Breast

Breast Augmentation

This procedure is appropriate for women with small or asymmetrical breasts.

Appropriate candidates for this procedure are women who want larger, more shapely breasts, and women who are seeking to balance the size of their breasts.

Patients considering this procedure are seen by Dr. Casso in consultation. Their goals are carefully considered. Patients are questioned about previous pregnancies and possible substantial weight loss or gain.

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Breast Implant Capsulectomy

Some women who undergo breast augmentation develop scar tissue around their implants which can cause firmness and/or distortion. Although this is less common with modern techniques and implants, it nonetheless does occur.

Additionally, some women with silicone gel breast implants sustain rupture of their implants, either following significant trauma, or through ordinary wear and tear. Older implants, particularly those inserted before 1992, were particularly prone to rupture and leaking. Rupture may be detected by a change in appearance or texture of the breast, abnormalities detected on mammogram or ultrasound, or, most definitively, by breast MRI.

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Breast Lift

Appropriate candidates for this procedure are non-smoking women in good general health with sagging breasts due to past pregnancies, genetics, aging, or massive weight loss.

Patients are seen in consultation and their goals are discussed. Dr. Casso suggests deferring surgery, if possible, until patients have decided on not having more children, as future pregnancies typically result in further enlargement and subsequent shrinking of the breasts, and recurrent sagging. Patients who are losing weight are also advised to defer surgery until their weight is stable, for the same reasons.

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Breast Reconstruction with Tissue Expander

There are several techniques available for breast reconstruction following mastectomy for breast cancer. While some surgeons offer flap procedures, such as TRAM flap, latissimus dorsi flap, as well as microvascular flap procedures, Dr. Casso prefers a simpler method which involves creation of a space under the skin and pectoralis muscle on the chest wall for insertion of a tissue expander, which is like an empty balloon. Beginning about a month after surgery, the patient undergoes monthly injection of saline into the expander in Dr. Casso’s office. The expander port is localized, local anesthesia is injected, and the expander is partially filled. When the expansion starts to feel tight for the patient, the expansion is terminated. In about another month, after stretching and relaxation of tissues has occurred, the process is repeated.

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Breast Reduction

Women with large, heavy breasts which may contribute to back, shoulder and neck pain, poor posture, bra-strap indentations, and chafing under the breasts, or which may cause a woman to feel out of proportion or to receive unwanted attention may benefit from breast reduction.

Appropriate candidates for this procedure are non-smoking women in good general health.

Women desiring surgery are seen in consultation with Dr. Casso. Their overall health is assessed. Patients with significant medical problems are encouraged to see their medical specialists for medical clearance prior to surgery.

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Male Breast Reduction

Male breast reduction surgery is performed on men who have experienced abnormal breast growth (gynecomastia).

This procedure is appropriate for men in good general health who desire reduction of the breast and improvement in contour.

Patients desiring this surgery are seen in consultation with Dr. Casso. The patient’s general health is assessed, and he is examined.

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Mastopexy / Augmentation

Appropriate candidates for a mastopexy/augmentation are non-smoking women in good general health with sagging breasts due to past pregnancies, genetics, aging, or massive weight loss. Patients who desire an increase in size of the breast, or to achieve a significant rounding of the upper aspect of the breast should consider a this procedure. In this procedure, a breast implant is inserted in addition to lifting the breast in order to achieve the desired result.

Patients are seen in consultation and their goals are discussed. Dr. Casso suggests deferring surgery, if possible, until patients have decided on not having more children, as future pregnancies typically result in further enlargement and subsequent shrinking of the breasts, and recurrent sagging. Patients who are losing weight are also advised to defer surgery until their weight is stable, for the same reasons.

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Nipple-Areola Reconstruction

Nipple-areola reconstruction is performed on women who have undergone mastectomy for breast cancer.

After the breast mound is reconstructed, and tissues are allowed to fully heal and settle, patients may undergo this procedure.

Patients desiring this procedure are seen in consultation by Dr. Casso. Options for surgery are discussed.

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