To gain the best possible results from aesthetic surgery requires careful patient selection. Not all procedures are suitable for all patients, therefore it is impossible to offer anything other than very general advice before seeing a patient. It is certainly better to have no procedure than an inappropriate one. To undergo aesthetic surgery is a major decision requiring appropriate discussion and thought.
Cosmetic Procedures
Breast Reduction

Large breasts may cause a woman to feel self-conscious or make buying clothes difficult, but also their weight can present a physical burden causing neck and back pain together with shoulder soreness because of tight bra straps. The surgery to reduce the size of overly large breasts (breast reduction) or to lift sagging breasts (mastopexy) has many similarities although, in the latter, no breast tissue is removed, it is re-shaped. The purpose of each operation is to make the breasts more shapely, better supported and, in the case of a breast reduction, smaller. In order to achieve this, it is necessary to elevate the nipple so that it is appropriately placed on the breast mound. There are many different techniques of breast reduction and mastopexy surgery and so the position of the resulting scars may vary a little.

In most techniques, there is a circular scar around the nipple and a second vertical scar running from the lower most point of the nipple to the fold beneath the breast (this is usually 5cms in length). Also, in most techniques, there is a transverse scar in the fold beneath the breasts and while this can usually be kept quite short (5 to 6cms) this does depend on the initial size of the breasts. In general, therefore, the scar will resemble an inverted 'T'. In some patients, particularly those with relatively small but sagging breasts, the procedure can be carried out with a circular scar around the nipple alone, and in others a vertical scar with no transverse scar is appropriate. Sometimes mastopexy (breast lifting) may be combined with breast augmentation.

Breast scars, like all others, are quite noticeable when they are new since they are red, but they fade over time (perhaps as long as a year to full maturity). Appropriate care after the surgery will aid this process, and usually they will end up fine, flat and pale. A few people, because of their genetic make-up, tend to produce red, raised (hypertrophic or keloid) scars, but this is rare and can be treated if it becomes a problem. Stretched scars are much less common with modern breast reduction techniques than with older methods.

Modern techniques are designed to preserve the sensation in the nipple, although this is often altered in the short term to being either more or less sensitive than usual. In general this will resolve to normal over a period of approximately three months, but there is a 10% incidence of permanent reduction in nipple sensitivity with this type of surgery. Also breast feeding after a future pregnancy should be possible, but it may, of course, result in some further stretching of the breast and change in shape. If the areola (dark pink skin around the nipple) has become stretched this will be reduced in size at the time of surgery.

It is possible to remove more or less breast tissue, according to the patient's wishes, and so although one cannot exactly guarantee the final size of the breasts it is possible to tailor the final result to satisfy the patient.

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