Breast Augmentation (Augmentation Mammaplasty)
Breast Lift (Mastopexy)
Breast Reduction (reduction mammaplasty)
Breast Implant Removal
Male Breast Liposuction (Gynecomastia)
Breast Revision/Reconstruction


Breast Augmentation (Augmentation Mammaplasty)
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Procedure: Breast Augmentation (Augmentation Mammaplasty) - Enhances the size and shape of breasts using inflatable implants filled with saline. In some cases silicone implants can be used at the discretion of the surgeon and with patient consent.

Anesthesia: General anesthesia recommended.

Side effects/risks: Temporary soreness, swelling, change in nipple sensation and bruising. Breasts may be sensitive to stimulation for a few weeks. Surgical removal or replacement of the implants may be required to treat problems such as deflation, capsular contracture formation, bleeding and infection. Mammography is generally not affected as long as the technician knows you have implants.

Recovery: Depending on your job, most people take 1 week off from work. We utilize a pain pump for the first 2 days after surgery. This pump is completely automatic and gives the patient a constant low dose of Marcaine, which is a local anesthetic used to numb the areas in which it is used. This greatly reduces the discomfort from surgery, but you will still feel pressure in your chest. You must be up and moving the day of surgery, but need to limit the use of your arms to non-strenuous activities for 2-3 days. You or your caregiver will remove the pain pump at home on day 3. Thereafter, any discomfort can be controlled by oral medication prescribed by your doctor. Swelling in the breasts may take 3-5 weeks to disappear. You will gradually be able to get back to your usual routines within 3-4 weeks. You will need to massage your breasts 4-5 times a day once your surgeon demonstrates the correct technique. This is most important to insure soft and natural looking breasts. Your scars will be firm and pink for at least six weeks, then they may remain the same size for several months, or even appear to widen. After several months, your scars will begin to fade, although they will never disappear completely. We recommend the use of Scar Solution, an over-the-counter product, starting about 2 weeks after surgery. This is a Band-Aid type strip impregnated with a silicone gel. It helps flatten out scars so that they become less noticeable.

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Breast Lift (Mastopexy)    View Photos

Procedure: Breast Lift (Mastopexy) - A mastopexy raises and reshapes sagging breasts by removing excess skin and repositioning remaining tissue and the nipples. Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. If your breasts are small or have lost volume--for example, after pregnancy--breast implants inserted in conjunction with mastopexy can increase both their fullness and their size. Techniques vary, but the most common procedure involves a "lollipop" shaped incision, which goes around the areola and down to the inframammary crease. When the excess skin has been removed, the nipple and areola are moved to the higher position. Stitches are usually located around the areola, in a vertical line extending downwards from the nipple area, and along the lower crease of the breast.

Anesthesia: General anesthesia recommended.

Side effects/risks: Temporary bruising, swelling, discomfort, numbness, dry breast skin, and permanent scars. Bleeding, infections, asymmetry, thickening of scars, and changes in nipple sensitivity are less common risks of this procedure.

Recovery: Healing is a gradual process. You will be up and around the day of surgery, but don't plan on returning to work for a week or more, depending on your job. Avoid heavy lifting for three to four weeks. You may feel some pain for the first few days-especially when you move around or cough. Oral pain medication will be prescribed. The stitches we use are usually dissolvable and don't need to be removed. Occasionally a few stitches may be used that will require removal. The implants will need time to "settle" after surgery. They initially will ride higher on the chest, which results in less fullness underneath. Over the next month or so the implants will settle into position and look more natural. You may experience some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This numbness usually fades as the swelling subsides over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.

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Breast Reduction (Reduction Mammaplasty)    View Photos
Procedure: Breast Reduction (reduction mammaplasty) - A reduction mammaplasty removes fat, glandular tissue and skin from the breasts, making them smaller, lighter, and firmer. It can also reduce the size of the areola, the darker skin surrounding the nipple. The goal is to give the woman smaller, better-shaped breasts in proportion with the rest of her body, and relieve pain and discomfort associated with their weight. Techniques for breast reduction vary, but the most common procedure involves an anchor-shaped incision that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast.

Anesthesia: General anesthesia recommended.

Side effects/risks: Temporary bruising, swelling, discomfort, numbness, dry breast skin, and permanent scars. Bleeding, infections, asymmetry, thickening of scars, and changes in nipple sensitivity are less common.

Recovery: You will be up and around on the day of surgery, but you should limit the use of your arms to routine activities. You may feel some pain for the first couple of days-especially when you move around or cough and some discomfort for a week or more. Your surgeon will prescribe oral medication to lessen the pain. You should avoid lifting or pushing anything heavy for three or four weeks. The stitches we use are generally dissolvable. You may have drainage tubes for a day or two after surgery. Most women can return to work (if it's not too strenuous) and social activities in about two weeks.

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Breast Implant Removal    View Photos
Procedure: Breast Implant Removal known as explantation, can be done to decrease the size or to make room for new implants. Sometimes, breast implant removal is necessary to treat problems that occur with the implants, including: deflation or rupture; shifting; the formation of scar tissue that tightens around the implant (capsular contracture), which may cause the breast to feel tight or hard; necrosis, or the formation of dead tissue around the implant, which may prevent wound healing; calcium deposits; implant wrinkling; sagging; asymmetry; bleeding; infection; or diagnosis of breast cancer. The three most common reasons for breast implant removal are change of size and shape, implant leakage or rupture, and capsular contracture.

Anesthesia: Breast implant removal is done under either general anesthesia or local anesthesia combined with IV sedation. The procedure usually takes 30 minutes to an hour and takes place in my private surgical facility. Operation is conducted through an incision in the inframammary fold (under the breast) or the peri-areolar incision (through the nipple). If the implant is made of saline, Dr. Caridi may choose to deflate it first to facilitate removal.

Side effects/risks: Occasionally, women who opt for removal of large breast implants, especially those that are inserted subglandularly (on top of the muscle and under the breast glands) are left with major cosmetic deformity in their breasts if they opt to not replace the breast implants or have further cosmetic surgery. Tissue atrophy and chest wall deformity often result from breast implant removal. Breasts may also be smaller than they were before the implants because of hormone changes or weight loss. Sagging may also become more apparent after breast implant removal. Some women suffer from psychological distress after breast implant removal. The change in the body's shape affects some women as profoundly as a mastectomy affects others. It is normal to feel some sadness after witnessing such a drastic body transformation.

Recovery: Recovery from breast implant removal surgery is usually quick, with many patients returning to everyday activity within a few days and full activity within two to three weeks. Full recovery often takes a few months. For the first few days after breast implant removal, there may be mild discomfort, swelling and bruising. Some uncommon, but possible, complications include: loss of nipple sensation; scarring; bleeding; and loose skin.

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Male Breast Liposuction (Gynecomastia)    View Photos
Procedure: Male Breast Liposuction (Gynecomastia) - This procedure reduces enlarged breasts in men using liposuction and/or cutting out excess glandular tissue.

Anesthesia: General Anesthesia, or in some cases IV Sedation with local anesthesia combined with IV sedation.

Duration of Results: permanent

Side effects/risks: Temporary bruising, swelling, numbness, soreness, and a burning sensation are most common. Infection, fluid accumulation, injury to the skin, rippling or bagginess of skin, asymmetry, pigmentation changes (may become permanent if exposed to sun), excessive scarring if tissue was cut away, and need for additional procedures to remove additional tissue are less common.

Recovery: You will feel some discomfort for a few days after surgery. However, discomfort can be controlled with medications prescribed by your surgeon. Although the worst of your swelling will dissipate in the first few weeks, it may be three months or more before the final results of your surgery are apparent. You'll be encouraged to begin walking around on the day of surgery, and can return to work within a few days. Any stitches will generally be removed.

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Breast Revision/Breast Reconstruction    View Photos

Procedure: This category of breast implant patients involves those women who have had a previous breast augmentation and are not completely satisfied with their results or they are having problems related to their enhancement. It has been estimated that up to 40% of breast surgery patients are not satisfied with their results. The most commonly seen problems include asymmetrical implants, hard implants with capsular contractures, and other issues related to the implants like rippling along the edges, thinning of the breast tissue or "rock in the sock deformity" with bottoming out of implants that were placed above the muscle and have fallen with time or pregnancies. Recently, the FDA has approved the use of silicone gel implants. This has resulted in a dramatic increase in the number of patients who want to exchange their saline implants for the silicone variety. Some women what to change their implant size and I know this may come as a shock to you but the vast majority of women I see in my office desire smaller implants!

Breast revisions typically involve exchanging implants (saline to silicone), adjusting the pocket to soften the breast and move the implants to a more appropriate position and adjusting the location of the implant (usually moved to a submuscular position). Tightening of the skin envelope or "mastopexy" may be suggested to obtain the most desirable shape to the breast. High riding implants sometimes found after a transaxillary augmentation (arm pit incision) can be corrected by lowering the implants after I adjust the pockets. Laterally displaced implants (those that move under the arm over time because of back sleeping or excessive opening of the lateral pocket at your original procedure) may require internal sutures to close off the pocket and repositioning of the implant.

Anesthesia: Most breast revisions require the use of a general anesthetic.

Side effects/risks: The risks from a breast revision procedure are typically greater than that of a first time enhancement. All issues that can occur with a breast implant can occur again. The rate of capsular contracture has been reported to be higher with each additional procedure but I have not personally seen this to be the case. It is unlikely that perfect results will be obtained but my experience has been that the overwhelming majority of patients are very happy with their decision to undergo additional surgery.

Recovery: Recovery is about the same or slightly longer than that of a primary breast enhancement which is typically four or five days. I see patients once a week for about three weeks to make sure we are moving the breasts correctly so that they remain soft and natural and symmetrical in appearance.

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