Breast Augmentation Part 2 of 4: The Procedure

The things you need to know to make better choices regarding Breast Augmentation are the following:

 

1)  Match your desires with reality

The surgeon can only work with the issues you bring him. If you want the best result, you have to balance what you want with what your breast tissue will allow you to have and what it can support over time. Also, no woman has two breasts that are the same, and no surgeon can create two breasts exactly the same. Cup size is extremely variable and inconsistent from one brand of bra to another. Women tend to buy a bra that they can fill (or that pushes their breast tissue where they want it to go to create a specific appearance), not necessarily a bra that fits.

Last of all, the bigger the breast you request (i.e. the bigger the breast augmentation), the worse it will look over time. You can’t pick out a breast from a book or magazine and expect the same result unless the woman in the picture looked exactly like you before surgery.

 

2)  Know about the implants

Breast implants are not perfect, don’t last forever, and require some maintenance. If you can’t accept these facts, don’t have a breast augmentation. If you do, then you need to think about:

a) Implant pocket location

Implants can be placed in front of, or behind the muscle. There are less capsular contracture rates when the implant is placed behind the muscle and you can obtain better or more accurate mammograms too. Also, in thin women, behind the muscle is preferable because adequate tissue coverage is most important. Think when you lie in bed, if you are covered by a bed sheet only, one can see the contours of your body a lot better than if you were to be covered by a doona cover, where they are less distinct. Having said that, an implant placed in front of the muscle, will always more predictably control breast shape. How do you decide whether to go in front or behind the muscle? If you pinch the breast tissue in the upper pole and it’s < 2 cm, your best option would be to go beneath the muscle, otherwise, you run risks of seeing the edges of the implant.

One aspect that often gets overlooked is the way the pocket is created. Blunt dissection techniques are fast and efficient but create more tissue trauma, tear tissues, create more bleeding, and result in longer recovery times. Electrocautery dissection techniques use an electric current to seal blood vessels and are thus, less traumatic and have shorter recovery times.

b) Implant Shape

Shapes of implants can either be round or teardrop (anatomical). There is a trend today of women wanting more upper pole fullness and therefore opting for round implants. Given that the breast is constantly evolving and that over time there is a loss of upper pole fullness as the breast tissue “melts away”, breast augmentation with round implants may be a good option for maintaining upper pole fullness in the long term. The other added advantage is that if it rotates, it doesn’t affect the shape of the breast. In contrast, a teardrop implant which is fuller at the bottom and tapers at the top will give an odd shape to the breast if it does rotate. However, breast augmentation with teardrop implants may be better in women who have oddly shaped chests (either long or wide for example) because you can tailor the dimensions of the implant more specifically to fit the breast “foot print” on the chest. Tear drop implants may also be beneficial in women with mild sagging breasts who do not want scars on their breast from elevating the nipple. Tear drop implants have a “bucket-handle” effect on the nipple, elevating them to a higher position on the breast.

c) Implant surface (or shell)

The surface of the implant is made of a silicone rubber and can be textured or smooth. Textured implants have a lower risk of capsular contracture than smooth implants.

d) Implant “stuffing”

The stuffing or filler of the implant can be silicone or saline. Saline is salt-water and is harmless if the implant ruptures. Its biggest disadvantage is rippling and that it takes up the ambient temperature, meaning if you went to the beach for a swim, when you got out, your implants would feel cold. Silicone gel filler, on the other hand, is more natural, more predictable and it is safe. There are grades of silicone gel that range from “jelly” consistency to that of “gummy bears”.

e) Implant size

Remember, the larger the implant, the more tradeoffs and risks you’ll encounter, especially long term.

f) Incision location

The scar can be placed in three areas. The breast fold incision offers the best degree of control for the wide range of breast types and is the commonest type used by far. The periareolar incision (around the nipple-areola) usually heals well because it’s located in the thinner skin but is limited and can’t be used if the areola is not large enough for access. The biggest problem is the increased exposure of the implant to bacteria if any of the breast ducts were to be cut. The armpit (axillary) incision places no scar on the breast but takes longer to perform and harder to control the position of the breast fold.

 

3)  Get well acquainted with the tradeoffs, problems, and risks

Tradeoffs always depend on the details of each specific case, the characteristics of your tissues, and the experience of your surgeon with different options. Every breast augmentation operation carries inherent risks and medical complications are not totally preventable by you or your surgeon. Remember, don’t have a breast augmentation unless you thoroughly understand and accept the potential risks and tradeoffs of the procedure.

 

4)  Know about the recovery

The more tissue trauma caused by your surgery, the longer and more difficult your recovery. That is why it takes longer to recover from a pocket created behind the muscle. Excessively large implants can produce excessive stretch marks that cause more discomfort and temporary or permanent sensory loss. Most women return back to normal duties within four weeks and athletic activities in six weeks.

Question:  Do you think that the benefits far outweigh the trade-offs for breast augmentation? You can leave a comment below.

Breast Augmentation revisions: 3 facts you must know!

Designing a surgical plan that can deliver a satisfactory result for women seeking surgical revision after breast augmentation can be quite difficult.  It still requires the plastic surgeon to obtain a good history, perform a careful clinical examination and identify the woman’s concerns and goals.

Revisional surgery after breast augmentation is typically more complex, because of the diversity of presentations and the interval elapsed since their primary surgery.  Additional surgery may be required because of anatomical changes caused by the previous procedure or that have occurred over me.  This information must be explained to and understood by women who may be expecting an easy fix. Furthermore, plastic surgeons may face the challenge of communicating with a dissatisfied and angry patient and therefore, in-depth and honest discussions outlining the risks, benefits, and costs of the various options remain paramount for achieving success.

There are 3 key facts women seeking revisional surgery after breast augmentation need to consider:

1)  Your plastic surgeon needs to listen carefully to what you’re saying.  They must find out what’s motivating you in order to satisfy your goals.  If your problem, however, is imperceptible to them, or you’re seeking an outcome they consider unattainable, they may not be able to help you reach your goals.

2)  Use visuals to enhance your consultation.  Visuals are extremely useful in helping you to understand all your options.  Your plastic surgeon should draw schematic diagrams to explain the various techniques and present you with lots of pictures of previous patients, which should be catalogued by physical attributes, rather than by implant volume or bra size.

3)  Make sure all your options are given to you in detail.  Your plastic surgeon should take a systematic approach to counseling you about your surgical options, beginning by describing the simplest, least-expensive procedure and moving up in terms of complexity and cost. Outlining all of the information so that you understand the basis for your recommendations and the likely outcomes should help you reach an informed decision and choose an operation that will deliver a satisfactory result.

If you have cost in mind and are dissatisfied after your recent primary surgery, then try and rectify the situation by returning to your previous surgeon. If this is not an option because of poor surgeon-patient communication, then you should seek another surgeon.

Thanks for reading!

 

Dr Tim – Sydney Cosmetic Plastic Surgeon

www.cosmeticculture.com.au
www.drtim.com.au

 

Can Breast Implants Raise a Low Nipple Areola Complex?

A youthful, cosmetically ideal breast has a nipple areola complex diameter of about 38-42mm.  Some breasts have large areolas from the time that they develop during puberty, and some enlarge later in life with pregnancy and breastfeeding. A large areola tends to make a breast look ’matronly’ even if it is not sagging. Nipple-areola complex diameter can definitely be reduced or enlarged, and this can be performed as a stand-alone procedure or as part of any breast enhancement procedure such as a lift, augmentation or reduction.

An attractive, well-positioned, and proportionate nipple areola complex is an important goal for many women looking to achieve a beautiful breast appearance. This small area of a woman’s anatomy can have a big impact on her satisfaction with her breasts. Women who are unhappy with the appearance of their nipple areola complexes, can have them corrected either alone or in combination with any breast enhancement procedure.

Breast augmentation with breast implants will not necessarily raise the nipple areola complex position in sagging breasts and in fact in some cases may make the areola larger. There are techniques to allow the implant to fall into the lower pole of the breast to create the illusion of lifting with more of the breast volume sitting lower on the chest. This is where using a tear drop (anatomical) breast implant can help as it creates a” bucket-handle” effect on the nipple areola complex.

The submuscular (below the muscle) breast implants are” innocent bystanders” to whatever happens to the breasts, as they are really chest wall implants that simply push the breasts forward. The submuscular breast implants are supported by the overlying pectoralis major muscles. In contrast, subglandular (above the muscle) breast implants are more likely to fall with pregnancy or weight loss, as they are supported only by the overlying breast tissues.

A periareolar (around the areola) or circumvertical (lollipop type) breast lifts are reasonable choices to reduce the nipple areola complex size and raise its position on the breast. These techniques reliably elevate the breast while keeping scars to a minimum. These breast lifts are desirable because of the nipple position (usually at or below the breast fold) and because of breast sagging. Neither nipple areola complex position nor breast sagging would be corrected with breast implants alone. “Blowing up the balloon” with larger breast implants will only create excessively large, still very saggy breasts. Reshaping the breast and elevating the nipple areola complex and breast back up onto the chest will play an important role in helping one achieve a cosmetically pleasing result.

Most plastic surgeons have a clear policy defining the financial responsibility of the surgeon and the patient in case of complications involving breast lifts, both short and long term. The policy should be made clear to each patient before surgery. It may differ from surgeon to surgeon with the majority of surgeons not charging their fee for reoperating on the patient but the patient having to pay the facility and anaesthesia costs.

Many women feel uncomfortable with their breasts their whole life because they had ’droopy’ or enlarged nipples or areolas that looked abnormal. A small surgical procedure to enhance the nipple areola complex can be extremely important for a woman’s self-esteem and self-image.

Question: Does it matter to you whether the nipple areola complex is proportionate to the remaining breast? You can leave a comment below.

The Facts on Male Breast Reduction

Enlarged male breasts (also called gynaecomastia) are the butt of many jokes, which explains why people suffering from this condition often feel embarrassed, humiliated, and insecure about their bodies. Understandably, many men suffering from this condition often have a lower self-esteem and some will not be caught dead without their shirts on. Male breast reduction surgery will help you get a flatter chest that most men can only dream of having.

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What Causes Enlarged Male Breasts?

Gynaecomastia is usually the result of excessive fat tissue in the chest area, which results in the appearance of a man having breasts. Loose skin can also result in this condition. Consequently, surgery is performed depending on whether excess fat tissue is the problem or the loose skin is the cause breast-like appearances. Fat tissue in the chest area can be due to excess body fat, hormonal imbalances, diet problems, or the use of certain kinds of drugs (marijuana and steroids being the most common). When the enlarged breasts are the result of loose hanging skin, it is usually because the individual has lost a considerable amounts of weight.

 

What Techniques are used for Male Breast Reduction?

The good thing about male breast reduction surgery is that it is a minimally invasive form of surgery. Below are a couple of surgical techniques used to ensure that you get a flatter chest:

  1. Liposuction: This is an effective technique for men who have relatively good skin elasticity. In this case, a small incision is made and the excess fat is removed using a cannula (a small hollow surgical tube). After this procedure, the chest assumes a normal masculine appearance without the need for further surgical intervention.
  2. Breast Tissue Removal: This procedure may be necessary in more severe cases of gynaecoamastia. Breast tissue removal can also be used in addition to liposuction, when removal of excess fat using a cannula does not suffice. However, this technique may also be used on its own.
  3. Skin Removal: Skin removal may be necessary in cases where there has been a massive weight loss prior to surgery. Skin removal can also be accompanied by breast tissue removal or liposuction.

 

Who Can Undergo Breast Reduction Surgery?

Generally, if you are a healthy man of any age, you can benefit from a male breast reduction surgery if you suffer from enlarged male breasts. Ideal candidates are those with elastic skin that will naturally reshape itself after the excessive fat or breast tissue is removed.

 

How Long Does Recovery Take?

Recovery from male breast reduction surgery takes about a week, although you will be discharged from the hospital on the day of surgery. The surgery is performed under general anaesthesia. Slight discomfort and pain is normal after the surgery. However, this can be managed using some pain medications. A chest garment is usually worn afterwards for up to six weeks to aid in reducing swelling and developing a collection (seroma or haematoma).

 

What are the Possible Risks of Male Breast Reduction Surgery?

Most risks associated with this surgery are usually very rare. Nevertheless, they are easily manageable and include bleeding, seroma, haematoma and infection. Proper post-operative care can effectively handle these problems if they do occur.

 

There is no reason to go through life suffering the embarrassment of enlarged male breasts. A simple male breast reduction surgery can help you achieve a flatter but muscular look that makes you look forward to removing your shirt the next time you are on the beach having some fun. This procedure poses few risks and you are usually back to your normal routine in just a couple of days.

 

Question: What is the most difficult thing you experience with having enlarged male breasts? You can leave a comment below.

Correction of inverted nipples: the facts that you need to know!

As many as 3% of Australian women have at least 1 inverted nipple but the subject of nipple inversion is seldom discussed amongst family, friends or the media. Clearly, nipples are an integral part of the breast, playing a role in appearance, in sexuality, and in motherhood. Therefore, many women who have inverted nipples, feel that it affects their self-esteem and body image.

Most cases of inverted nipples are just born that way (congenital). However, some nipples become inverted after breastfeeding when scar tissue builds in the milk ducts. Nipples that become inverted after birth are usually caused by one of three things: not enough skin at the base of the nipple, constricted milk ducts, or scarring of the milk ducts due to breastfeeding. There are 2 types of inverted nipples: shy and densely inverted.

  1. Shy inverted nipples– can be drawn out with physical stimulation, either sexually or for breastfeeding. Shy inverted nipples may only cause cosmetic and psychological problems.
  2. Densely inverted nipples– this is where the nipples never come out, even when aroused or in very cold water. Densely inverted nipples also have functional repercussions, such as the inability to breastfeed, infection or irritation of the nipple when natural secretions become trapped.While a procedure to correct inverted nipples can have a great impact on the patient’s psyche and correct irritation problems, the ability to breastfeed cannot be guaranteed, as some or all of the ducts may need to be divided in order to free the nipple so that it is drawn out completely. The particular technique I use to correct inverted nipples was taught to me by my colleague and friend Dr. Grant Stevens, a plastic surgeon in Los Angeles, who is a pioneer in new techniques for procedures in breast surgery. The technique is safe, effective, has a short downtime, and the results are long-lasting. Before the procedure begins, the nipple and areola are numbed with an ice cube or pack, and a local anaesthetic given using a tiny needle the size of a hair. This means the patient experiences little or no pain, despite the sensitivity of the area.

The surgery itself is broken into 3 stages:

Stage 1: an incision measuring 4 to 5 mm is made in the lower portion of the nipple. The fibres or ducts are then released that are pulling the nipple down. The nipple is drawn out with much care in order to preserve the ability to breastfeed.

Stage 2: involves a series of stitches around the nipple.  If the nipple is imagined like a clock, the stitches run from 12 to 6 o’clock, then again from 3 to 9 o’clock.  By bunching up the tissue around the nipple, these stitches create a new pedestal for the nipple to rest on. A dissolving “purse-string” stitch is made around the base of the nipple, weaving in and out of the skin, which tightens the base of the nipple.

Stage 3: a small plastic “stent” – like a tiny medicine cup – is placed over the newly extracted nipple. This stent actually holds the nipple in place and ensures that the nipple heals in an outward position. Not only does it help with the nipples’ projection, but it also protects the nipple in the healing stages. This stent is kept on for 1 to 3 days. The patient then returns for a follow-up visit to remove the stent and the process is complete.

Post-operatively, there is little care needed. While the stent is on, patients cannot get the area wet and sexual contact is discouraged for the first week after surgery. Occasionally, the patient may need an ointment to aid the healing, although this is rare. The wound heals very quickly – to the point where the scar is usually invisible by the time the patient returns to have the stent removed (the stitches dissolve within 10 to 14 days). Possible complications include the retraction of the nipple or a local infection.

Although the correction of inverted nipples is a procedure that can greatly assist both the self-esteem of the sufferer and the function of the breast, more and more women are coming to my practice seeking nipple surgery for repair, correction, and enhancement of other conditions too:

  1. Enlarged nipples can be corrected with simple outpatient surgery reducing the length or diameter of one or both nipples.
  2. Reducing enlarged areolas is a quick fix as the areola can impact the appearance of the breasts more than any other feature.
  3. “Puffy” areolas put a cone-like cap on the breasts that some people find unattractive. A simple surgery can flatten the areola and beautify the breasts.

So despite the fact that nipples are usually hidden, women still want them to look attractive. Many women suffer with nipple and areola abnormalities such as inverted nipples, enlarged nipples, and puffy, enlarged or discoloured areolas.  Many of these conditions can impact breast function, but they all impact the way women feel about their bodies. The nipple can be repaired during outpatient surgery or during breast enhancement surgery.

Question:  Do women feel inverted nipples is such a big issue to warrant surgery?  You can leave a comment below.

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There are many reasons why women seek breast augmentation. Some women feel that increasing their breast size will give them greater self-confidence. Others would like to feel more proportional between their top and bottom so they fit better into their clothing. Mothers frequently seek breast augmentation to restore what was lost with breastfeeding and ageing. Supporting loose skin and giving upper breast fullness are also common reasons for choosing breast enlargement.

Good communication with patients in breast augmentation is key. There’s a need to review their medical histories and ask patients what their goals are for breast augmentation. In some cases, it is a modest increase in size to fit better in their clothing. Other times it’s a significant increase in volume to change their look. A patient may desire an improved breast shape or, possibly, better symmetry is their goal. Still others may want to restore their pre-pregnancy figure and may choose to combine their augmentation with a breast lift or other procedures.

On examining the patient, one needs to consider many features including breast volume, width, height, nipple position, areola size, ribcage curvature, skin tone, droopiness, asymmetry, and crease position. Breasts are highly variable, and I help the patient understand what their best options are based on their physical characteristics. We then come to a common agreement about what our goal will be. Remember, that “breast are sisters, not twins” so more often than not there is quite some variation between the two breasts so you can’t expect a perfect match following breast augmentation.

When the patient returns for their pre-operative visit, typically 1-3 weeks before surgery, I have them look through many digital photographs of breasts to show me their desired result. If there is a discrepancy between what we have discussed and what the patient is showing me with pictures, I’ll identify the difference and sort out what they really want, often using the 3D VECTRA which can simulate what the breasts may look like after augmentation. At the end of our meeting, I’m fairly confident that I understand what the patient desires. Likewise, the patient feels comfortable with our communication and our plan.

The photographs are then brought with me to the operating room. When the patient is asleep, I create the pockets for the implants on each of the breasts, and I occasionally use implant sizers to confirm the volume and shape of the optimal breast implants for the patient. Most patients are back to work and most of their usual routine in several days or up to a week. Strenuous exercise should be avoided for several weeks.

To learn more about breast augmentations, request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 

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Breast reduction surgery is considered to be medically necessary if a patient suffers from symptomatic macromastia. The typical criteria for health fund coverage of a breast reduction include: bothersome symptoms detrimental to quality of life, failure of medical therapy prescribed by another doctor, and removal of a minimum estimated weight of breast tissue.

Most health funds will cover this procedure for patients with these symptoms if they have attempted conservative medical treatment without success. The best way to determine if your procedure is medically indicated is in a consultation with me at the clinic.

To learn more about breast reduction, request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 

Breast Implants & Anaplastic Large Cell Lymphoma (ALCL)- No Cause For Alarm

Breast Implant & ALCL

Only recently described, breast implant–associated anaplastic large cell lymphoma (ALCL) usually presents as an effusion-associated fibrous capsule surrounding the implant and less frequently as a mass. Little is known about the natural history and long-term outcomes of such disease. It is estimated that between 5 and 10 million women have breast implants. Due to the rarity of a diagnosis of ALCL (3 in 100 million per year in the USA diagnosed with ALCL in the breast) a worldwide collaboration is required to provide robust data to investigate this possible link.

ALCL is a lymphoma and not cancer of the breast tissue. When breast implants are placed in the body, they are inserted behind the breast tissue or under the chest muscle. Over time, a fibrous scar called a capsule develops around the implant, separating it from the rest of the breast. In women with breast implants, the ALCL was generally found adjacent to the implant itself and contained within the fibrous capsule. ALCL is a lymphoma which is a type of cancer involving cells of the immune system. It is not cancer of the breast tissue.

The most recent clinical studies state that it is not possible to confirm with any certainty whether breast implants have any relation to an increased likelihood of developing ALCL, and particularly whether any one type of implant can create a higher or lower risk than another of developing the disease. It should be noted that ALCL is extremely rare and treatable. This is evidenced in particular by three recent papers:

  1. A Danish nationwide study – ‘Breast implants and anaplastic large-cell lymphoma: a Danish population-based cohort study’– concluded that in a nationwide cohort of 19,885 women who underwent breast implant surgery between 1973 and 2010, no cases of ALCL were identified
  2. A review of cases within another recent comprehensive article, ‘Breast implant-associated anaplastic large-cell lymphoma: long-term follow-up of 60 patients’ concluded that: “most patients with breast implant-associated ALCL who had disease confined within the fibrous capsule achieved complete remission. Proper management for these patients may be limited to capsulectomy and implant removal. Patients who present with a mass have a more aggressive clinical course that may be fatal, justifying cytotoxic chemotherapy in addition to removal of implants.”
  3. In a study reported in the Journal of Clinical Oncology, Roberto N. Miranda, MD, Associate Professor in the Department of Hematopathology at The University of Texas MD Anderson Cancer Center, and colleagues assessed disease characteristics, treatment, and outcomes in 60 cases. They found that outcomes are better in women with effusion confined by the fibrous capsule, whereas disease presenting as a mass has a more aggressive clinical course.Patients should be advised that ALCL is a very rare condition and until any further evidence is presented there is no need to remove breast implants as a matter of course.

 

These data suggest that there are two patient subsets. Most patients who present with an effusion around the implant, without a tumour mass, achieve complete remission and excellent disease-free survival. A smaller subset of patients presents with a tumour mass associated with the fibrous capsule and are more likely to have clinically aggressive disease. We suggest that patients without a mass may benefit from a conservative therapeutic approach, perhaps removal of the implant with capsulectomy alone, whereas patients with a tumour mass may need removal of the implants and systemic therapy that still needs to be defined.

 

We continue to advise that any women with breast implants who experience any sudden unexplained changes, lumps or swelling should speak to their GP or their surgeon.

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Breast reduction surgery patients are among the happiest of all plastic surgery patients because they both look better and feel better following surgery. When women have large, burdensome breasts, they frequently suffer from a condition called symptomatic macromastia. Symptomatic macromastia is considered to be a medical problem that may include the following symptoms:

  1. Pain in the neck, shoulders, breasts, and upper or lower back
  2. Bra strap indentations
  3. Rashes underneath the breasts
  4. Finger or hand numbness
  5. Difficultly exercising, fitting into clothing or examining the breasts

To learn more about breast reduction, request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 

Teenage Cosmetic Surgery: Why So Much Pressure?

 

There has been a storm brewing for some me now regarding teenage cosmetic surgery.  A concoction made up of quick fixes,  a society obsessed with beauty, and the commercialisation and overexposure of cosmetic surgery. This has all lent themselves to the growth of cosmetic surgery for  Generation  X and younger.  This has been further compounded by the increasing number of medical specialists entering the cosmetic arena.

My worry is that this Generation X and their successors wanting teenage cosmetic surgery may become an abused marketplace.  It would appear that they have it a little easier, in the sense that, they have parents or relatives who have had cosmetic surgery and are approving of it, in an economy that has been both buoyant and robust for some time now.  This takes away from the fact, that teenage cosmetic surgery needs much more scrutiny because it can play on people’s insecurities and promises of an instantly better life.

Most plastic surgeons I believe are responsible individuals with a conscience who try and counsel teenagers, usually in front of their parents, of the risks, benefits, and outcomes of procedures, as well as whether they are appropriate or not. They try very hard to show that TV programs like Extreme Makeover,  Dr.  90210  and  The Swan trivialise and glamourise cosmetic surgery and that glossy magazines like Teen Vogue or Teen Cosmo display airbrushed photos of models and celebrities that are in reality unachievable.

Now teenagers who want to have cosmetic surgery usually have different motivations and goals than adults.  They too have cosmetic surgery to improve physical characteristics they feel are awkward or flawed,  that if left uncorrected, may affect them well into adulthood.  Teens tend to have cosmetic surgery to fit in with peers, to look similar.  Adults tend to have cosmetic surgery to stand out from others.  Teenagers frequently gain self-esteem and confidence when their physical problems are corrected.  In fact, successful teenage cosmetic surgery may reverse the social withdrawal that generally accompanies teenagers who feel different.  Not every teenager seeking cosmetic surgery is well suited for an operation.  Teenagers must demonstrate emotional maturity and an understanding of the limitations of cosmetic surgery.

I would caution teenagers and parents to keep in mind that cosmetic surgery is real surgery, with great benefits, but also carries some risks. Teenagers should have realistic expectations about cosmetic surgery and what it can do for them. In addition, certain milestones in growth and physical maturity must be achieved before undergoing cosmetic surgery. The most rewarding outcomes are expected when the following exist:

  1. The teenager initiates the request.
    The young person must appreciate both the benefits and limitations of cosmetic surgery, avoiding unrealistic expectations about life changes that will occur as a result of the procedure.
  2. The teenager has realistic goals.
    While parental support isn’t lessened at all, the teenager’s own desire for cosmetic surgery must be clearly expressed and repeated over a period of time.
  3.  The teenager has sufficient maturity.
    Teenagers must be able to tolerate the discomfort and temporary disfigurement of a surgical procedure.  Cosmetic surgery is not recommended for teens who are prone to mood swings or erratic behavior, who are abusing drugs and/ or alcohol, or who are being treated for clinical depression or other mental illness.

Some of the commonest teenage cosmetic surgery procedures include:

  1. Rhinoplasty (nose reshaping)

Cosmetic surgery may be performed on the nose to straighten the bridge, remove an unsightly hump, reshape the point or open breathing passages. Ordinarily, this is not performed until the nose reaches its adult size –  about age 15 or 16 in girls and a year later in boys. The procedure accounted for nearly 50 percent of all cosmetic surgical procedures performed on this age group.

2.Otoplasty (ear surgery)

Surgical correction of protruding ears, in which the ears are pinned back, may be performed any time after the age of five. Otoplasty made up 11 percent of all cosmetic surgical procedures performed on this age group.

3. Correction of Breast Asymmetry

When one breast grows to a much larger size than the other, an operation may correct the difference by reducing the larger breast, augmenting the smaller, or both. Many teenagers who want breast augmentation tend to have one breast that is larger than the other – sometimes a full cup size or more in difference. This condition is called breast asymmetry. Using a breast implant in the smaller breast allows the patient to have breasts of the same size. Although waiting may prolong the physical awkwardness, it is advisable to delay surgery until breast growth ceases in order to achieve the best result.

4. Breast Augmentation

Breast implants can be used for breast augmentation in women 18-years or older and for breast reconstruction.

Many teenagers who want breast augmentation to have one breast that is larger than the other -sometimes a full cup size or more in difference. This condition is called breast asymmetry. Using a breast implant in the smaller breast allows the patient to have breasts of the same size. Although waiting may prolong the physical awkwardness, it is advisable to delay surgery until breast growth ceases in order to achieve the best result.

5. Breast Reduction

Surgical reduction of very large breasts can overcome both physical and psychological burdens for a teenage girl.

In fact, many teenagers suffer ongoing back pain due to overly large breasts. Although waiting may prolong the psychological awkwardness, it is advisable to delay surgery until breast growth ceases in order to achieve the best result.

6. Acne and Acne Scar Treatment

Acne eruptions may be controlled by the proper use of modern prescription drugs. In addition to supervising the use of these medications, plastic surgeons may improve acne scars by smoothing or “refinishing” the skin with a laser or with a fine sanding technique called microdermabrasion. Other treatments for acne related skin problems include laser skin resurfacing, dermabrasion, and chemical peels.

7. Male Breast Reduction (Gynaecomastia)

Teenage boys with large breasts, known as gynecomastia, are often eager to undergo plastic surgery. Surgical correction can be accomplished in a variety of ways including liposuction and/or surgical excision of the breast tissue.

As a plastic surgeon, I am an advocate for the right teenage cosmetic surgery, at the right time, and for the right reason. Things like correction of prominent ears, breast reduction in adolescent boys or breast reconstruction in young girls with an underdeveloped breast can truly advance the person’s quality of life. It is our responsibility as plastic surgeons to guide teenagers (and their parents) in the right direction and to educate them that cosmetic surgery is not a panacea for the everyday pressures that teenagers’ face. Cosmetic surgery can make you more attractive but not necessarily happier!

Question: What do you think is the commonest reason teenagers want cosmetic surgery? You can leave a comment below.