Some women feel that the size of their breast is less than what would make them comfortable. An increase in size would make them happy and confident about themselves. Many creams etc are advertised. Logic says that unless the content under the skin increases, the breast can not become bigger. This is done in 2 ways: Implants: These are made of silicone. They come in different sizes and the size used is based on the build of the person and the desired extent of augmentation. The implants can be introduces inside by different routes and the best route will be decided in consultation with the patient. The surgery is done under anesthesia and as a day care procedure ( no overnight stay required). The first few days can be challenging , because of the stretch in the area. But normal life is possible in 1-2 weeks. Controversies about its link to cancer have been addressed by research. Fat Transer ( Lipo filling) This can be done by harvesting fat from the lower stomach skin or from the thighs and injecting it into the breasts. The advantage is that there are no visible scars. The problem is that more than one procedure may be required depending on the volume increase required.
The size of the breast may increase beyond expected proportions. This can cause social problems ( comments, embarrassing stares, difficulty in wearing certain clothes) or physical problems ( shoulder pain, wounds caused by rubbing of skin, difficulty in physical work, sometimes inability to sleep flat) . An enlarged breast can weigh a extra kilogram or more each side and carrying this is not easy. To reduce the size the options are liposuction and surgical reduction. Surgical reduction achieves a number of goals. There is a reduction in breast size, the nipple that is hanging low is restored to a more normal position, the size of the nipple is reduced, the shape of the breast is restored too. It will leave some scars behind. Some of these scars will fade but some may remain. While this can be a matter of concern, the physical relief is so significant to the person, that they are willing to overlook this. Some of my most happy patients are those who have undergone this procedure.
Liposuction is an option for those in whom the Fat content is high. This is usually the case in older women. The advantage is that this is a day care procedure and involves less scars. The disadvantage is the unpredictability of the shape.
Lipofilling for the Breasts
It is possible to Increase the size of the breasts with fat . The fat is extracted from the lower part of abdomen or inner thighs. The injection leaves no noticeable scars. There is a limit on the volume that can be injected at once. More than one procedure may be required. It is done as a day care procedure. Results will be known in 2-3 months.
Breast lift or Mastopexy
The effects of age and skin ( laxity) loosening results in the breast also sagging with age. The larger the breast, the greater the sagging. This can cause discomfort/ unease at the shape. Some dresses can not be worn. To lift up the breast, the contents inside have to be redesigned and re arranged. The skin is opened up in the lower half of the breast in different ways and the tissue below is moved to give a push up. The Nipple is relocated to a position that is appropriate and prominent. These procedures are surprisingly nearly pain free. These can be done without admission also.
During puberty or sometimes following pregnancy, a bulge develops in the armpit. This is likely to be some breast tissue which is located higher up. This can cause pain, or more likely discomfort . Some dresses also can not be worn. Removal is a challenge as scar should be hidden. Sometimes, the fat can be suctioned out ( Liposuction). But if the skin is loose and the bulge is big, skin tightening is required. This is a day care procedure.
The Male breast can sometimes enlarge at the time of puberty. This is the commonest reason. It can also enlarge as a result of some diseases or by some drugs. This can cause embarrassment as it prevents the affected person from wearing normal shirts/ exposing the area. it can also invite many comments. Reduction is achieved by Liposuction usually. This is done using small openings. Following removal of the fat, the skin shrinks and the shape improves. Sometimes, if there is hard gland tissue inside, it may have to be removed. This is a day care procedure and people can resume routine daily activities in 3-4 days
Skin Tightening in Males
Sometimes the skin bulge is significant and the skin is unlikely to shrink. Drooping/ sagging can also be a problem. In these cases, liposuction alone may not help. A limited skin removal is planned. It can be done in a way that the scar is not easily seen.