Breast augmentation, or a boob job as the surgery is more commonly known, is the most popular plastic surgery procedure carried out. Every year women of all ages choose to have breast augmentation to improve their breasts and how they feel about them. A boob job looks to enhance a woman’s breasts rather than striving for perfection; as a result, the surgery is often referred to as breast enhancement.

As suggested by Dr Rey, in 2016, it’s recommended for girls to take pictures of their breast in their late teens if they are happy with them as “this will make our plastic surgeons’ job much easier in giving you back what you are aiming for”.

Breast augmentation means mainly adding volume and possibly change shape while also improving position or symmetry. Any additional procedure will come under the name of symmetry surgery, breast lift or similar.

WHAT CAN BREAST AUGMENTATION ACHIEVE?

• Enhance your body contours, if for any reason, you feel your breasts are too small.
• Correct a reduction in breast volume or shape after pregnancy.
• Balance the size and shape of your breasts.
• Reconstruction after another breast surgery.

WHAT ARE THE ALTERNATIVES TO BREAST AUGMENTATION?

The goals of your surgery will dictate the most appropriate procedure for you. In some instances, a breast lift will be recommended instead of, or alongside a breast augmentation procedure.

BEFORE YOUR BREAST AUGMENTATION

When it’s time for your surgery we want you to feel as relaxed and comfortable as possible and this starts with establishing good communications between you, your surgeon and the clinic team. You will meet the surgeon during your consultation, when you will be able to discuss your personal circumstances and seek further information and advice.

DURING YOUR CONSULTATION, YOU WILL:

• Have the opportunity to explain your reasons for seeking breast surgery
• Be given the opportunity to pose questions to Dr Cotrufo
• Undergo a health evaluation
• Have a full assessment of your chest area, asymmetry and how this is affecting your decision.

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If you had previous breast plastic surgery, it could be very difficult to say what is best for you. Dr Cotrufo has 5 star reviews on Google and RealSelf for revision breast surgery. Nevertheless, if you are not 100% on his surgical plan, Dr Cotrufo will support you in seeking a second or third advice from “independent practitioners” to sort out your doubts. Dr Cotrufo will always refer to European or UK board certified plastic surgeons.

BEFORE YOUR BREAST AUGMENTATION SURGERY:

In the weeks leading up to your procedure and the days immediately prior to it, you may be asked to make some small changes to your lifestyle or to avoid particular medications or activities.

This may include:

• Taking a blood test or other medical tests.
• Stopping smoking.
• Adjusting or taking certain medications.
• Avoiding aspirin, herbal supplements and anti-inflammatory drugs.
• Refraining from drinking alcohol.
• Avoiding overexposure to the sun, particularly to your face area and wearing a hat.
• Committing not to make stringent changes to your diet.

Those undergoing general anaesthetic will need to follow specific fasting instructions (usually nothing by mouth six hours before the surgery).

THE BREAST AUGMENTATION PROCEDURE

• The surgery time will depend on the anaesthesia and breast augmentation technique used, generally about 1.30 hours for a dual plane (both breasts) technique.
• Usually, an incision will be made in the crease where the breast meets the chest, around the areola or in the armpit.
• Your surgeon will lift the breast tissue and skin to create a pocket, either directly behind the breast tissue or underneath your chest wall muscle.
• The implants are then inserted and centred beneath your nipples.
• Sutures are used to close the incisions. When you wake up you may also find these have been taped for greater support.

AFTER YOUR BREAST AUGMENTATION

Once you have been discharged from the clinic, we strongly advise you to have a friend or relative drive you home and help care for you as you recover.

•  You should avoid alcohol.
• All strenuous exercise must be avoided for around 1 month and you should avoid eating hot and spicy foods.
• You will need to care for your wounds as advised by the clinic.
• You will need to attend aftercare appointments with Dr Cortufo, who will also be available to discuss your progress via telephone.
• A support bra must be worn for the first six weeks.
• Swelling should subside approximately 7-21 days after surgery.

STILL HAVE QUESTIONS ABOUT BREAST AUGMENTATION?

If you would like to discuss your suitability for surgery or to discuss the breast augmentation procedure in further detail, please call our clinic on 0207 8732330 to organise a personal consultation.

WHAT CAN BREAST REDUCTION ACHIEVE?

• Ease back, neck and shoulder pain from excessive breast weight.
• Reduce excessive sweating, rashes or infection under breasts (including hyperhidrosis).
• Back to any sporting activities and physical exercise.
• Allow you to wear a greater variety of clothes.
• Realign droopy breasts.
• Even/improve the symmetry between your breasts.

WHAT ARE THE ALTERNATIVES TO BREAST REDUCTION?

If your breasts are sagging, your surgeon may recommend a breast lift alongside a reduction. If the breast needs to be lifted but the volume is not adequate, Dr Cotrufo might recommend adding an implant immediately or in a second stage.

BEFORE YOUR BREAST REDUCTION:

Good communication between you and your surgeon is essential. It will help you to establish the best procedure for your goals and reassure and relax you throughout your surgery journey. This begins with your consultation.

Dr Cotrufo will present different prospective pictures to show you how surgery will change your profile. You will always be invited for a second and third consultation before proceeding with your surgery; and if you are not sure about the surgical technique or any other aspects of your procedure, Dr Cotrufo will refer you to other trusted physicians for second opinions.

The usual advice is that: the more you reduce, the longer you will keep the result. “The heavier the breast, the faster it will drop down…. We don’t have instruments to fight against the force of gravity.”

DURING YOUR BREAST REDUCTION CONSULTATION:

Dr Cotrufo will discuss with you what will happen before, during and after your procedure.

You will:

• Have the opportunity to explain your reasons for seeking breast reduction surgery and score it from 0 to 10.
• Be given the opportunity to pose questions to Dr Cotrufo.
• Undergo a health evaluation and assessment of your chest area, including specific measurements and discussion of minor/major asymmetry.
• Discuss the options that best suit your needs, including breast implants, two stages procedure, costs and timescales.

In the weeks prior to your surgery, you may be asked to make some small changes or to avoid particular medications or activities.

This may include:

• Taking a blood test or other medical tests (usually at the time of booking to find out about any abnormalities).
• Stop smoking.
• Adjust or taking certain medications.
• Avoid aspirin, herbal supplements and anti-inflammatory drugs.
• Refraining from drinking alcohol (usually 1 week for not-alcoholic).
• Avoid overexposure to the sun.
• Committing not to make strict changes to your diet: complete diet is essential for proper healing, at least for 6 weeks after surgery.

When breast reduction is carried out under a general anaesthetic you will be required to follow fasting instructions before the surgery. This generally invites you to have “nothing by mouth” for the 6 hours before surgery.

THE BREAST REDUCTION PROCEDURE:

• The time and steps of a breast reduction surgery will differ according to how much excess breast gland, fat and skin are removed and whether any other procedure is being carried out.
• Dr Cotrufo can perform excellent breast reduction surgery with different shape of incisions in order to achieve the best outcome and reduce the amount of residual scar.
• Excess glandular tissue, fat and skin is removed and the nipple and areola are repositioned into a higher position.
• Liposuction may be used to remove excess fat around the breast/chest wall area.
• Most often, the nipples stay attached to vessels and nerves coming from the breast gland, however, in some cases they may be damaged. Some extreme cases are associated with high risk of vascular failure and should be addressed for free nipple graft.
• Free nipple graft is a procedure in which the nipple-areolar-complex (NAC) is completely detached from the gland (keeping its original “hat” conformation”) and then replanted as a skin graft where it is calculated to be in its best “new” location. NAC grafts can restore some “touch” (or sensory) function with time. They often become flatter than they were originally, so that the nipple prominence is not obvious any longer. NAC graft is still a very reasonable option when the breasts are very large and very low.

AFTER YOUR BREAST REDUCTION:

After your operation, you will likely be required to stay in the clinic for a period of 24 to 48 hours.  When you wake up, you may find you have a drip in your arm to keep you hydrated and small drainage tubes inserted beneath the skin to prevent fluid buildup, these will be removed before you are discharged.  We advise you to have a friend or relative drive you home after your discharge, so they can care for you during your breast reduction recovery period. After that:

• You will need to wear a supporting bra day and night for around 6 weeks: the risk otherwise is that your scars will stretch under the weight of your breast.
• You should start walking around as soon as possible to reduce swelling and to help prevent blood clots.
• You will be able to return to work a few days after surgery,  particularly when no implants or drains are used.
• After 7-10 days following surgery, your stitches will be removed. Dr Cotrufo uses dissolving sutures in breast reduction so you will just need a quick check up.
• Bruising should subside 7-14 days after surgery. The final breast volume is often obvious at six weeks. It is also important to use the support garment for as long as possible: even longer than 3 months (ideally you should keep in touch with Dr Cotrufo and make sure you are following the right path).
• You will need to avoid strenuous exercise for around one month.
• Heavy lifting should be avoided and you will need to lie on your back.
• You will attend scheduled aftercare appointments with Dr Cotrufo who will monitor your progress and advice carefully of your progression: safety first.

DO YOU STILL HAVE QUESTIONS ABOUT BREAST REDUCTION?

Choosing breast reduction surgery is a very personal matter and one that shouldn’t be taken lightly. Dr Cotrufo is an expert in plastic and reconstructive microsurgery and will certainly give you the best advice.

In addition to performing hundreds of successful breast surgery procedures, he has spoken on the topic of breast procedures at meetings of the Oncoplastic and Reconstructive Breast Surgery and European Society of Plastic Surgery. He is frequently asked to act as a consultant surgeon at some of the UK’s leading hospitals and has also provided advice to the medical supply industry about the latest trends in breast surgery. Should you have any queries or want to discuss your options further, you can organise a personal consultation with Dr Cotrufo by calling our clinic on 0207 8732330.

If you feel self-conscious and have a lack confidence in the appearance of your chest area because of your nipple-areola, Dr Cotrufo can advise you on how to get the overall appearance you are looking for.

WHAT CAN AN AREOLA REDUCTION ACHIEVE?

• A smaller and neater looking areola
• Confidence in the appearance of your nipples

WHAT ARE THE ALTERNATIVES TO AREOLA REDUCTION?

Our surgeon will speak with you about any possible alternatives to nipple surgery that may better suit your individual requirements. This will occur in your consultation.

BEFORE YOUR AREOLA REDUCTION SURGERY?

Every areola reduction surgery is different, depending on the needs of the patient. That’s why establishing good communication between you and your surgeon is an essential part of a relaxed and comfortable surgery experience. This starts with your consultation.

DURING YOUR AREOLA REDUCTION CONSULTATION, YOU WILL:

• Have the opportunity to ask Dr Cotrufo questions about the surgery
• Explain your personal reasons for seeking areola reduction surgery
• Undergo a full health evaluation and chest examination
• Discuss the surgical options that are open to you, as well as costs and timescales

To make sure you are in the best health before your surgery, the surgeon and clinic team may ask you to make some important lifestyle changes in the run up to the surgery.

This can include:

• Refraining from any stringent diets
• Stopping smoking
• Adjusting or stop taking certain medications
• Stopping drinking alcohol
• Avoiding aspirin, herbal supplements and anti-inflammatory drugs
• Being careful while in the sun, being careful not to suffer overexposure to the chest area

THE AREOLA REDUCTION PROCEDURE:

• Areola reduction surgery can be performed under local anaesthetic and normally takes about 1 hour.
• The incisions are normally made in circles around the edges of the areola, your surgeon will then remove excess tissue and skin from the surrounding area
• The incisions are closed with sutures around the areola; which are pulled in, tightening the surrounding skin

AFTER YOUR NIPPLE SURGERY:

You will usually be able to return home the same day, though we do advise that a relative or friend accompany you.

After that:

• You should walk as soon as you feel able
• You are likely to feel tired and sore for a few days following your surgery, but you will be up and around in 24 to 48 hours
• You should be able to return to work within a few days of surgery
• You may notice some bruising around your areolas, which is to be expected and will subside about 10-14 days after surgery
• You should avoid vigorous exercise and heavy lifting for several weeks
• It is important that the surgical incisions are not subjected to excessive force, abrasion or motion during the time of healing
• You will need to attend scheduled aftercare appointments with Dr Cotrufo, who will monitor your recovery and progress

STILL HAVE QUESTIONS ABOUT AREOLA REDUCTION?

Dr Cotrufo is an expert in plastic surgery and reconstructive microsurgery. In particular, he specialises in aesthetic breast surgery and reconstructive breast surgery and has contributed to a number of industry journals and conferences on the topic as well as acting as a consultant to several of the UK’s leading hospitals.

If you would like to discuss nipple surgery in more detail, including your suitability for any of these procedures, please call 0207 873 2330 to organise a consultation.

Dr Cotrufo is an expert in breast reconstruction surgery and has carried out a great deal of research in the field.

WHAT CAN BREAST RECONSTRUCTION SURGERY ACHIEVE?

• Restore balance to the chest area
• Boost confidence post-mastectomy

IS THERE AN ALTERNATIVE TO BREAST RECONSTRUCTION SURGERY?

Many women find they don’t want to undergo reconstructive breast surgery after cancer treatment, speaking to a surgeon as well as support groups will help you decide whether it is right for you.

DURING YOUR BREAST RECONSTRUCTION CONSULTATION, YOU WILL:

• Talk about what you hope to achieve with breast reconstruction surgery
• Learn more about the reconstruction procedure and breast implants
• Discuss the care you can expect to receive before, during and after reconstructive surgery
• Undergo a full health evaluation
• Have an assessment of the chest area
• Ask questions and talk through what other options may be available to you
• Talk about timescales and costs

WHAT TO EXPECT BEFORE YOUR BREAST RECONSTRUCTION PROCEDURE?

It’s exceptionally important that you feel comfortable with your surgeon and as relaxed as possible during the surgery process from start to finish. You will need to establish good communication with your surgeon. You will be able to talk through your goals and hopes for your surgery during your consultation.

As the date of your procedure approaches you may be asked to make some small lifestyle changes and in particular to avoid certain activities and medications in order to ensure you are in the best possible health for surgery.

This may include:

• Taking medical tests including blood tests
• Stopping smoking
• Adjusting or taking certain medications
• Avoiding aspirin, herbal supplements and anti-inflammatory drugs
• Refraining from drinking alcohol
• Avoiding sun overexposure, particularly to the chest area
• Committing not to make stringent changes to your diet

For surgeries performed under general anaesthetic, you will be given fasting instructions to follow by the surgeon.

THE BREAST RECONSTRUCTION PROCEDURE

• The length of time for breast reconstruction varies according to the extent of the work done and is sometimes completed in two stages
• Generally, breast reconstruction takes several hours
• If the procedure is being completed in two stages the implants will be inserted last, with the first surgery dedicated to inserting a tissue expander in the area of reconstruction
• As most women have their nipple removed as part of mastectomy, you may undergo a third procedure to have a new nipple before your breast settles into its final size and shape

YOUR AFTER BREAST RECONSTRUCTION SURGERY

Following surgery, you will be required to stay at the clinic at least overnight. You will then return home, we advise a friend or relative accompanies you. The stages that follow will apply depending on what type of procedure you have undergone.

• You should walk as soon as you feel able
• You will need to wear a supportive bra day and night for several weeks
• You will need to follow guidance for dressing your wound as provided by the clinic
• You will need 1-2 weeks of rest and should not return to work until this time has elapsed
• You will need to attend scheduled aftercare appointments with Dr Cotrufo and will also be able to discuss your breast reconstruction recovery with him over the phone

STILL HAVE QUESTIONS ABOUT BREAST RECONSTRUCTION SURGERY?

Dr Stefano Cotrufo is a plastic surgery and reconstructive microsurgery expert who has spent much of his career focusing on reconstructive and aesthetic breast surgery. As well as treating hundreds of reconstructive breast surgery patients and performing combinations of breast lift, reduction, augmentation and fat grafting, he has also provided advice on the latest trends in this area of surgery to the medical supply industry. He’s also spoken at several leading industry conferences. If you are looking for more information about reconstructive breast surgery and the options open to you, you can book a personal consultation by calling 0207 873 2330.