Breast augmentation This is accomplished by inserting an implant either behind the breast tissue (subglandular) or behind the muscle beneath the breast (subpectoral). The commonest approach is through a short incision in the crease under the breast. The implants most often used are silicone. Earlier concerns about silicone have been put to rest. A large range of implants is available and the best is selected on the basis of the breast dimensions and the woman's wishes. The fold beneath the breast needs to be dropped to accommodate volume expansion and prevent the nipple pointing down. Complications are uncommon but formation of a fibrous capsule around the implant still occurs despite the use of modern textured implants. Breast reduction There are a variety of techniques for breast reduction (reduction mammoplasty). The most common involves an anchor shaped incision with the anchor pointing down from the nipple. Smaller reductions can be achieved through a simple vertical incision (Lejour). The extent of the reduction is determined by the need to preserve a pedicle of breast tissue to keep the nipple alive. Scars on the breast can stretch over time to give variable results, but symptoms of breast hypertrophy are as a rule successfully relieved. According to the approach, patients may require a few days in hospital to recover from surgery.
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