Breast Enlargement Surgery to Correct Prominent Nipples

Breast Enlargement Surgery to Correct Prominent Nipples

Hello. My name is Adrian Richards. I’m a plastic and cosmetic surgeon based in the south of England, and I’m the Surgical Director of Aurora Clinics. In this video, I’m going to be taking you through an operation I performed earlier on today on a lady who’s got a small bust, as you’ll see, but with quite prominent, dome-shaped nipples. I’m going to be performing a breast augmentation to help correct that, and I’m also going to be taking two small moles off the side of her chest. I’ll show you each stage of the operation which I hope you’ll find useful and informative.

Here we can see the pictures taken before the operation. The nipples are at an even height, but there is some herniation, that’s doming of the nipple particularly on the right. You can see there’s more on the right actually than the left in this case. This doming is going to be partially corrected by the implant which I’m going to insert.

This is the first stage. This is where I’m going to make my pocket. This is the boundaries of my pocket I’m just drawing here. This is an OpSite, which is a clear dressing I put over the nipple to reduce the risk of infection.

I put some local anaesthetic in the wound, and I’m just creating a pocket underneath the breast tissue there with my scissors and I’m going to infiltrate this local anaesthetic mixture into that pocket. This has a dual benefit of providing really good analgesia, so no pain for the patient for eight hours after the operation, and it also contains adrenaline, which reduces the risk of any infection.

After I’ve completed infiltrating my anaesthetic, I’m going to make a five centimetre incision in the new inframammary crease. In this case, I’ve lowered it because this lady didn’t really have a very well developed inframammary crease and I placed it seven centimetres below the nipple.

Here I am just cutting through the fatty tissue of the lower part of the breast with my electrocautery. I find this gives me really good control of any bleeding.

The next stage is to go to the pincer. This is the forceps electrocautery and I just create the pocket. You can see very, very little bleeding, and I’m just going to slowly separate the breast tissue off the underlying muscle.

Here I am going on the inner aspect just finally making sure the pocket is a good size and shape and it’s going to fit the implant.

This is my sizer, which is a temporary implant which I put inside the pocket. Now I use this just to gauge the optimum size for the implant because I can blow it up slowly, 50 mils at a time to the rough volume that we selected before the operation. It gives me really good control before I decide on the final size of the implant. In this case I’m going to blow it up to 330 ccs which gave me a very good breast shape. I remove that temporary implant.

The next stage is to really wash the cavity out with sterile saline and then put some iodine ointment on the skin to reduce the risk of infection.

I then change my gloves so I’ve got absolutely new gloves touching the implant. I will be the only one touching the implant with these new gloves. Some antibiotics inserted in the cavity to reduce the risk of infection. Here’s the new fourth generation cohesive gel implant which I’m just inserting there through the hole.

I like to sew the area up in three layers with all absorbable stitches. You can see this is just the deepest layer going in there. I’m just completing that deep layer. That’s the layer completed.

The next stage is just to put a further layer under the skin before the final skin closure. Again, these are all absorbable stitches which will remain for approximately two months following surgery and will give really good support to that incision during that time.

This is just the final layer of closure, which is a subcuticular running stitch placed in the fold there. You can see all we need to do is trim those edges.

On the right side I’m just taking off two moles. A little mole there. I’m just curetting this larger mole here. You can see it comes off very easily because it’s very, very superficial. You can see it just peels off nicely leaving a little white mark which will go slightly pink and then fade. You can just see there is the mole which I’ve removed.

I’m just completing the closure with tissue glue here which will protect the wound.

Here you can see the appearance of both breasts at the end, the herniation reduced, and really quite a nice shape to the bust.

Thank you very much for taking the time to watch this video which I hope you found useful and interesting. If you’d like any information on any other plastic procedure, please feel free to contact us either via our website, which is Aurora-Clinics.co.uk, or by phoning us directly on 01844 214362. Thank you.