To enhance the body contour of a woman who, for personal reasons, feels her breast size is too small.
To correct a reduction in breast volume after pregnancy.
To balance a difference in breast size
As a reconstructive technique following breast surgery.

The breast implant options include saline filled breast implants and silicone gel filled breast implants. The FDA has recently approved the use of silicone implants and therefore both silicone and saline implants are now available for all patients.  The breast augmentation will be performed by Board Certified Plastic Surgeon, Alan Bienstock at either his Manhattan, New York or the plastic surgeon's Princeton (Lawrenceville), New Jersey surgical facility.  Click Here to Learn More About Breast Augmentation (Breast Implants)

BREAST REDUCTION

Large, pendulous breasts may cause a number of challenges and health concerns. These include poor posture, chronic back and neck pain, and struggles with skin hygiene, irritation, and ulceration underneath the breasts. Heavy breasts can pose restrictions on physical activities and exercise. Bra straps often leave indentations in the shoulder area. Many women, especially teenage girls, are very self-conscious if they have unusually large breasts.
Breast reduction (reduction mammaplasty) removes fat, glandular tissue, and excessive skin to create healthier, more comfortable breast that are better-shaped in proportion to the rest of the body. With breast reduction surgery, women of all ages can feel better about themselves without the physical and emotional anguish of back pain and self consciousness.

Surgical techniques for Breast Reduction

Inferior Pedicle approach (or Wise Pattern)
horizontal incision under the breast and a vertical incision
Vertical Reduction (LeJour approach)
vertical incision from the bottom of the breast up to and around the nipple.
Vertical Scarless Breast Reduction
new and promising strategy  sculpts and suspends the breast tissue
provides long lasting results with no vertical scar.
Click Here to Learn More About Breast Reduction

Breast lift / mastopexy

Loss of breast skin elasticity, gravity and other factors such as weight loss, weight gain, pregnancy and breast-feeding ultimately affect the shape and firmness of  breasts. Patients who are generally satisfied with the size of their breasts but desire more firm and shapely can have a breast lift to raise and firm them, resulting in a more youthful breast contour.

A breast-lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts.  The procedure can also reduce the size of the areola (the darker skin surrounding the nipple) as well as elevate and reposition the nipples.  Breast implants inserted in conjunction with a mastopexy procedure can increase both firmness and size for patients who have lost significant breast volume.
 

Techniques

Crescent Mastopexy
 Removes  crescent of skin above the areola, Minor breast lift with elevation of the nipple

Vertical Scar Mastopexy
 (LeJour Technique) - Breast lift with mild to moderate breast ptosis (sagging), Incision is around the areola/nipple with a vertical incision to the breast crease

Benelli Lift
Scars are only around the areola, A donut shaped piece of tissue around the skin is removed, Mild breast lift with nipple elevation

Inferior Pedicle Mastopexy
Full mastopexy, T – shaped incision around the nipple, vertically to the fold/crease, and a horizontal incision in the breast crease, Nipple is repositioned and breast is reshaped

Breast reconstruction

The breast is such a vital organ for women in terms of maintaining femininity and sensuality, wholeness (spiritually and bodily), and social interactions. In conjunction with a cancer diagnosis, the loss of a breast may emotionally and physically scar a breast cancer patient. Reconstruction of the entire breast after a mastectomy or a portion of the breast after lumpectomy due to cancer or other disease is quite possible with today's surgical procedures.  The procedure is covered by  insurance carriers after breast cancer surgery. 

The goals of breast reconstruction are:

Goals of Breast Reconstruction

Reconstruct a natural  breast that matches the opposite breast
Allow women to throw away prosthesis
Restore balance and body integrity
Enhance sexual interactions

The choice of reconstruction must be tailored to the individual patient depending on her needs and physical attributes, such as breast size, body habitus, degree of ptosis or breast droop, and skin changes and quality, (particularly if exposed to radiation). Each of the techniques has its advantages and disadvantages and can be done immediately following mastectomy or in a delayed setting.

Breast Reconstructive Techniques

Expander/ Breast Implant Reconstruction
Stage I: Tissue expander is placed under the skin and muscle of the breast, Stage II: a permanent implant is placed,  Difficult to achieve symmetry with other breast

Latissimus Dorsi with Breast Implant
Muscle of the back with overlying skin is rotated to chest, Muscle will cover an implant, Better symmetry than with implant alone

TRAM Flap (Transverse Rectus Abdominis Myocutaneous Flap)
Integrates abdominal skin, fat, and muscle, resembling the texture and color of the breast best, tool to mold a natural breastrequires abdominal wall muscle harvest/sacrifice

Perforator Flap (DIEP Flap and SIEA Flap)
Examples: Deep inferior epigastric perforator flap and Superficial inferior Epigastric Artery flap

Abdominal muscles are not injured or sacrificed, Decreased abdominal morbidity, Requires microsurgery

If you are interested in speaking with Plastic Surgeon Alan Bienstock, MD about a particular breast surgery (breast implants, breast reduction, or breast reconstruction) please contact him at either his Manhattan, New York Plastic Surgery / Reconstructive Surgery Office via phone (917) 257-7560 or his Lawrenceville (Princeton), New Jersey Plastic Surgery facility via phone at (609) 977-9286.  The plastic surgeon may also be contact via email at info@drbienstock.com.