Breast surgery covers a wide range of procedures performed for medical reasons, such as treating cancer, and for cosmetic or reconstructive purposes. Operations can vary from removing cancerous tumors to altering the size, shape, or appearance of the breasts.
Medical and preventative breast surgeries
Lumpectomy: This is a breast-conserving surgery that removes only the cancerous tumor and a small margin of healthy tissue around it.
Mastectomy: This procedure involves removing the entire breast, including all the breast tissue.
Total (simple) mastectomy: The surgeon removes the entire breast but leaves the chest wall muscles intact.
Modified radical mastectomy: The entire breast is removed along with most of the lymph nodes under the arm.
Radical mastectomy: This is a more extensive procedure that removes the entire breast, chest wall muscles, and all underarm lymph nodes.
Nipple-sparing mastectomy: The breast tissue is removed, but the skin, nipple, and areola are preserved, which can improve the cosmetic result of immediate reconstruction.
Prophylactic (preventive) mastectomy: This surgery removes one or both breasts to prevent cancer in individuals with a very high risk, often due to a strong family history or a genetic mutation like BRCA1 or BRCA2.
Lymph node surgery: This is performed to determine if cancer has spread to the lymph nodes.
Sentinel lymph node biopsy (SLNB): The surgeon removes only the first one to three lymph nodes that receive drainage from the tumor. This reduces the risk of side effects like arm swelling (lymphedema).
Axillary lymph node dissection (ALND): A larger number of underarm lymph nodes are removed.
Surgical breast biopsy: A small sample of breast tissue is removed for laboratory testing to diagnose a potentially cancerous lump.
Cosmetic and reconstructive breast surgeries
Breast augmentation (Augmentation mammoplasty): This surgery increases breast size and improves shape and contour, most often using implants. It can also use fat taken from another part of the body (fat grafting).
Breast reduction (Reduction mammoplasty): This procedure removes excess fat, breast tissue, and skin to reduce breast size, often to relieve physical discomfort like back, neck, and shoulder pain.
Breast lift (Mastopexy): This procedure lifts and reshapes sagging breasts by removing excess skin and tightening the surrounding tissue.
Breast reconstruction: This rebuilds the breast's shape following a mastectomy or lumpectomy.
Implant-based reconstruction: Saline or silicone implants are used to recreate the breast mound, often in a two-stage process using a tissue expander first.
Flap reconstruction (Autologous tissue reconstruction): The surgeon uses a flap of tissue, including skin, fat, and blood vessels, from another part of the body (such as the abdomen or back) to create a new breast.
Nipple and areola procedures: These are used to create or reshape the nipple and areola after surgery.
Considerations for breast surgery
Risks: As with any surgery, risks include bleeding, infection, and reactions to anesthesia. Specific risks depend on the procedure but can include scarring, changes in sensation, and implant-related issues.
Consultation: Before surgery, a patient meets with their surgeon to discuss goals, medical history, and treatment options. It is important to have realistic expectations about the results.
Recovery: The recovery time depends on the specific procedure. Patients will receive post-operative instructions for wound care and activity restrictions. Support bras or bandages are often used to aid healing.
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