Patient Perspectives:
July 13th, 2009
It is such a personal decision to have cosmetic surgery and I thought it was only something for glamorous people in movies or television. I never even considered cosmetic surgery until my body changed after four pregnancies. I was always known in the small town I grew up in as having a nice chest. There weren’t many augmentations in the eighties when I graduated from college, so my rather ample cleavage stood out. I felt proud of my figure. But the toll of running 6 days a week with athletic bras of questionable quality and nursing three children finally caught up with me. I felt sad about my new shape.
I started to look into the possibility of a breast lift or other corrective surgery. I brought up my concerns to my husband. He didn’t think it was necessary, but understood how it bothered me. I’d have to tuck my breasts carefully into bras or they would droop terribly. The cute running bras were out of the question. I’d joke to my sister that if I’d lie down on my back, they’d fall into my armpits! I decided to set up a consultation. I didn’t know what to expect. I was a little nervous, but very excited too. Dr. Bashioum was very easy to talk to and I felt comfortable asking him questions. After leaving the consultation, I was even more excited and very well informed! It turns out that I was a wonderful candidate for elective surgery. I set up a surgery date for a short while later. I then started counting the days until surgery. I’d dream of having my pre-baby body again.
When I arrived the day of surgery, I felt like a princess. It sounds strange, but I really did feel special. Everyone was taking such great care of me. When I woke up, I felt a lot of pressure on my chest. I don’t remember too much other than my nurse giving me ice. I went home, had lunch, watched TV and iced. I received a call that night from Dr Bashioum to check on me. I was doing great and I didn’t have much discomfort. The next day, I took a shower as instructed and looked at my new breasts. The swelling made my chest look kind of strange. I thought, “Oh, what did I do?†A few weeks later the swelling went down and my new shape took form. I really love my new breasts. I can wear nice bras and workout tops now. The hardest thing for me during recovery was to take it easy. I couldn’t wait to start my work outs again. I’d do this surgery again in a minute. I just wish I would have done it a few years earlier. Now I feel much better about myself.
Patient name withheld upon their request.
Nippin’ Out
July 9th, 2009
I just do not know how else to describe the recent article in Allure Magazine. Quoting a London Daily Mail article about Victoria Beckham, they show a photo of her is a fitted top. The photo prominently displays the shape of her nipples and areola. The article claims surgical enhancement to create this appearance is becoming more popular.
The breast can be separated into three profile components. First is the breast mound, which accounts for the majority of the breast size. Traditional breast enlargement surgery enhances this through placement of an implant beneath the breast and/or muscle. The center portion of the breast is highlighted by the nipple and areola. This is the eye point or where a person looks when they look at another person’s (man or woman) chest. The nipple is the central portion of this area. It projects out from the breast normally. The nipple represents the termination of the breast milk ducts allowing breast feeding. The darker skin around the nipple is known as the areola. Its color varies widely with genetic background and past pregnancy history. The areola is usually flat in relation to the surrounding breast mound. Sometimes this projects above the breast mound to add another contour to the breast. This is apparent in the Allure photo.
There are a variety of cosmetic nipple surgeries. The most common procedure in the past has been correction of inverted nipples. In this condition, the normal milk ducts are too short and cause the central part of the nipple to be drawn inward thus reducing the nipple projection. Correction of inverted nipples eliminates the ability to breast feed and can interfere with nipple sensation. It is important to understand nipple inversion can be a sign of breast cancer. The internal mass can cause scarring of the milk ducts which draw in the nipple. If a patient experiences this inward movement after having normally projecting nipples, they must be evaluated for a possible breast tumor.
Some women are self conscious of nipple prominence. It embarrasses them when they wear clothing. For those women I suggest the use of clear plastic adhesive dressings which flatten the nipples. The dressings are imperceptible beneath clothing.
Other women are requesting increased nipple and sometimes areola projection. There are implants available but these are generally reserved for nipple reconstruction after breast cancer surgery. In addition, there are many reconstructive nipple procedures which use the remaining skin and fat after the cancer surgery to make a new nipple. The potential scarring resulting from these procedures require that they generally keep those surgeries in the realm of reconstruction surgery.
Women considering increased nipple and areola projection might consider temporary fillers like Restylane ® or Juvederm ®. These will be reabsorbed after six to nine months. If there are any reservations regarding the appearance, nothing need be done. A more permanent solution is fat graft injections. Fat taken from another area of the body is transferred with injections to the areola and/or nipple. The result can be permanent but some of the initial improvement will be lost as the body absorbs some of the transferred fat.
Just like clothing and hair styles, this fashionable trend may only be popular only for a season or two. I think temporary solutions to increase nipple and areola projection are the best choices. Any surgery is serious business and it should not be considered frivolously.
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