Aesthetic Breast Surgery

Breasts

As a member of the Center of Excellence of Breast and Reconstructive Surgery at Cedars-Sinai Hospital, Dr. Rogers teaches plastic surgery fellows the intricacies of aesthetic surgery and routinely performs post-mastectomy breast reconstructions for cancer survivors. His ongoing experience in reconstruction enables Dr. Rogers to be at the forefront of aesthetic breast procedures for both cosmetic and reconstructive cases.

Breast surgery encompasses many different procedures. To the left please find a list of the breast surgery options at Leif Rogers, M.D., FACS Plastic Surgery. Click on a title for more information about a specific procedure.

Whatever your breast surgery needs, Dr. Rogers’ skill is your best asset for achieving the results you want.

Fat Grafting to the Breast

Today there is an array of breast augmentation choices. The two most commonly known choices are saline and silicone implants. However, Dr. Rogers provides a new form of breast augmentation, which allows patients to move undesired fat from certain areas of their body and transfer it to their breasts. This procedure is called “implant-free breast augmentation”. Implant-free breast augmentation can be performed for cosmetic purposes, but can also be used to reconstruct deformities or repair previous breast implants. Because the breasts are augmented using the patient’s own fat the results can offer a more organic look and feel than other techniques.

What does an “implant-free breast augmentation” entail?

Have you ever stared into the mirror and wondered, “Why can’t the fat in my tummy just move to my breasts?” Now it can! This is basically how an implant-free breast augmentation works. The implant-free breast augmentation is performed in a two-part procedure. Prior to surgery patients may be instructed to wear a tissue expander. Much like a breast pump, the tissue expander contains a vacuum that gently applies a three-dimensional pull on the breasts. This pressure causes cells to replicate and gradually create new tissue over the entire breast area, which later aids the transplant procedure.

Part One, Harvesting: A liposuction procedure is done to remove fat from unwanted areas of the body (i.e. the butt, thighs, or stomach areas). Next, the fat stem cells are extracted from the fat and centrifuged for refinement. This can range anywhere between fifteen minutes to a few hours, depending on the amount of fat needed for transfer. Purifying the fat then removes impurities increasing the likelihood of a successful cell transfer. After this transformation, the fat cells are ready to be re-injected into the breasts.

Part Two, Injecting: In a four to six hour procedure, the refined fat is carefully injected into the breast. This is done in a series of small injections to allow the surgeon to sculpt each breast. The fat is injected into the layers of the breast by way of six to eight incisions in each breast that are roughly two-millimeters in size (slightly larger than a pen mark). The fat is injected into the space between the skin and the breast capsule and/or into the space between the breast and chest wall. The injections are layered from the pectoralis major muscle up through the top of the breast. Blunt syringes and cannulas (small tubes that can be inserted into the body) are used to administer the fat into the breasts. These are used to avoid damage to blood vessels and nerves. In order to survive in their new location, the transplanted fat cells need to be able to establish a blood supply.

Implant-free breast augmentation is a less invasive augmentation technique that has a recovery time of approximately 48 hours. Implant-free breast augmentation is less likely to interfere with future mammograms than implant-based breast augmentation. Since the fat cells come from the patients own body there are fewer risks of rejection or allergic reaction. However, if a substantially larger breast size is desired a saline or silicone implant should be considered. The implant-free breast augmentation is not recommended for increasing the breasts by more than two cup sizes.

During the procedure fat cells will be over-injected to compensate for the possibility that necrosis (cell death) may occur, resulting in a decrease of fatty tissue. In an implant-free breast augmentation, the fat cells that are injected into the breasts are living, so unlike saline or silicone implants, the size of the breasts will fluctuate in accordance to weight loss and gain.

If you are interested in enhancing your breast without implants and without the possibility of rejection or allergic reaction, implant-free breast augmentation may be the answer for you.

Augmentation Mammaplasty

For those seeking larger breasts with implants, Dr. Rogers offers a large variety of choices for his patients, including saline and silicone implants, as well as trans-umbilical breast augmentation (TUBA).

Saline Implants

Saline implants are the least expensive and typically entail the smallest incision since the implant is filled after insertion and is the only option should a patient desire insertion through the navel area for a scar-free result.  Saline, or sterile salt water, is used to fill the implants.

Silicone Implants

Silicone filled implants offer an organic feel and are generally less likely to ripple than saline filled implants. All implants used since November 2006 are made of cohesive silicone gel as opposed to the liquid silicone previously used. The benefit of cohesive gel is that should rupture occur, the gel will not run.

Trans-Umbilical (TUBA) Method

Trans-Umbilical Breast Augmentation (TUBA) is a scar-less or belly button breast augmentation method for increasing the breast size by inserting breast implants through the umbilicus, navel or belly button. This method offers minimal scarring and will often require less recovery time.

Dr. Rogers will consult with each patient to discuss their desired outcome to determine which procedure is most appropriate.

Mastopexy

After child bearing, nursing, or extreme weight loss, breasts can lose volume and sag. A breast lift can restore firmness and shape. A breast lift can usually be performed on breasts of any size, but results may not last as long in larger breasts and may require a breast reduction to achieve the best results. However, if you’re planning on having children, are currently nursing, or intend to lose 20 pounds or more in weight, these factors may offset the results of a breast lift procedure.

Dr. Rogers’ extensive experience with reconstructive surgical techniques will be your best asset when making choices for breast lift and he will work closely with you to insure the best possible outcome.

If you are uncomfortable with the condition of your breast and are interested in restoring a more youthful appearance to your body, a breast lift may be the answer for you.

Reduction Mammaplasty

Breast reduction surgery is a surgical procedure that reduces the volume of tissue and fat in the breasts. Naturally large breasts can cause physical discomfort and even difficulty with breathing. Some women may feel awkward and self-conscious about the proportion of their breasts in comparison to the rest of their body. Breast reduction surgery can alleviate pain and make performing daily activities easier. This procedure can also result in a more aesthetically appealing and proportional silhouette. The breasts are lifted and the shape and firmness of the breasts are enhanced with breast reduction surgery. Breast reduction procedures can only be performed on patients whose breasts are fully developed.

For some patients who only need fatty tissue removed, liposuction can be performed to reduce the size of the breasts. Although this method does not result in dramatic results, it is less invasive.

For those struggling with the discomfort of overly large breasts, breast reduction surgery may be the answer for you.

Gynecomastia

Gynecomastia is the abnormal development of tissue and/or glands in the male breast. The condition is fairly common in adolescence and in the elderly, but over development of breast tissue can occur in men of any age due to medications, hormone imbalances, obesity and other factors. Enlargement usually occurs on both sides of the chest. If it is one-sided, firm and hard, see your doctor immediately to rule out male breast cancer. Male breast cancer is rare; less than 1% of all breast carcinomas occur in men. The mean age at diagnosis is between 60 and 70 years, though men of all ages can be affected with the disease. Although gynecomastia is much more common than breast cancer in men, both can be felt as a growth under the nipple, which is why it’s important to have any such lumps checked by your doctor.

For common gyecomastia a root cause is difficult to determine and varies from individual to individual. Gynecomastia has generally been attributed to an imbalance of sex hormones or an imbalance of estrogenic and androgenic effects on the breast. Diseases of the liver, which is an important organ in male and female hormone metabolism, can change a man’s hormone balance and lead to gynecomastia. Obesity can also cause higher levels of estrogens in men. Overuse of steroids is another known cause.

Gynecomastia can be psychologically challenging. While the appearance of overdeveloped breast tissue in men is not physically harmful, the psychological effects can be difficult to overcome. Many men have trouble discussing concerns about their bodily appearance and gynecomastia presents a particularly difficult subject to talk about openly. It is important for anyone dealing with a psychologically distressing issue to open up to a doctor. Talking with a professional can be a powerful antidote for negative feelings and is the beginning point for the healing process. For many men struggling with gynecomastia the best solution is medical treatment.

Treatments for gynecomastia include surgery, liposuction and non-surgical ultrasound massage or a combination of these procedures. Liposuction and ultrasound massage can address fatty tissue build up in the breast and surgery is used to reconstruct the contour of the chest.

The first step for treatment is a consultation with a board-certified plastic surgeon. This evaluation will determine if you are a good candidate for male breast reduction. Before treatment certain diagnostic testing will be done to help determine the underlying cause of the condition. In general, the best candidates for surgery are healthy men of relatively normal weight whose breast development has stabilized.

For physically active men whose attempts to lose the fat around the breast area with an exercise or weight loss program have not succeeded, surgical treatment may be the best option.

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