Breast surgery

Overview – breast surgery

Patients undergo breast surgery for cosmetic and medical reasons. Breast surgery is a surgical procedure that is conducted on both female and the male breast(s) to alleviate medical conditions, such as breast cancer. This type of surgery is quite common worldwide. This surgery is also performed to prevent the onset of certain health conditions. Patients also choose breast surgery purely for cosmetic purposes such as to alter the shape, appearance, and size of the breast(s).

When should you undergo breast surgery ?

• Breast surgery is not performed on women alone. Even men can suffer breast cancer and may need to undergo surgery.
• Some men have pronounced breasts that can make them self-conscious. Gynecomastia, the condition that causes men to have conspicuous breasts, finds a cure with breast reduction surgery.
• Patients undergo breast surgery where part of the breast or the complete breast(s) is surgically removed to treat breast cancer. For few patients, mastectomy is performed as a form of preventative strategy.The surgery may also be to do away with benign lumps inside the breast.
• Patients who have undergone mastectomy may want to undergo breast reconstruction procedure for cosmetic purposes. This is usually performed after the breast cancer surgery.
• Some patients undergo medical problems due to oversized breasts and may need breast reduction surgery.
• Many women are unhappy with the size of their breasts. Those with very small breasts have the option of going for breast augmentation surgery. This is a purely cosmetic procedure where the size of the breasts is enhanced.

Evaluation for breast surgery

A consultation with the surgeon is the first step before breast surgery, whether it is for medical or cosmetic reasons. The surgeon makes an assessment to completely understand the situation. The specialist will also decide whether you fit into all the requirements and make a good candidate for the surgery.  It is at this time that the surgeon will ask you questions and you can use the opportunity to clarify specific queries pertaining to your condition. Some of the ways the surgeon makes the evaluation is as follows:

The specialist will want to know

• The reason for the breast surgery
• Medical history , mainly if there is a genetic predisposition to breast cancer
• If you have any allergies to drugs or anaesthesia
• The nature of medical treatments undergone in the past and present
• Medications presently in use
• Herbal supplements and vitamins in use
• About use of alcohol, illegal drugs or tobacco
• Medical surgeries undergone in the past
• Presence of any pre-existing health conditions
• Examination of  breasts
• Ascertain physical health
• About pregnancy

If the surgery is for cosmetic reasons, the surgeon will want to know if the inspiration is from the patient or due to the pressure from a relative or anyone else. Patients can use this time to ask the healthcare provider about the details of the surgery.

Further, this is a good time to ask the surgeon questions about his experience and qualification, to rest assured about safety.

Specific clarifications

• Surgeon’s medical qualifications with certifications
• Years of experience and training
• Personal risks of the surgery
• Period of recovery
• Risks and side effects
• Appearance of breasts after surgery
• The possibility of more surgeries in future
• Appearance of breasts after few years
• Ability to breast feed
• Way forward if patients are unhappy with the outcome of the surgery

Cost of breast surgery

Some of the key factors that influence the cost of breast surgery in India are:

• Patient’s age
• Surgeon’s expertise and experience
• Cost of laboratory and diagnostic tests
• Hospital admission room and facilities
• Health condition of patient
• Anticipated complications post-surgery

The cost of breast cancer surgery in India is estimated to be anywhere between INR 5 to 6 Lakhs. This cost includes testing, surgery, and radiotherapy.

Further, the cost of a single mastectomy can be from INR 70,000 to INR 2 lakh. This will depend on the hospital and infrastructure. For a lumpectomy, the cost of the surgery will be anywhere between INR 35000 to INR 50000.

Breast augmentation surgery in India will incur a cost range from INR 80,000 to INR 120,000 based on the technique employed. The cost of the implant will vary depending upon the manufacturer. It can cost between INR 30,000 to INR 80,000 and will depend upon the expertise of the surgeon.

Breast reduction surgery costs average around INR 1,30,000 in India.

Preparation for surgery

Once the decision is for breast surgery, there will be a few guidelines and action points:

• Blood and diagnostic evaluation as suggested
• Stop the use of recreational drugs, alcohol and nicotine
• Alteration of dosage for medications or stopping few drugs for a certain period, especially aspirin that can hamper blood clotting
• Intake of more multivitamins as prescribed
• Incase of cancer, surgeon will decide on the type of surgery- lumpectomy or mastectomy depending upon the location and size of cancer
• Take measurements of the breasts before breast reduction, augmentation, or reconstruction
• Communication with the surgeon about size and modification of breasts

The surgeon will take photographs of the breasts to view the changes after surgery. Breast cancer surgery, breast augmentation, and breast reduction can be performed both as inpatient and outpatient procedures. Lumpectomy surgery is mostly performed as an outpatient procedure. Those undergoing mastectomy surgeries will need to stay at the hospital overnight.

Procedure for breast surgery

Breast surgeries are quite complex and the duration of the surgery will depend upon the type of surgery. If the patient is undergoing breast reduction surgery, it will take close to five hours. In case the surgery is a lumpectomy, it takes about one or two hours.

If the patient is undergoing breast augmentation, the procedure will be as follows:

• The first step is to administer either general anaesthesia or intravenous sedation
• The surgeon makes an incision either in the armpit or at the fold below the breast, along the areola. The position of the incision will be according to the breast implant type
• The implant is inserted either behind the breast tissue or below the pectoral muscle
• The surgeon closes the incision using sutures. A skin adhesive or surgical tape is used to ensure skin is closed. In time, the incision scar will fade
• The patient can immediately see the change after the effect of anaesthesia wears off

During breast reduction surgery, the patient is given general anaesthesia and the cut is made in the region surrounding the nipple. Once this is done, the surgeon removes extra tissue, fat, and skin. The next step is to reposition the nipple to a place that improves the appearance of the breast. The surgeon closes the incisions and the wound is dressed. Usually, a tube for drainage is installed at the site of the incision.

Once the surgery is over, the patient is under close observation by the healthcare team. To offset any inflammation at the site, dressing and an elastic bandage or support bra is necessary. To manage pain, doctors prescribe painkillers.

Risks of breast surgery

Some of the risks of breast surgery are:

• Leakage or tear of implant
• Infection
• Anaesthesia(adverse reaction )
• Unsuccessful surgery and need for a revision surgery
• Pain
• Excessive bleeding
• Scarring
• Alterations in the sensation of breast and nipple

Patients do report pain for 4 to 5 days following the breast augmentation procedure. Scarring is a possibility after breast reduction surgery. Swelling, feeling sore, and pain is a common complaint among patients.

Post-op care and things to keep in mind

The recovery time post-surgery is usually anywhere from one week to six weeks. Patients do feel sore in the weeks following breast surgery. The surgeon will recommend guidelines for care during the recovery period.

In certain cases, the recovery may be longer. It also depends upon the type of breast surgery. Patients can possibly return to work about two weeks following a lumpectomy. It may take about four to six weeks following a mastectomy.

Patients who have undergone a breast augmentation or reduction surgery can resume their routine occupation after a week.

The site of surgery wears a bruised appearance and patients may feel tingling and numbness, especially under the armpit and arm. Pain relievers are good to tide over the first few days post-surgery. It is good to avoid unnecessary movement or strenuous exercise during the first few days.

After a week, doctors permit patients to take warm showers and allow the application of lanolin or Vitamin E lotion on the incisions. This helps the scars heal.

Extra care for the breasts

Irrespective of the type of breast surgery, it is important to care for the breasts, such as changing the bandages and ensuring the area is always dry. The dressing on the incision site has to be changed every day, after receiving the care guidelines from the surgeon. To alleviate swelling and pain, it is crucial to wear a support bra.

It is also important to take extra care if the surgeon has installed a drainage device. The tube has to be drained out periodically. The quantity of fluid draining out will reduce during the recovery phase and there will be a visible change in colour.

Patients will need to avoid swimming for at least one month following the surgery.  After the healthcare provider permits, patients can begin to use the shower, although the use of the bathtub is not allowed for a month.

Patients cannot resume their normal pace of activities until they check with the surgeon.  They should not drive during the recovery period until the surgeon allows it.

Lifting heavy objects is a big risk. If patients wish to go back to their normal exercise routine, it is usually possible after a month.

Complications of breast surgery

You need to contact the doctor if you experience the following symptoms:

• Breathlessness
• Loss of appetite
• Inflammation close to the incision
• Swelling under the arm or hand
• Extreme pain that does not subside with pain medication
• Sutures giving way
• Fever
• More liquid draining out
• Problems with digestion
• Headaches
• Blurred vision
• Dizziness

Do not ignore any of these symptoms, you need to seek medical attention immediately.

Breast augmentation surgery with implants can hamper cancer detection. Further, these implants do not last for a lifetime. Repeat surgery may be needed. Changes are possible to the breasts due to pregnancy, weight loss, and menopause. Therefore, more breast surgeries may be needed either to replace implants or to remedy any medical condition.

Best option

Patients will benefit from a service that offers complete healthcare from consultation to surgery and recovery.

goficure has a team of surgeons with years of experience performing breast surgeries, both for medical purposes and cosmetic reasons.

So, when you contact us, we will fix an appointment for your consultation, schedule your surgery, help with transportation during surgery as well as post-surgery, and offer support during recovery. We also assist you with the necessary paperwork for insurance claims.

It is possible to claim insurance for breast cancer surgery. However, it is not possible to claim insurance if breast surgery is performed for cosmetic reasons.

References