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A person may decide to undergo plastic surgery to enlarge or reduce their breasts, to achieve a balance in size or shape for their breasts, or to reconstruct one or both breasts after mastectomy. Whatever the motivation, breast surgery is safer and easier now than ever before. Please review the list of services we provide to help you make an informed decision and achieve the most satisfying results.
Breast Augmentation
Breast Reduction
Breast Reconstruction
 The most frequently performed cosmetic surgery procedure in the U.S., breast augmentation can give women with small or unevenly sized breasts a fuller, firmer, better-proportioned look through the placement of implants in the breast. Women may elect to undergo breast augmentation for many different medical and aesthetic motivations, including balancing breast size and compensating for reduced breast mass after pregnancy or surgery. The procedure may be combined with others such as a breast lift for more satisfying results.
Implants are silicone shells filled with saline (salt water) and are placed behind each breast, underneath either breast tissue or the chest wall muscle. The procedure lasts one to two hours and is typically performed with general anesthesia, although local anesthesia combined with a sedative is also possible. After surgery the patient’s bustline may be increased by one or more cup sizes.
Incisions are made in inconspicuous places on the breast to minimize scar visibility (in the armpit, in the crease on the underside of the breast, or around the areola, the dark skin around the nipple). The breast is then lifted, creating a pocket into which the implant is inserted.
Placement behind the chest wall muscle offers a few advantages over placement beneath the breast tissue only. These include reduced risk of capsular contracture (post-operative tightening around the implant) and less interference with mammogram examinations. Possible disadvantages include need for drainage tubes and elevated pain in the first few days following surgery.
After the implants are placed and centered beneath the nipples, incisions are stitched, taped and bandaged. In a few days these bandages may be replaced with a surgical bra. Most patients feel tired and sore after surgery, but this usually passes in a day or two and many patients return to work within the week. Stitches are removed in a week to 10 days and any post-operative pain, swelling and sensitivity will diminish over the first few weeks. Scars will begin to fade in a few months and will continue to fade for months or years.
Complications following surgery are uncommon and usually minimal. They may include capsular contracture, swelling and pain, infection around the implant, a change in nipple sensation, milk production if you nursed a baby within a year before the procedure, and breakage or leakage of the implant as a result of injury or the normal compression and movement of your breast (if this happens the implant will simply deflate in a few hours and your body will absorb the salt water).
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 Large breasts may cause physical and mental discomfort and can even harm the women who have them -- the size and weight of large breasts can result in self-consciousness, improper posture, pain in the back and neck, indentations from bra straps, skin rashes, breathing problems and skeletal deformities. Breast reduction surgery is usually done to provide physical relief from these symptoms, not for cosmetic reasons. Performed under general anesthesia, the two- to four-hour procedure removes fat and glandular tissue and trims resultant excess skin to produce smaller, lighter breasts that are in a healthier proportion to the rest of the body.
Please consult with Dr. Dufresne if you intend to breast-feed since many of the milk ducts leading to the nipples may be removed.
During the procedure an anchor-shaped incision is made from the new location of the nipple down to and around the crease beneath the breast. The surgeon removes excess glandular tissue, fat, and skin, relocates the nipple and areola, and reshapes the breast using skin from around the areola before closing the incisions with stitches. Liposuction may be needed to remove excess fat from the armpit area, and in some cases when only fat needs to be removed from the breasts, liposuction alone is used for breast reduction.
For a few days after surgery the breasts are bound with an elastic bandage or a surgical bra and you may be given surgical drainage tubes for fluid removal. Stitches come out in a week and the surgical bra must be worn for about a month.
A little pain is normal after surgery, whether it’s mild discomfort, swelling during menstruation, a measure of numbness or sensitivity, or random, shooting pains that may last for a few months. Swelling, bruising, crusting and slight changes in breast size are also common. Most patients return to work in about two weeks, although you should avoid heavy lifting for three to four and only gentle contact with the breasts should occur for six weeks.
Scars fade with time but will not disappear, although they can be hidden with a bra, bathing suit or low-cut top.
Risks are rare and usually minor but may include bleeding, infection, reaction to the anesthesia, small sores around the nipples, slightly mismatched breasts or unevenly positioned nipples, and permanent loss of feeling in the nipple or breast.
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 Modern surgical technology makes it possible to construct a natural-looking breast after mastectomy (breast removal) for cancer or other diseases. The procedure is commonly begun and sometimes completed immediately following mastectomy, so that the patient wakes with a new breast mound instead of no breast at all. Alternatively, reconstruction may begin years after mastectomy
Women whose cancer seems to have been eradicated with mastectomy are the best candidates for breast reconstruction. Those with health problems such as obesity and high blood pressure and those who smoke are advised to wait. Others prefer to postpone surgery as they come to terms with having cancer, consider the extent of the procedure, or explore alternatives.
The reconstruction itself consists of multiple operations, the first of which involves creation of the breast mound and is performed during or after mastectomy in a hospital under general anesthesia. Later surgeries, if necessary, may be done in the hospital or an outpatient facility, with either general or local anesthesia.
There are several ways to reconstruct the breast, both with and without implants. Dr. Dufresne will work with you in deciding which is the best for you.
Breast reconstruction has not been proven to affect the recurrence of cancer or other diseases, chemotherapy or radiation treatment.
Nevertheless, in addition to the complications possible from any surgical procedure (bleeding, fluid collection, excessive scar tissue, or difficulties with anesthesia), there are some risks inherent in breast reconstruction, including infection around the implant, if an implant is used, and capsular contracture, when the scar (capsule) around the implant tightens, causing the breast to feel hard. Treatment for capsular contracture varies from “scoring" the scar tissue to removing or replacing the implant. Some patients may need time to come to terms emotionally with their new breasts.
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