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MUSC Health Plastic Surgery

Cosmetic Breast Surgery Procedures

MUSC Health offers the following cosmetic breast surgery procedures:

 

Breast Augmentation

Heredity, hormones, health, lifestyle and gravity will affect the way your breasts take shape and change over the years. Most breast augmentation candidates complain that their breasts are smaller than desired, were once full but have shrunken following pregnancy, or that they became less than perfect as a result of age.

Enlarging your breasts restores the balance between chest, hips and waist, which gives width, projection and a more feminine figure.

Your MUSC plastic surgeon will examine you and find out what your goals are in order to help you choose the most appropriate size and type of implant. During surgery, the implant usually will be inserted through a small incision that is well hidden in the natural crease under the breast, but there are other options. You and your surgeon will discuss those and whether it is best to place the implant above the pectoralis muscle (subglandular) or below the muscle (submuscular).

The American Board of Plastic Surgery advises women under the age of 22 to have saline implants. Otherwise, the decision to place a saline or silicone implant is up to the individual. Both have an outer shell composed of silicone, but saline implants are filled with salt water, and silicone implants are filled with silicone gel.

While silicone breast implants were taken off the market as a result of safety concerns brought to the forefront by journalist Connie Chung in the 1990s, the Food and Drug Administration ultimately concluded that silicone implants do not increase the incidence of disease and in 2006 allowed them to be used again. As a result of Chung, the silicone breast implant is the most researched medical device in the world. It’s true that breast implants – saline or silicone – will rupture eventually, but there is little likelihood of harm to the patient.  The average lifespan of an implant is 13.5 years.

Because today’s silicone implants are made of a “cohesive gel,” the inner material does not “leak” and the capsule of scar tissue around the implant keeps it secure. Most people don’t notice that their silicone implant has ruptured. This usually has to be determined by an MRI. In contrast, when a saline implant ruptures, the saline leaks out and the implant goes noticeably flat.
   
The average lifespan of an implant is 13.5 years. Replacing implants typically takes half an hour per breast and is an outpatient procedure.

  • Surgery length: 1 hour, outpatient
  • Anesthesia: general, IV sedation
  • Recovery: temporary swelling, numbness and bruising
  • Back to work: as early as 5-7 days
  • Resume normal activities: 6 weeks
  • Risks: Bleeding, scarring, infection, loss of sensation in breasts and nipples, hardening of the implant (capsular contraction)

Implant
Inframammary fold incisions for breast augmentation (most common approach)
Image via the American Society of Plastic Surgeons

Implant
Sub-pectoral breast augmentation
Image via the American Society of Plastic Surgeons

 

Breast Reduction

Patients with very large breasts may struggle with back, shoulder and neck pain as well as bra-strap grooving, rashes, self esteem issues and difficulty exercising – issues that we can resolve with cosmetic breast reduction surgery.

In a breast reduction, the incision is made around the areola and a vertical line extends downward and follows the natural curve of the crease under the breast. During a breast reduction, excess breast tissue, fat and skin are removed allowing the breast to be re-shaped into a smaller, lighter, firmer breast that is in proportion with the rest of your body. Your nipples are not detached from your breast. They are simply moved to a higher position so that most women retain nipple sensation and the ability to breastfeed.

  • Surgery length: 2-3 hours; outpatient
  • Anesthesia: general
  • Recovery: swelling, bruising, numbness, and permanent scarring
  • Back to work: 2-3 weeks
  • Resume normal activities: 6 weeks
  • Risks: bleeding, infection, loss of sensation, and asymmetrical breasts or uneven position of nipples

Breast reduction
Image via the American Society of Plastic Surgeons

 

Mastopexy

Your surgeon can give you a breast lift (mastopexy) to correct sagging (ptosis) due to genetics, pregnancy, weight loss, or aging. Mastopexy rejuvenates breasts by elevating and reshaping them. An incision is made around the areola and extends vertically beneath this toward the crease under the breast. The nipple is not removed – it will be moved to a new, higher position – but the excess skin above and below the nipple is removed, and the breast is reshaped. If you are happy with the size of your breasts, but they are sagging, then a breast lift may be an appropriate surgery for you.

  • Surgery length: 2 hours, outpatient
  • Anesthesia: general
  • Recovery: temporary swelling, numbness and bruising
  • Back to work: 1-2 weeks
  • Resume normal activities: 6 weeks
  • Risks: bleeding, scarring, infection, uneven nipple position, loss of sensation in breasts and nipples

 

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