February 25, 2015
By Caroline A. Glicksman MD
ThePlasticSurgeryChannel.com 
Breast surgery tends to be one of the most popular types of cosmetic surgery requested by women of every age. Women may feel they need to improve the size, or shape of their breasts, but are often unsure about which procedure will produce the look they want.
Fortunately, there are many different procedures and they can be used in different combinations that can improve the appearance of each breast. It is important to know what each procedure entails, and who is a good candidate, so that you can select the most appropriate for you and your situation.
Breast Augmentation
Breast augmentation, sometimes called a breast enhancement on many web sites, sounds like a general term, but it is so much more. Also referred to as an augmentation mammaplasty, this type of procedure is used to change the size and shape of a woman’s breasts. Women who desire a breast augmentation can be divided into three groups: those who are very small breasted, and desire to be larger, those who have lost volume and shape either because of pregnancies and breastfeeding or weight loss, and those who want larger breasts for other personal reasons. Breast augmentation has evolved dramatically over the last 35 years and American women finally have access to the same choices in silicone implants as woman around the world.
Breast Lift
A breast lift, technically known as a mastopexy, is a procedure that lifts the breasts so that they are no longer sagging. Weight loss, pregnancy, and breastfeeding can result in the breasts becoming saggy while losing their overall firmness. It is very important that women understand that a breast augmentation is not a fix for very droopy breasts, and the reduction of excess skin and loose breast tissue must be addressed as a separate issue.
Many women are fearful of the potential scarring produced by a breast lift, and either request implants or are talked into implants. The results of implants alone for a woman who really needed a lift are very short lived, as skin stretch only becomes worse with the added weight of the implants. These decisions should be made between a board certified plastic surgeon and the patient, which will give women should the longest lasting procedure for their problem.
Breast Reduction
A breast reduction is a breast surgery procedure used when a woman is largely busted and has problems that may include chronic back pain, deep grooves in her shoulders from years of bra strap pressure, and possibly rashes under the breasts. There was a time when excessively large breasts (also known as macromastia) was considered a medical condition and covered by almost all insurance plans. Unfortunately, those days are long gone for many women seeking this procedure. Insurance companies are requiring years of documentation and many require over a year of physical therapy before they will approve this procedure. Usually only women who require a very large volume reduction will be eligible. This unfortunately excludes the vast majority of women who may very well benefit from this procedure.
For many women breast reduction surgery has become an out of pocket elective cosmetic procedure.
Breast Reconstruction after Cancer
Breast reconstruction is a type of surgery that is used to restore a woman’s breast that has been altered by a surgical procedure to remove a malignancy. The goals of breast reconstruction have changed over the years, and are now more about creating an aesthetically beautiful and long lasting reconstruction, not just about giving a woman something to fill her bra. Meticulous attention to detail begins with the team approach between the oncology surgeon and the plastic surgeon.
Planning for the desired breast shape and size begins before the very first procedure. The newest highly cohesive form stable breast implants can provide the most natural appearing breast reconstructions and have very low complication rates. Although the total amount of benefits provided by each insurance plan may vary, breast reconstruction after cancer is mandated by Federal law under the Women’s Health and Cancer Right’s Act of 1998.