Breast Surgery, Here's What You Should Know

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Breast Surgery, Here's What You Should Know
Breast Surgery, Here's What You Should Know
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Breast surgery is a procedure to change the breasts, both in women and men. Broadly speaking, breast surgery can be done to treat diseases of the breast or to improve the appearance of the breast according to the patient's wishes

Breast surgery is generally safe to do. However, before deciding to undergo this procedure, make sure the doctor chosen has the right qualifications and sufficient experience in breast surgery. Also make sure that the selected hospital meets the standards.

Breast Surgery, Here's What You Should Know - Alodokter

After getting the right doctor and hospital, first discuss with the doctor about the goals, benefits, and risks that may occur after breast surgery.

Types and Indications of Breast Surgery

Breast surgery can be divided into two categories based on its purpose, namely surgery for medicinal purposes and surgery for cosmetic purposes. The full explanation is as follows:

Breast surgery for treatment

Medical breast surgery is performed as a therapy to treat tumors or breast cancer. This surgery is generally done on the advice of a doctor. The following are examples of breast surgery for treatment:

  • LumpectomyLumpectomy is the surgical removal of small tumors, early-stage breast cancer, or abnormal tissue in the breast. Lumpectomy is usually followed or may be preceded by radiation therapy.

  • MastectomyMastectomy is a surgical removal of the breast and some of the surrounding tissue. This procedure is performed to treat breast cancer that cannot be treated with a lumpectomy or to prevent breast cancer in women who are known to be at risk for it.

  • Breast reconstruction surgeryThis procedure aims to reshape the breast after a mastectomy or repair the shape of the breast that has been severely damaged by an injury. Breast reconstruction surgery after mastectomy can be performed immediately after the mastectomy or postponed for some time.

Breast surgery for cosmetic

Breast surgery for cosmetics is done to change the appearance of the breasts. This operation is usually performed at the request of the patient, but may also be recommended by the doctor. The following are types of cosmetic breast surgery:

  • Breast enlargement surgeryBreast enlargement surgery is a procedure that aims to enlarge the breasts, making the breasts look symmetrical, proportional, or in accordance with the patient's expectations. This surgery is performed by implanting implants into breast tissue or chest muscles.

  • Breast reduction surgery

    As the name implies, breast reduction surgery aims to reduce the size of the breasts. This procedure is done by removing some of the fat tissue, connective tissue, and skin of the breast.This operation generally aims to make the breast shape more proportional and in accordance with the body shape. However, apart from that, this surgery can also be performed on women who experience neck or back pain due to large breasts, or on men who suffer from gynecomastia (large breasts).

Breast Surgery Alert

Before deciding to undergo breast surgery, there are several things that the patient must know first. The following are things that patients should know, based on the type of breast surgery they want to undergo:

Breast surgery for treatment

Breast surgery for cancer treatment cannot guarantee that the cancer will be completely cured. After a lumpectomy or mastectomy, patients may still have to undergo other treatment methods, such as radiotherapy or chemotherapy, depending on the type of cancer they have.

In addition, not all patients with breast cancer can undergo this surgery. Generally, patients with connective tissue diseases, such as scleroderma and lupus, are not advised to undergo breast surgery because it can worsen the disease and make the recovery process more difficult.

In particular, lumpectomy should not be performed on patients with the following conditions:

  • Has two or more breast tumors that are far apart, so they can't be removed through one incision
  • Has small breasts with large tumors, because it can give a bad appearance of the breasts afterwards

Meanwhile, mastectomy cannot be performed or needs further consideration in breast cancer patients whose cancer has spread (metastasized) to other organs or originates from cancer in other organs.

Breast reconstruction surgery after undergoing a mastectomy or after an injury also has certain conditions. Breast reconstruction surgery should not be performed on patients with the following conditions:

  • Over 65 years old
  • Have you had radiation therapy to the chest area before
  • Obesity
  • Lung or heart disease that is classified as severe
  • Breast cancer stage 3 or stage 4
  • Emotional control disorder
  • Smoking habit you don't want to stop

Breast surgery for cosmetic purposes

When deciding to undergo breast surgery for cosmetic purposes, patients need to choose a hospital and doctor who are trusted in this field. In addition, the patient also needs to know the following:

  • Breast augmentation surgery cannot prevent sagging or drooping breasts.
  • The results of breast augmentation surgery may be affected by the patient's age and weight gain or loss.
  • Breast implants don't last a lifetime and need to be renewed every 10 years or maybe sooner.
  • Breast implant surgery or breast reduction surgery can cause difficulties during the breastfeeding process.
  • Users of breast implants should undergo breast ultrasound or breast MRI regularly, to determine the possibility of implant rupture.

When consulting a doctor, the patient is expected to provide details about the desired breast size and appearance.Patients also need to provide information about their overall medical history, history of drug consumption, smoking habits, and medical procedures they have undergone.

Not everyone can undergo breast surgery for cosmetic purposes, either to enlarge or reduce breasts. In general, the following are some of the conditions that make cosmetic breast surgery unacceptable or need to be postponed:

  • Suffered a breast infection
  • Suffering from tumor or breast cancer
  • Has a history of autoimmune disease
  • Has excessive expectations of the outcome of the operation
  • Are undergoing radiotherapy
  • Pregnant
  • Being overweight or obese
  • Suffering from diabetes
  • Suffering from blood clotting disorders
  • Suffer from heart or blood vessel disease

Especially for patients who wish to undergo breast augmentation surgery, the operation may be canceled if the patient is known to have an allergy to silicone.

Before Breast Surgery

If the patient is declared to be able to undergo breast surgery, there are several things that need to be prepared, namely:

  • Perform a breast physical exam, breast ultrasound, or mammogram
  • Do blood test
  • Stop taking certain drugs for some time before surgery
  • Fasting 8–12 hours before surgery
  • Ask family or relatives to accompany the patient during and after surgery

Breast Surgery Procedure

Before breast surgery begins, the doctor will first inject general anesthesia, so that the patient sleeps and does not feel pain during the operation.After the anesthesia works, the doctor will start breast surgery whose stages depend on the type of surgery to be performed. Here's the full explanation:

Lumpectomy

Lumpectomy begins with making an incision in the breast. Next, the doctor will remove the tumor and a small piece of tissue around the breast. If needed, the doctor can also remove the lymph nodes around the breast.

After the removal process is complete, the doctor will close the incision with stitches or use a special adhesive. The lumpectomy procedure is generally short, about 1 hour.

Mastectomy

Mastectomy begins with making an incision around the breast. After that, the doctor will remove all the breast tissue. If necessary, the doctor will also remove the tissue around the breast, depending on the degree of spread of the breast cancer experienced by the patient.

There are several types of mastectomy surgery, namely:

  • Simple/total mastectomy, which is the removal of all parts of the breast, including the nipple, areola, and breast skin
  • Modified radical mastectomy, which is a simple mastectomy procedure which is accompanied by removal of all lymph nodes in the armpit
  • Skin-sparing mastectomy, ie removal of the breast glands, nipple, and areola, without removing the skin of the breast
  • Nipple-sparing mastectomy, which is the removal of breast tissue by leaving the nipple and breast skin
  • Radical mastectomy, which is the removal of the entire breast, lymph nodes in the armpit, and the pectoral muscles under the breast
  • Double mastectomy, which is a preventive measure for women who are at risk of developing breast cancer, by removing both breasts

The length of the procedure varies, depending on the type of mastectomy performed and the patient's condition. However, a mastectomy generally takes 1–3 hours.

Breast reconstruction surgery

Breast reconstruction surgery can take 1–6 hours. There are two types of breast reconstruction surgery to choose from, depending on the patient's condition and needs, namely:

  • ImplantationImplantation begins with inserting a tissue expander into the breast skin, so that the breast skin expands. After that, the doctor will insert the implant, which is made of silicone gel or saline (sterile s alt water).

  • Tissue flapTissue flap is performed by taking tissue from the patient's back or abdomen to form a breast mound. The removed tissue can be left connected to the old blood vessel or cut off and connected to the new blood vessel.

After the breast reconstruction is complete, the patient can undergo a nipple reconstruction procedure. This procedure is performed by removing tissue from the back or abdomen.The tissue taken is then shaped so that the texture, color, and size match the original nipple.

Breast reduction surgery

The method used by doctors in breast reduction surgery depends on the shape and size of the patient's breasts, how much breast tissue will be removed, and how the patient wants her breasts to look after the operation.

The following are some methods of breast reduction surgery:

  • Liposuction or liposuction Liposuction is performed by making small incisions in the skin of the breast, which then becomes access to a small tube that functions to suck up excess tissue and fat in the breast. breast. This method is used when only a small amount of fat and tissue is removed.

  • VerticalThe vertical method is done by making an incision around the areola to the crease under the breast.Breast reduction surgery with this method is chosen if the breast tissue to be removed is not too little but also not too much.

  • Inverted-T or anchorAnchor method is done by making an incision on the outside of the areola up to the crease under the breast, so that the shape of the incision resembles an anchor. This method is used if there is a large amount of breast tissue to be removed.

After the breast tissue has been successfully removed, the doctor will remove the fluid in the breast using a special tube (drainage), then close the incision with stitches. Breast reduction surgery usually lasts 2–5 hours, but it can also take longer.

Breast augmentation surgery

Breast enlargement surgery aims to increase breast size or improve breast shape. The following are the steps performed by plastic surgeons in breast augmentation surgery:

  • Making an incision under the breast, under the armpit, or around the nipple
  • Separate the breast tissue and its surroundings to form a sac in front or behind the outermost muscle in the chest wall (pectoral muscles)
  • Inserting an implant made of silicone gel or saline into the formed sac and placing it behind the nipple
  • Sew up the incision and cover it with a special bandage or adhesive

Breast augmentation surgery generally takes 1–2 hours.

After Breast Surgery

After the breast surgery is done, the doctor will take the patient to the recovery room. The doctor will control the patient's blood pressure, pulse, and breathing rate. The doctor will also tell the patient how to treat the incision, when to change the bandage, and recognize the signs of infection.

Depending on the condition and the type of breast surgery performed, the patient may be discharged or need to undergo further recovery in hospital after surgery. In patients who are discharged home, the doctor will inform the schedule for the control to remove sutures, bandages, or drainage tubes.

In the recovery process, the patient may feel tired easily and experience pain, bruising, swelling, or numbness in the breast. These complaints are common and can last for several weeks or months after surgery. Scars will also be visible for a few weeks, then fade over time.

To help the recovery process, there are several things that the patient must do, namely:

  • Get plenty of rest and don't do strenuous activities until fully recovered
  • Take painkillers prescribed by the doctor
  • Using a compression bandage or a sports bra to keep the breasts from moving around
  • Do the examination according to the schedule given by the doctor

The results of breast enlargement or reduction surgery are generally visible after a few months, while breast reconstruction surgery takes 1-2 years for breast tissue to heal and scars to fade.

Risks of Breast Surgery

All types of surgery have a risk of complications, as well as breast surgery. Some of the risks that can occur due to breast surgery are:

  • Bleeding
  • Infection
  • Pain, bruising and swelling in the breast
  • Pain and stiffness in shoulder
  • Numbness in the armpits and breasts
  • Formation of scar tissue, such as keloids, in the surgical area
  • Blood accumulation (hematoma) in the surgical area
  • Damage to nerves and blood vessels in the surgical area

Especially for breast surgery that uses implants, complications that can occur include:

  • Breasts asymmetry
  • Liquid buildup around the implant
  • Breast skin around the implant becomes wrinkled
  • Implant position changed
  • Implant leaks or breaks

Immediately consult a doctor if you experience complaints after breast surgery, such as:

  • Fever
  • Discoloration of the breasts or scars
  • Liquid coming out of the incision
  • Pain or swelling in the breast that gets worse

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