Breasts are one of the most defining features of a woman’s figure and there is little doubt that the size, shape and appearance of the breasts influences how women feel about their bodies and is part of their self esteem. Factors such as genetics, weight gain or loss, pregnancy and aging tend to change the size, shape, and overall appearance of the breast. Breast enhancement surgery is as diverse in procedures and outcomes as women are in appearance: from reducing large breasts and enhancing small breasts to lifting sagging breasts and restoring a breast disfigured by or lost to disease.

Breast surgery is a highly emotional and fulfilling experience for many women. According to the American Society for Aesthetic Plastic Surgeons (ASAPS), 678,705 women underwent breast augmentation, lift or reduction in 2007; additionally over 57,000 women chose breast reconstruction. Results for many of these women are a more positive body image and enhanced self-confidence.

There are many different options and choices. The first and most important is selecting a board-certified plastic surgeon you can trust and develop a good rapport so that you can openly discuss your concerns and particular needs throughout the process of consultation, surgery and aftercare.

While you may have an idea of what you want your ideal breast to look like, it is important to know that what nature has given you may influence the outcome you are hoping to achieve. Every woman’s breasts have unique attributes such as size, shape, nipple position and degree of sag. During your consultation with Dr. Jewell, he will take measurements to help qualify and quantify the differences that you may have. Ask him to show you before / after pictures that have similarities to help you visualize an expected outcome. As an expert in breast surgery, he will try to match your wishes to your tissues.

Breast augmentation enhances the size and shape of a woman’s breast with a surgically-placed implant. There are several choices that need to be made by you and Dr. Jewell as you develop a plan for surgery including: type, size and shape of the implants, incision location, and implant location. Breast implants that are approved by the FDA are made of materials that have been researched and are deemed safe for placement in the human body. Implants have a smooth or textured silicone shell and the shell shape may be round or contoured. The varying implant shapes and sizes available allow each woman seeking breast augmentation surgery to obtain optimal long-term results. Dr. Jewell offers saline, conventional silicone gel and the new form-stable, shaped implants.

Dr. Jewell is currently in two FDA-approved studies for the form-stable cohesive silicone implants. You may have heard them referred to as “gummy bear” implant, but don’t be fooled by the novel name-unlike the candy these cannot be pulled and stretched, the form stable cohesive gel implants maintain their shape once inside the body. This allows them to maintain a tapered edge to the upper breast and maximum projection where it is most needed.

The decision about the location of the incision, is best done after a physical examination with your surgeon, as it is interrelated with the choice of implants. The three most acceptable locations are: in the fold of the breast (Inframammary incision), around the nipple (Periareolar incision), and in the arm pit (Axillary incision).

Implant location is either above or below the pectoralis muscle. Subglandular is above the muscle and under the breast tissue. Submuscular implant placement is placed below the pectoral muscle and the overlying breast tissue. Dr. Jewell helps each of his patients decide what is best for them as there are many factors that influence this particular decision. Sagging, quantity of native breast tissue, recovery, and activity level are just some of the factors that need to be considered when planning surgery.

Breast lift, also called a mastopexy, is an operation to decrease sagging of breasts following pregnancy, weight loss, or when it is a factor of heredity. You may be a good candidate for a lift procedure if your breasts are pendulous (nipples positioned below the inframammary fold or breast crease), lack substance or firmness, and your nipples point downwards and are positioned below the inframammary fold. Incisions for this procedure will vary with the amount of sag that exists and the amount of lift desired. To correct sagging, incisions are made to sculpt the breast, reduce excess skin and raise the nipple-areola complex to a more desirable position. A mastopexy may be performed as a solitary procedure or be combined with size enhancement (augmentation-mastopexy). It is recommended that a woman considering a breast lift procedure have completed child bearing, as future pregnancy could stretch out breast skin again. This operation is for non-smokers or individuals who have been nicotine free for 3 months.

For many women, large breasts have a negative affect on health, quality of life and self esteem. Breast reduction, also called a reduction mammaplasty, enhances your overall appearance by making your breasts more proportional to the rest of your body. Large, heavy breasts often interfere with normal physical activities and cause musculoskeletal pain. Breast reduction is generally considered a reconstructive plastic surgery procedure. Insurance coverage for breast reduction is defined by individual insurance companies.

In addition to alleviating physical problems, it improves the shape of your breasts and the nipple areas. By removing excess tissue and fat, the breast is sculpted into a smaller shape. The nipples, still attached to their blood/nerve supply and not removed, are repositioned up onto the firmer breast. In some cases, Dr. Jewell will use Vaser® liposuction to remove fat in and around the breast.

In some cases, this operation can be performed on younger females prior to child bearing. A consultation with Dr. Jewell will help understand the impact of reducing excessively large breasts and finding the best time in a woman’s life for surgery. Most patients’ incisions heal well with time after breast reduction, but normal visible scars are a trade-off for better proportion and improved physical quality of life. This operation is best performed when a woman is close to her normal body weight, as weight fluctuations will impact the long term results from this procedure. This procedure is for non-smokers or a woman who has quit the use of nicotine for a minimum of 3 months.

Facing breast cancer and the disfigurement it bears is heartbreaking for many women. Breast reconstruction following breast cancer surgery can be physically and emotionally rewarding for women. Reconstruction of a breast that has been partially or completely removed is possible through a combination of plastic surgery techniques. Breast reconstruction following a masectomy involves a number of procedures that are performed in multiple stages. Having a plastic surgeon involved in your case prior to a masectomy is beneficial. Reconstruction can be performed immediately after the cancer operation or delayed; the timing of your reconstruction depends upon the cancer treatments recommended for you.

Breast reconstruction attempts to restore a breast to near normal shape, appearance and size following a masectomy. Dr. Jewell’s first choice for his patients’ reconstruction is the use of an implant following tissue expansion technique; as it is usually shorter procedures that require the least amount of recovery and downtime. An expander is placed beneath the chest muscle and is filled with sterile saline solution over many weeks, creating enough healthy tissue to cover the breast mound. The tissue expander is then replaced with a new implant that feels and is shaped like a breast. After a few months, you can choose to reconstruct a nipple and tattooing can be done to color the areola. Dr. Jewell also performs surgery on the opposite-side breast to help it match the size of the reconstructed breast.

Flap reconstruction can be done also; however, there are many pros and cons that are based on your body type, breast cancer surgery and subsequent breast cancer treatments.

Overall health and personal outlook can greatly impact the outcome of reconstructive surgery. Honestly share your expectations and fully disclose your health history, medications, usage of vitamins and herbals. This procedure is for non-smokers or those who are nicotine free for a minimum of 3 months.

Women who already have breast implants may require surgery to maintain their outcomes, remove or replace the implants. Dr. Jewell offers all forms of breast revision surgery.

Gynecomastia is a condition of over-developed or enlarged breasts, which is common in men at any age. It may be the result of hormonal changes, heredity, disease or the use of certain drugs. Excess localized fat, excess glandular tissue development or a combination of both produce enlargement of the male breast. Enlarged breasts in obese men, is generally not categorized as gynecomastia. Gynecomastia in adolescent and adult males may be more than a physical problem; it can cause problems with self-confidence.

Plastic surgery to improve gynecomastia is technically called breast reduction for men. This can be performed at any age but is best when a male’s overall physical growth is complete. Dr. Jewell often is able to use Vaser® liposuction alone to remove the fat. Through small incisions around the perimeter of the breast, a cannula is inserted to loosen and suction excess fat deposits. Excision techniques are used when there is significant glandular breast tissue or excess skin needs to be removed to enhance chest contours. In some cases both liposuction and excision techniques are used to provide a better masculine chest contour.