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Breast surgery: implants, lift, reduction & reconstruction
Sydney plastic surgeon Dr Peter Laniewski uses several techniques to help women overcome any issues they may have with their natural form. He strives to build a close rapport with his patients and works with them individually to decide on the most suitable procedure – be it a breast lift, reconstruction, reduction or augmentation.
Breast augmentation is a cosmetic surgical procedure to increase the volume of the breasts through the insertion of implants. ‘The extensive range of implants available in Australia allows us to find the ideal fit for just about everyone,’ says Dr Laniewski.
Generally, the preferred breast implants used in Australia are silicone-gel filled, which is regarded as one of the most common and compatible materials for implanting into the body. They tend to feel softer to the touch and more like natural breasts than saline implants. The prospective patient has a number of choices to discuss with her surgeon, including the location for the incision, the type, shape and size of the breast implant, and its placement.
‘These are all dependent on the patient’s body shape and size, natural breast tissue, as well as her expectations and desires,’ says Dr Laniewski. ‘That’s why it’s important an experienced surgeon guides her through the decision-making process and provides all the relevant information before she decides to go ahead with surgery.’
As every woman’s physiology and presenting conditions are different, the way breast augmentation is carried out varies with each individual. In some cases, augmentation surgery can be accompanied by a mastopexy, or breast lift, for patients who have sagging breasts.
Restoring drooping breasts to a more youthful shape and position can dramatically improve a patient’s aesthetic and personal outlook. It is inevitable that factors such as ageing, gravity, genetics and child bearing will affect a woman’s breasts.
‘Breast size is also a factor in ptosis, with large breasts dropping sooner than smaller breasts,’ says Dr Laniewski. ‘Breasts that have begun to sag and droop have a more empty or heavy appearance. A breast lift, or mastopexy, can help restore a more youthful appearance.’
A breast lift is an operation that not only elevates the breast and areola but also reshapes it. Dr Laniewski prefers to use a vertical incision to minimise scarring. For patients seeking a straightforward rejuvenation, the breast lift can be performed alone. For those wishing to add volume in addition, an implant can be incorporated to increase cup size.
Breast reduction surgery can significantly improve the quality of life for large-breasted women, affecting how they feel about themselves and alleviating associated physical concerns such as back and shoulder pain.
‘The main aims during breast reduction surgery are to lift and reshape the breasts and nipples and to reduce the volume of the breasts,’ explains Dr Laniewski. ‘Breast reduction involves the removal of breast tissue and some skin, and then reshaping the breast and repositioning the nipple and areola to create a harmonious result.’
‘We offer a refined vertical short scar technique that utilises a keyhole method,’ he says. ‘This modern technique results in more discreet scars, as it involves a short incision that only stretches from the areola to the inframammary fold.’
Breast reduction surgery differs from some other types of breast surgery as it tends to be carried out to correct medical concerns such as backache, rather than purely for aesthetic reasons. Therefore it can be performed on women of any age once breast maturity has been reached.
Breast reconstruction after mastectomy is a complex yet valuable procedure in restoring the breast and creating curves. It is typically performed using implants, the patient’s own tissue (flap breast reconstruction) or a combination of the two.
‘I believe a DIEP flap breast reconstruction is the current gold standard. It can offer the most natural-looking result and feel, as it uses the patient’s own excess skin and fat,’ Dr Laniewski explains. ‘Importantly, it preserves the rectus muscle (and core strength) and also has the benefit of an abdominoplasty (tummy tuck).’
Regardless of the type of breast surgery carried out, there is no “one size fits all” approach. ‘An experienced and skilled surgeon will tailor the procedure to each individual patient’s needs and anatomy, taking into account her body shape, existing breasts, circumstances and desires,’ Dr Laniewski says. ‘There needs to be a strong patient- doctor relationship built on trust, care and openness, so that together we can achieve the best outcomes possible.’