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Breast Enlargement
Breast Lift
Breast Reduction
Liposuction
Abdominoplasty (Tummy Tuck)

Breast Enlargement     Photos

Although it's easier to disguise small breasts than overly large ones, being small-breasted is quite traumatic for some women. For example, one young woman had never worn a bathing suit or gone swimming until after she had her breasts enlarged (called augmentation mammaplasty).

Not every woman who chooses augmentation is completely flat-chested. Some have small or average-sized breasts and choose augmentation because they want to be a little (or a lot) bigger than they are.

Augmentation is the second most popular cosmetic procedure for women after liposuction, yet the procedure remains somewhat controversial. Doctors continue to debate implant types and where these should be placed in the chest. Consumers worry that the implants could cause cancer or arthritis like diseases.

Like every other plastic surgery procedure, breast augmentation involves trade-offs. On the plus side, you will have larger breasts that often look natural and feel soft, that allow you to wear a wider variety of fashionable clothes, and that enhance your self-image. On the down side, there is a chance that your breasts may begin to feel unnaturally firm and there may be a change in the sensitivity of your nipples and breast skin. In addition, when your breasts are examined by x-ray as part of your regular health-maintenance program, you will require the services of a radiologist with the special skills needed to examine augmented breasts. Even with this special care, tissue may not be seen clearly when examined for cancer. (For this reason, a woman who has a personal or family history of breast cancer may want to carefully consider whether implants are worth any extra risk.)

Despite the potential for problems, the vast majority of women who choose augmentation say they are happy with the results.

Augmentation will increase your breasts by one or more cup sizes. The basic shape of your breasts will not change, although augmented breasts are slightly lifted. Almost all implants retain their size over time, so even if your breast tissue shrinks somewhat following menopause, pregnancy, or weight loss, your breasts will always appear larger than they were before surgery.

As breast tissue sags with age, the implant may remain in its original position, while the breast tissue and nipple droop. If this is severe enough to be bothersome, it can be surgically corrected with a breast lift.

The Consultation
Be candid about your expectations. Sometimes the biggest disagreement women have with their plastic surgeons centers on the size of the implants used. Doctors would rather discuss options with you before surgery--obtaining an understanding of what you hope for and giving you a clear picture of what can be achieved--than have you be unhappy with the results. Some doctors may ask you to bring in a photograph of a woman with breasts you like, as long as you understand that a perfect match is impossible. If your doctor feels that your breasts sag too much, he may suggest a breast lift in conjunction with augmentation. Be aware, however, that a lift is a completely different procedure, with different trade-offs involved.

Thoroughly discuss the different types of implants and surgical techniques available. There are three main choices that must be made: the kind of implant used, the location of the incisions, and the placement of the implant. Plastic surgeons are constantly conducting research to determine the most effective combination, but to date there is no one right way to do the operation. Each has its own advantages and disadvantages.
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Breast Lift     Photos
A breast "lift" or Mastopexy, is not a simple operation. Sagging breasts are probably the most common breast "deformity" among women, yet mastopexy--a removal of excess skin akin to putting darts in a dress--is not as popular as other breast procedures because even today's modern techniques leave noticeable scars for what may be a temporary result. Sooner or later, gravity prevails and breasts may begin to sag again. For women whose breasts are very heavy, the sagging may begin soon after the operation. To offset this, in women whose breasts are also smaller than desired, implants are often inserted during the lift procedure for better, longer-lasting projection.

Best Candidates
A mastopexy is often sought by women who have had children, since pregnancy and nursing leave a stretched outer skin envelope with less volume inside. (However, if you plan to become pregnant again, it's best to postpone surgery.)

The best candidates for mastopexy are women with small, sagging breasts, especially since they're also likely candidates for implants. However, breasts of any size can be lifted.

The Consultation
Your surgeon will examine and measure your breasts while you are sitting or standing (never when you're lying down). In a mastopexy, the nipple and areola will be moved higher. Generally, your nipples should rest about eight and one-half inches below the notch in your collarbone, roughly even with the crease beneath your breasts. Let your surgeon know exactly what results you would like to see. Moving the nipple again later would cause additional scarring--you want to get it right the first time.
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Breast Reduction     Photos

Breast Reduction--called reduction mammaplasty--removes fat and glandular tissue from oversized breasts and sometimes reduces the size of the areola, the dark area around the nipple. Breast reduction is designed for women in excessively large breasts, which often cause medical problems like back pain, skeletal deformities, breathing difficulties, skin irritation, restricted motion, and numbness in the hands. Most women with oversized breasts also develop indentations in their shoulders where their bra straps press into their flesh. For these reasons, breast reduction is usually considered a reconstructive procedure.

Women who seek reduction usually have extremely large, pendulous breasts that cause considerable physical discomfort and functional problems, as well as embarrassment. Most will say they want reduction for physical relief rather than for cosmetic improvement.

Best Candidates
Breast reduction can be performed at any age after puberty. The best candidates are those who have a clear understanding of the procedure and what results can be expected.

In breast reduction, the degree of scarring is unpredictable and it may take a year or more for scars to fade. However, if a woman is well-informed, if her surgeon has shown her photos of the usually expected results, and if reduction will provide physical relief, she is likely to be very happy with breast reduction surgery.

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Liposuction     Photos
The good news is that a low-fat diet and regular exercise will keep you healthy, hearty and fairly shapely. The bad new is that there are some localized fat deposits that no amount of aerobics or fasting can remove.

Fatty deposits are often the result of genetics and aging. As we grow older, body fat redistributes itself, muscle mass diminishes, and skin loses its elasticity. Unsightly accumulations of fat often collect in saddlebags, love handles, and double chins.

In the early 1980s, the French technique for suction-assisted lipectomy revolutionized the ability to recontour the body, providing to be safer and more effective than previous, cruder approaches. Also called lipsuction, fat suction, or suction lipectomy, this procedure has been embraced by American plastic surgeons and their patients.

In less than a decade, suction lipectomy has become the most commonly performed cosmetic surgery procedure in America; certified plastic surgeons perform more than 100,000 procedures a year to remove unwanted fat from double chins, hips, thighs, abdomens, buttocks, and legs. About 10 percent of these operations are performed on men, usually under the chin or around the waist, and 12 percent are done on people over fifty. Liposuction is becoming a common added feature in operations like facelifts, tummy tucks, and some breast reductions in men. More recently, ultrasonic liposuction has greatly enhanced the removable volume.

The results of liposuction are permanent--at least as long as a sensible diet and exercise program are followed. Some physician believe that by the time we reach puberty the number of fat cells in the body is fixed, although they can and do grow larger if we overeat. However, there are studies that have contradicted this theory, suggesting that in some instances (such as when weight increases by 50 percent or more), the number of fat cells can increase later in life.

The total amount of fat that can be removed at one time is limited, so liposuction cannot be used as a substitute for weight control. It rarely produces a significant weight loss, nor is it used as a cure for obesity. Liposuction alone also will not improve the dimpled skin called cellulite.

Best Candidates
The best candidates for suction lipectomy have pockets of fat concentrated in particular areas, as well as firm, elastic skin. More than any other factor, skin quality determines the success of the operation. Loose skin will not reshape to your body's new contours. The excess skin will then have to be cut away, sometimes leaving significant scars. Experienced plastic surgeons can evaluate skin elasticity by feeling, pinching, and looking at it.

Suction lipectomy is not advised for individuals with a history of significant health problems. For example, it is generally not an option if you have had recent surgery on the spot to be sculpted, if you have poor blood circulation in that area (such as phlebitis in your legs), or if you have heart or lung disease.

The Consultation
Your doctor will examine you to determine where your fat deposits lie. Most people fall into three main categories f body type: the tall, thin ectomorph; the more muscular mesomorph; and the endomorph whose fat is distributed throughout the body.

Your plastic surgeon should review the various body contouring methods available. For some people, particularly those who have sagging skin, suction lipectomy alone is not the answer. For example, you may need an abdominoplasty, or tummy tuck, to remove excess skin as well as fat. Your surgeon should also explain the risks and limitations of suction lipectomy, so that your expectations do not exceed the possibilities.

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Abdominoplasty (Tummy Tuck)     Photos
Don't be deceived by the merry nicknames "tummy tuck" and "mini-tummy tuck." These happy-go-lucky phrases minimize the extent of the surgery. Abdominoplasty cuts away excess skin and fat, tightens the abdominal wall, and repairs a hernia if one exists. This is a dramatic operation that requires a long convalescence and produces a long, permanent scar. Although liposuction my be done at the same time, abdominoplasty is a much more complicated procedure than fat suction alone.

No matter how much doctors stress the extensive, invasive nature of this opertion, most patients are still shocked by the aftermath. Many women who have unobtrusive pelvic scars from gynecological surgery expect the same from a tummy tuck. However, the pubic area is slack and relaxed, without the tension characteristic of the abdomen. Scars that cross areas of tension tend to widen and take longer to heal than those in the pubic region.

Best Candidates
The best candidate for abdominoplasty is a healthy individual whose weight is stable and, in the case of a woman, who no longer plans to become pregnant. The best candidate for a "mini-tuck" (partial abdominoplasty) is someone with loose skin and muscle only in the lower abdomen.

Abdominoplasty may remove stretch marks or previous scars from a hysterectomy, appendectomy, or cesarean section, but only if they're located in the skin being removed. The procedure will not slim your hips, thigh, or buttocks. Finally, your new abdomen will be flatter, but not completely taut.

The Consultation
As with every cosmetic procedure, your doctor should determine your goals and expectations at the time of the consultation, cautioning you about the trade-offs, in this case, a long recovery period and scarring. In preparation for surgery, the intended incision lines may be marked when you are wearing your bathing suit, so that they are as unobtrusively placed as possible.
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