May 2012 The Irish Association of Plastic Surgeons

Mr Ross was an invited keynote speaker on the use of breast implants in aesthetic and reconstructive breast practice.

Mr Ross was an invited keynote speaker on the use of breast implants in aesthetic and reconstructive breast practice.

Breast reshaping following pregnancy

With the rise of the ‘mummy makeover’, post-pregnancy breast augmentations are becoming increasingly popular. Leading plastic surgeon Mr Gary Ross offers an insight into this procedure and how to make it work for you.

The effects of pregnancy and breast feeding often lead to the sagging of skin and a decrease in the amount of breast tissue. New mothers are frequently concerned about both the size and shape of their breasts and the aim of aesthetic breast surgery is to both change and improve the appearance. Personally, I aim to achieve these improvements by concentrating on the individual patient’s needs and expectations. Pre-operative consultations are an important part of my service, as they allow the development of our patient/surgeon relationship and provide a means to discuss any concerns and clarify the patient’s needs and expectations. Techniques available for post-pregnancy breast surgery include both augmentation and mastopexy (uplift) and these two techniques can be combined in one surgical procedure and tailored to the individual to provide the optimal result. The two main aspects of aesthetic breast surgery are size and shape. When the patient has sufficient size but poor shape and if there is enough remaining breast tissue, an uplift alone may be sufficient to achieve the desired result. Where the nipple height is already at an optimal level and the patient has good shape but insufficient size an augmentation alone may suffice. Often, however, there are elements of both poor size and poor shape and a combination procedure including both uplift and augmentation is required to deliver a natural, lasting result.This can be performed in one operation or as two separate procedures. Different techniques, different implants, differing scarring patterns and different positioning of the implants require detailed discussion. atients before the surgery, explaining the benefits of each option, which allows them to make an informed decision about which procedure is best for them individually. Optimising results without compromising safety is paramount.

 

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May 2012 The 5th Sentinel node biopsy conference was held in Amsterdam. Mr Ross was a keynote speaker and committee member on the use of sentinel node biopsy in head and neck cancer

The 5th Sentinel node biopsy conference was held in Amsterdam. Mr Ross was a keynote speaker and committee member on the use of sentinel node biopsy in head and neck cancer.

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Breast Reduction Explained

Suffering from overly large breasts? Plastic surgeon Mr Gary Ross explains how breast reduction surgery can dramatically improve your quality of life.

Aesthetic breast surgery aims to both change and improve appearance. The expectations of breast surgery are based on individual requirements. Breast reduction or reduction mammoplasty is a surgical procedure that involves the reduction of the size of the breasts.

It involves the excision of excess fat, skin and glandular tissue and the reshaping of both the remaining breast tissue and the breast skin and the repositioning of the nipples.

Worldwide, the size of the average breast is increasing and younger women are requesting breast reduction surgery, aiming towards a natural, long lasting result. Patients opting for reduction surgery complain that their breasts hinder their mobility, impair them functionally and often they experience back and neck pain.

The additional weight on the shoulders may lead to skin irritation due to the pressure of the bra straps. Patients are also frequently concerned with the shape of the breasts and an inability to find bras and clothes to fit. Sometimes the size of the breasts causes emotional as well as physical discomfort with a detrimental effect on self confidence.

Breast reduction is a surgical procedure that may be combined with other cosmetic procedures such as breast lift and liposuction. These techniques vary depending on the individual requirements of each patient. These requirements dictate the number and length of incisions. The most important aspects of breast surgery are in relation to size and shape.

I aim to change and improve appearance by concentrating on the expectations and needs of the individual patients. Preoperative consultations allow the development of the patient / surgeon relationship and are a means to discuss any concerns and prioritise your needs and expectations.

Changing techniques

Breast reduction is usually combined with lifting of the nipple to a new position (mastopexy) and often liposuction. A combination of procedures are tailored to the individual to provide the optimal result.
Providing a natural, longlasting result is paramount and the procedure involves careful consideration of the different elements of breast surgery and addressing each component individually. Excess breast tissue can be removed and the remaining tissue moulded to create an enhanced shape. The nipple is moved to a position relative to the stature and chest width of the patient and the excess skin is adjusted to redrape over the new breast in such a way that the blood supply to the nipple and the skin are not compromised. Final touches can be applied to remove fat by liposuction or place fat via a lipomodelling technique to give a symmetrical aesthetic result.

Newer techniques such as the vertical scar only technique prevent the need for a scar underneath the breast and all three examples shown have been performed using this method. Drains are not required and minimal dressings are applied immediately postoperatively. The results of surgery are therefore immediately apparent and patients are able to see the results instantaneously.

Patients can mobilise on the day of surgery and are encouraged to wear a sports bra day and night for the first four weeks following surgery. Bruising and swelling does occur although this has almost subsided by one week postoperatively when the minimal dressings are removed. All the stitches are dissolvable thus minimising discomfort and maximising outcome.

Results

The results of breast reduction are immediately apparent although it does take six weeks for all bruising and swelling to settle. Results can be dramatic with immediate relief of the pain associated with excessive breast tissue. The scarring following breast reduction can take longer to settle and scars remain pink for the first few months before usually fading into fine white lines. Change in mobility and functionality combined with the dramatic improvement aesthetically allows breast reduction patients a substantial improvement in quality of life.

Safety first

Optimising outcomes without compromising safety is paramount. By practising and operating aesthetically in one hospital I am able to provide patients with a dedicated service. Preoperative consultations and all post operative visits are with me and provision of 24-hour perioperative anaesthetic cover with dedicated intensive facilities ensures that every eventuality for all patients can be provided for on a single site.

 

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