The procedure is done under general anesthesia

There are several techniques for breast reduction, the most used of which are the inverted T scar with different nipple-aroela transfer patterns, and the single longitudinal scar techniques (Lejour Method)

The first technique is done through an incision around the areola, avertical scar from the areola down to meet a transverse scar under the breast forming a T-shaped final scar.

The latter method is suitable for small to moderate sized reduction and is done wthout the transverse incision component.

Surgical drains are usually placed for 48 hours and the patient usually stay overnight in hospital. 

The scars usually heal well, the scars are usually inconspicuous, the transverse scar is not visible being hidden under the breast.

future lactation can not be guaranteed after surgery despite the fact that lactiferous ducts are preserved in many techniques used. 

Breast augmentation

The procedure has not been found to cause any harmful side effects, nor to cause cancer. There are two types of implants: the saline filled implants and the silicone gel implants. Both types can be implanted under the breast or under the chest muscles below the breast. The latter way is used more as the implant can not interfere in the future with breast examination, mammograms or any breast procedure.

The main concern in breast augmentation is the development of breast capsule (fibrous tissue reaction around the implant) which may cause alteration of the shape of the breast if what is known as capsular contraction occurs.

Ways to avoid breast capsular contraction:
Many methods to prevent capsular contractions are used
1- Selection of implant type: Saline filled implant have very little incidence of capsular contraction compared with Silicone gel implants
2- Selection of implant surface: Textured implants have very little incidence of capsular contraction compared with smooth ones
3- Place of implantation: Submuscular implantation have very little incidence of capsular contraction compared with subglandular ones
4-  Postoperative breast excercises: During postoperative period, the patient is instructed to do certain breast excercises in all directions which markedly reduces the possibility of developing capsular contraction

The procedure is done under general anesthesia as a day case surgery, the patient can leave hospital at the same day.

Postoperatively there is no significant pain, just slight discomfort from the muscle being stretched over the implant, which will fade over the following weeks, meanwhile the patient is instructed not to lift heavy objects.

The patient will wear restrictive garments or hard bras for the first week after surgery in order to keep the desired position of the implant and to help moulding the shape of the augmented breast.

It is a safe and simple surgery with almost no side effects and a great aesthetic benefit.
 

Breast lifting (Mastopexy)

According to the degree of breast ptosis, different modalities of treatment are used:

1-In mild ptosis: use of breast implant alone can achieve the desired lifting with minimal enlargement of the breast through a very small incision on the under surface of the breasts.
2- In moderateptosis: the desired lifting is usually done through incisions around the areola and a longitudinal incision below the areola . Both incisions usually heal very well with the least conspicuous scars
3- In severe ptosis: A formal lifting procedure should be employed entailing a circumareolar incision, a longitudinal incision as well as a transverse incision under the breast (The formal T-incision)

In all conditions the patient can leave hospital the same day. The use of drains may be needed which are usually removed after 48 hours. The patient will wear non-soft bras immediately after surgery.

It can be done at the same time of mastectomy operation provided proper staging shows early cancer (Stage 1-2), or can be done later on after operation.

There are different ways for reconstructing the breast:
1-The use of implants
2- The use of muscle flaps from the back (Latissmus dorsi flap) and from the apron area below the umbilicus (TRAM flap)

The best results and least interference with postoperative cancer theraphy is the use of the TRAM flap with transfers, muscle, fat and skin from the abdomen below the umbilicus to fill in place of removed breast, entailing the performance of an abdominplasty as well

The transfered tissues have the advantages of feeling similar to that of the breast, adequate size and the tolerance to post-mastectomy radiotherapy.

The abdominal wall defect following muscle transfer is uasually closed directly, and in some cases closed with the aid of a prolene mesh.

Drains are usually removed after 5 days, after which patient is discharged from hospital.

The stitches are removed after 10 days, after which radiotherapy can be started.

Nipple and aerola reconstruction can be done thrre months following breast reconstruction as a day case surgery

This condition can be caused by a variety of conditions, most common being idiopathic, it can be caused by obesity, some hormonal disturbances, testicular or liver problems

The breast enlargement can be purely fat, purely hypertrophied breast gland or more commonly a combination of both.

Treatment starts with search for a cause through physical examination, hormonal assays , and sometimes xrays & sonography.

If a conditiion is revealed it should be addressed first then gynecomastia can be dealt with.

The ways to remove the enalrged breast liposuction for fatty breasts.
It there is a small glandular element , it can be removed at the end of liposuction procedure through a small incision around areola.

In cases of purely glandular enlargement and/or huge enlargement, a formal surgical excision is mandatory.

 After liposuction, the patient wears a restrictive breast garment for atleast two weeks and stitches are removed after 10 days

In cases of small and moderate cases, patient can leave at the same day, but in cases of huge enlargement, drains are placed fo 24 hours after which patient can be discharged. 

The procedure consists of the use of a small 8-mm wide strip of the back of the scalp removed  surgically and closed primarily leaving a fine scar inbetween hairs which is completely hidden with no areas of alopecia.

This strip in dissected under magnification into hair follicles which are then implantation into the desired ares thourgh small slits in order to leave no scars.

The procedure in performed under local anesthesia in 2 stages, the first is about 25-30 minutes long in which the scal strip is harvested after which the patient is transferred back to his room.

Follicule dissection takes around 3 hours after which the patient in invited back to the operating roon, where local aneshesia to recipient area is administered and follicles are implanted.

The area is covered by bandage for 2 days after which bandage is removed and the area is washed gently and left exposed. The scabs covering transplanted grafts should be left undisturbed till they fall spontaneously.

The transplanted follicles remain dormant for 3-6 months after which hair starts to grow naturally.

The number of cessions needed vary according to the extent of baldness and the size of the area to be covered.