts and, consequently, self-esteem. Mammary asymmetry, small breasts, breasts too large (gynaecomastia) or simply saggy breasts find in plastic surgery the solution to improve form, volume and firmness.

Breast augmentation

Breast implants have enjoyed great popularity amongst women. The almost immediate, almost painless and excellent final results make it the most desired surgery by the vast majority of women. Dr. Zamarian has performed breast augmentation on patients from Londrina, Paraná, Brazil and abroad, with the skills and experience necessary to help them achieve their aesthetic goals.

The small development of breasts, also called hypomastia (small breasts), can be easily improved with breast implants. The surgery is usually performed by Dr. Zamarian under general anaesthesia, and it is a fast procedure (approximately one hour) with a very smooth recovery.

Silicone implants used at the Zamarian Clinic are coated with polyurethane, from Silimed, which protects against the risk of contracture, flaccidity and stretch marks, giving greater firmness to the breasts, being once considered the best implants in the world by the European Commission.

Hospital stay after breast implant surgery is 24 hours, and Dr. Zamarian usually puts a drain exterior to the underarms, which he draws on the morning following the surgery, before the patient is discharged from hospital. This drain is essential since the body usually accumulates approximately 100ml of liquid in each breast during the first 24 hours, so it reduces the risk of infection and contracture.

Postoperative care for breast augmentation with silicone implants is fairly uneventful. There is no need to remove stitches, since Dr. Zamarian uses surgical adhesive (Dermabond). We recommend that the patient sleeps belly up during the first month and refrain from physical effort during this period. Three weeks after the surgery, the patient can already drive and after thirty days, raise the arms above the shoulders and carry light weight. The return to work depends on the area of activity, but on average, it may occur in seven to 15 days.

Breast lift

Breast flaccidity occurs when the breast droops over the chest, and, to put it into easy terms, when the breast can hold a pencil or a pen underneath it, with patient standing up. Treatment for breast flaccidity with plastic surgery is called breast lift, or mastopexy (masto = breast, pexia = lift). Mastopexy differs from breast reduction in the sense that, in the mastopexy, the surgeon removes little volume, since the main objective is to lift the breasts. Whereas in reduction mammoplasty, the main objective is to reduce the size of the breasts, thus, it involves bigger scars than breast lift.

The breast lift technique, largely used by Dr. Walter Zamarian in Londrina, is the Arie-Pitanguy, or the Rhomboid technique. In this technique, the resulting scar is often just around the areolas and vertically on the breasts, many times preventing scars in the infra-mammary sulci. However, when there is greater flaccidity, it may be necessary to make a horizontal incision, resulting in a small inverted T, to make sure the scar does not show below the brassiere line.

Mastopexy can be associated with the placement of silicone breast implants for firmer breasts, with greater projection of the upper pole and longer-lasting results. This surgery is called breast lift with with silicone implants.

Both the postoperative period and the time to return to normal activities are the same as described above, for the placing of silicone implants, alone. Within a month, patients can sleep on the side again, raise their arms, take hikes and light bike rides and return to their normal romantic activities.

Breast reduction

Reduction mammoplasty, or breast reduction, consists in removing large amounts of volume from the breasts, especially in patients who suffer as a result of their breasts weight: rashes below their breasts, grooves on their shoulders (caused by the bra) and backaches. Breast reduction gives more comfort, helps to correct postural problems and eases the pain and the rash.

The classic breast reduction technique by Professor Ivo Pitanguy results in an inverted T scar and it can reduce even very large breasts, a condition called gigantomastia. During this surgery, the areolas and breasts are lifted, and, as in a mastopexy, the sensitivity of the areolas is preserved most of times. This technique allows breastfeeding after surgery and the recovery period is the same as that required by breast augmentation and breast lift.

Dr. Zamarian's patients have a long-term follow-up programme after surgery, to make sure that the scars have the best possible outcome.

Gynaecomastia surgery

Male breasts can acquire greater than expected volume and may cause embarrassment to men when wearing tighter shirts or when taking them off on the beach or by the pool. There are several factors that can influence excessive development of breasts in men, but mostly, the cause is unknown. The excess volume of the breasts may be due to fat, gland or both. This increase of breasts in men is called gynaecomastia.

When the excess volume found in the breasts is just fat, with no important skin flaccidity, liposuction alone can solve the problem. In cases in which the surgeon performs liposuction and, at the end, there is still fibrous tissue projecting the areola and its surrounding areas, the gland also needs to be removed, and quite often, this can be accomplished with a intra-areolar incision at the lower aspect of the areola, or by removing a little skin around the areola. For the most extreme cases, a large amount of breast tissue and skin may require a longer surgery, with a greater scar, which may be similar to that of reduction mammoplasty.

Patients must wear a vest after this surgery and lymphatic drainage and endermology, which begin on the 5th and 10th days after the surgery, respectively, will guarantee more comfortable recovery, with less risk of fibrosis and adhesions.