A guide to the best possible breast surgery, since no one operation fits all
Written by two breast-specialist cosmetic surgeons, this book provides a wealth of information, coupled with their personal experiences, to bring together all of the relevant aspects of breast augmentation in an informative, readable, and current source of reference for prospective patients. Breast augmentation remains the most common cosmetic surgery operation on both sides of the Atlantic. Advances and improvements in both the implants available and techniques possible make the procedure more reliable. Because expectations also continue to rise, it is vital that each individual has a realistic idea of the outcome. There is plenty of discussion on the internet, from the media, and among friends, but the majority of women have no medical training to put the surgical issues into context. Informed decisionmaking gives the best possible chance of optimal result and patient satisfaction, and requires clear communication of the risks and benefits, such as the kind found in this guide.
|Publisher:||John Blake Publishing, Limited|
|Product dimensions:||5.10(w) x 7.70(h) x 0.70(d)|
About the Author
Miles G. Berry, MS, FRCS, is a plastic surgeon who has published more than 50 peer-reviewed articles. He has also written two textbooks and a series of review articles for the Journal of Plastic, Reconstructive & Aesthetic Surgery (JPRAS). JPRAS awarded a paper of his on breast surgery "Best Paper in 2011." Dai Davies, FRCS is a consultant plastic surgeon and the author of Plastic Fantastic and Safe Cosmetic Surgery.
Read an Excerpt
The Good Boob Bible
Your Complete Guide to Breast Augmentation Surgery
By Miles G Berry, Dai Davies, Maxine Heasman
John Blake Publishing LtdCopyright © 2013 Miles Berry and Dai Davies
All rights reserved.
INTRODUCTION: WHY DO WOMEN HAVE THEIR BREASTS ENLARGED?
MAXINE HEASMAN, AUTHOR OF THE ULTIMATE CLEAVAGE, GIVES A PERSONAL ACCOUNT.
Ever since my late teens I had been unhappy with the size of my breasts. Even though back then I considered them too small, they were very firm and pert so I could not really complain too much. I never regularly wore bras as I had nothing much to fill the cups; there would always be a dimple in the bra material due to the lack of substance behind it! This lack of support over the years meant my 34A breasts inevitably gave way to gravity. The final straw came when I saw myself topless on the beach on a holiday video. I looked awful! What little I had looked all droopy and saggy; I realised my breasts were past their peak and would never be the same again. It was then that I knew there was nothing else for it: I had to have my breasts improved with implants.
I was worried and confused about so many things and absolutely petrified of going under the anaesthetic. How I wished then that I could speak to someone about my concerns, not a surgeon or a clinic but someone who had been through it herself and would really know what I was experiencing. I know it sounds corny, but I started looking at modern female celebrities and decided if they could go through with it and come out looking as wonderful as they do, then so could I. It is fair to say that every celebrity with breast implants was an inspiration to me.
Eventually, after many months of dithering and pondering I made my decision and I will never look back. My new figure has given me so much more confidence and a completely new outlook on life. I now walk into a lingerie department and know that I can wear almost anything in stock and look sexy in it. In the days of my 34A all I could do was look with envy at the sexy bras, knowing full well that if I tried to wear them I would look ridiculous rather than sexy.
For most women, breasts symbolise femininity and consequently, having small ones can lead to a feeling of being unfeminine. If you do not feel feminine, you do not feel sexy and these two aspects alone can lead to feelings of insecurity and inferiority. Many women do not let their partners see them naked for months, sometimes years, due to unhappiness with the way they look. If a woman's small breasts are really causing her concern, it seems as if they are glaringly obvious to everyone else – it's as if she has a big red spot on the end of her nose and there's a tendency to assume everyone is looking at it. In reality, most people will look at the woman as a whole and probably not even think twice about the size of her breasts. Of course, there will always be men who will talk to a woman's breasts instead of her face, but that's an exception!
There will not be a day that goes by without seeing curvy full-breasted women in advertising, magazines or films, however, and it is this continual image portrayed by the media that can exaggerate feelings of unhappiness with their breasts in women. Some live with this self-consciousness but others may decide to opt for cosmetic surgery.
This unhappiness can result from:
A failure of normal breast development at puberty, resulting in small breasts or breasts that differ in size and/or shape.
Beautiful breasts before or during pregnancy, which are lost after breastfeeding.
An improvement for other personal reasons.
'I never developed much to begin with ...'
Inadequate breast development during puberty produces breasts that do not appear normal. An abnormal shape may be either a deformity or an imbalance with the rest of a woman's figure. If the breasts develop abnormally during puberty, their shape can be abnormal and can affect how she feels about herself. No woman has two breasts exactly the same and sometimes the amount of variation in breast shape and size is large. Imagine the difficulty in trying to buy clothing, dressing to feel normal and how you might feel when clothing is removed.
'I lost everything I had after my baby ...'
After pregnancy, the breasts will have been stretched and there is an enlarged skin envelope, with less breast tissue to fill it. The result is an empty upper breast and a droopy appearance of the lower breast.
'I want to improve for personal reasons ...'
The third group of women who seek augmentation usually wish to improve the shape and/or size of the breast for a variety of personal reasons. These are women who want to feel better, to be the best they can be. The reasons are personal and every woman has the right to optimise any aspect of her appearance.
'Wanting to be normal ...'
There is nothing wrong with wanting to feel normal and to be the best you can be. We all have an idea of normality created by media, including magazine advertising.
WHAT IS NORMAL?
If you ask 100 women, you might get 100 different answers. What is normal is personal to each individual and important to you alone. Wanting to feel normal and to be the best you can be are human traits that motivate and reward on a personal level.
Women's breasts are special to them, special in ways that may differ among women and special to each woman in a personal way. Breasts change significantly during a lifetime. Ageing alters the shape and position of a woman's breasts and is not necessarily consistent; they are also never the same.
As a result of this constant change, a woman may view her breasts differently at different times. The best breast at one time may not necessarily be so at another.
EXPECTATIONS: WILL I BE HAPPY?
The best breast is the natural female breast until nature misses a beat, takes its toll or a woman decides her breasts are not how she would like them to be. Although it sounds obvious, the only truly natural breast is a completely natural one. An augmented breast is not totally natural and you should not expect it to be. However, a well-performed augmentation should leave you with a better shape than you had pre-op.
If you want totally natural breasts, you should probably not have breast augmentation (BA)! On the other hand, if the benefits outweigh the trade-off and the risks of BA are acceptable to you, augmentation provides options that can improve what you cannot improve or restore.
Your expectations for augmentation must be realistic for you to be happy with the results. The goal of auugmentation is to improve the size and shape of the breasts to the extent that the results meet your goals and you can have a more positive self-image. Although these feelings may allow you to project a more open, positive image to others, the only completely predictable change is larger breasts.
This is an operation on the breasts, not the brain!
Positive psychological effects are common and widely reported, but not necessarily predictable. Certainly, your breast augmentation cannot be expected to have any predictable effect on other people. Some will notice and others may not, depending on your choice of clothing and breast exposure. Your love life and relationship may improve, or it may not. The breasts are only one of many factors that affect the quality of one's love life. A better figure does not necessarily guarantee more modelling jobs or an actress more roles. The decision to have a breast augmentation must be based on realistic personal objectives that you should discuss with your surgeon.
There are many women who will be quick to comment that we should be happy with what we have been given and not try to change ourselves. This book makes no such judgements: it has been written for those who do wish to change the way they look. It will, however, bring to your attention many aspects of the procedure that require careful consideration, balancing compromises and trade-offs.
A FEW COMMENTS FROM PATIENTS
'I have been flat-chested all my life and teased because of it. My ex-husband used to be cruel to me and call me half a woman. My present partner never mentions my chest.'
'I have always wanted bigger boobs. I have lost a lot a lot of weight and my boobs have got even smaller; a 36A is too small now. Well, it was my 50th birthday in June 2011 and my husband said if I wanted them done, he will pay for them as a 50th birthday present.'
'My partner helped me to save some of the cost, but I had to borrow the remainder from my bank although I did not think they would approve of me spending money on cosmetic surgery so I made out that I wanted to buy a car!'
'I never let him see me full frontal; I keep myself covered up. My two teenage daughters are very voluptuous and this makes me feel even more inferior – I just want a nice bust to feel like a normal person for once in my life.'
'My feelings go back to being nineteen years of age when I was as thin as a poker. I eventually developed and was quite content with myself, but two of my friends (who were all large-breasted) used to rib me. I did not think at that time that they were all a lot fatter than me and most of it was probably fat anyway. If I am perfectly honest I remember even writing to an agony aunt, who more or less told me to be happy with the rest of my life. My partner's previous wife was built like Pamela Anderson and I think that sometimes he may compare me with her. I tell myself that I have a better personality to compensate! The bottom line is I have other problems, i.e. stretch marks, broken veins in my legs, and all the signs of maturity. I can live with them, cover them up, anything, but this is a real deep problem, which has taken away my self-confidence.'
'The thought of having bigger, firmer, and shapely boobs occupies almost every thought. I have wanted implants since the birth of my third child, six years ago. They have become less firm, and now they look like two wet socks dangling on a washing line. I look like I have an old women's chest now; my nipples point outwards and what I have got flops about, and I am feeling totally miserable.'
'I am only 34AA and I feel really unfeminine; it really does get me down and depressed. I would be so happy with the B cup.'
'I was constantly subjected to cruel jokes about my bust by boys and girls alike. I wore padded bras, even under my halter-neck tops. I am sick of being called a little girl. Although I like to wear sexy clothes, I do not feel womanly ever.'
'I get really depressed at the moment because I feel like I have a little girl's figure. I have even split with my husband over it through jealousy – I do not like him looking at other women, even my own sister (who, I might add, has quite a bit up top). I have had both my sister and her husband take the mickey out of me and made me cry many a time. I do not even go to family parties because I am not happy with myself – I have let it rule my life quite a bit.'
IF YOU DON'T KNOW WHERE YOU'RE GOING, YOU ARE UNLIKELY TO GET THERE!
Let us start by assuming you would like to have breasts that are beautiful, or at least better than they are now.
What is a beautiful breast?
What is better than they are now?
The more clearly you define your expectations and the better you communicate individual and specific desires to your surgeon, the more likely you will achieve your goals.
A good place to start is to make a list: What do you dislike about your breasts? Here are some examples.
My breasts are too small for my figure
I wish the top of me matched the bottom
I cannot fill up any bra
I wish I could wear a T-shirt or top without a bra
I am sick and tired of buying things to fit the bottom and having to spend more money altering or filling the top
'Cleavage' is not a word in my vocabulary
Every bathing suit I buy must contain helpful devices
My upper breasts look like ski slopes – no, they look worse than a ski slope!
I wish I had what I had before I was pregnant or I wish I had what I had when I was pregnant.
What would you like? List the basics based on what you know and refine your list after reading this book. For example:
Fuller upper breasts
A certain bra 'cup' size
Bulkier breasts, not huge but proportionate to my figure
Larger natural breasts
A better shape to my breasts
Please fix my weird nipples
More equal in size and shape
'Jordan' or 'Beckham' breasts – large, round and globular.
Now study your list carefully and ask yourself if, in the long term, you are willing to live with your choices.CHAPTER 2
THE ORIGIN AND DEVELOPMENT OF THE BREAST
The word 'mammal' derives from the Latin mammalis, meaning 'of the breast', indicating that mammals conceive and develop their young within the uterus and after birth, nourish them with milk produced by the mammary glands. Any word containing 'mamma' or 'mammo' therefore refers to the breast – for example, 'mammoplasty' indicating plastic surgery of the breast.
As with teeth and feathers, breasts develop from between the two layers of embryonic skin, and are, in fact, modified sweat glands. Both men and women develop breasts from the same embryological tissue. The milk lines are two vertical lines formed by thickenings of the epidermis (skin) called the mammary ridges and these are along the underside of mammals of both sexes. They extend from the armpit to the groin and develop in the embryo. This milk line fragments into individual buds, which in primates develop only in the chest area whereas in other animals, such as in pigs and dogs, they develop along the entire length of the trunk.
Nipples can develop anywhere along the milk line. Most humans have two nipples, but in some cases extra or accessory nipples will develop along the milk line. Sometimes women can grow extra breasts (e.g. in the armpit), but this is very rare.
In pious early Christian times, extra nipples or breast tissue were associated with witchcraft. Hence, witch hunters were allowed to inspect women and those found to have any extra nipples were sentenced to death by burning. More modern reference to the stigma of extra nipple(s) can be found in Ian Fleming's The Man With the Golden Gun, where Scaramanga plays the James Bond baddie.
Because primates live in trees and have to carry their offspring around with them, a small litter of one allows much more freedom for climbing. Primates have therefore evolved over time to produce a single child with each pregnancy, thus only one pair of breasts. All primates, except the human female, have flat chests when not lactating.
Primates usually walk on all fours, which has the effect of concealing the chest. Sexual signals are therefore displayed from behind through the rump and are a key mating stimulus. A human female stands upright and so her breasts are the primary sexual signal, while the buttocks are relatively flat and concealed.
The anthropologist, Desmond Morris, conjectured that the breasts mimic the buttocks as one of the prime areas of sexual signal transmission and their success in this regard has interfered with their primary physical function, that of producing milk. The obvious and clearly displayed primate rump plays a significant role in mating signals because primates walk on all fours. This is completely opposite in the human as we stand upright on two legs, so the female breasts are a significant feature in display. Often the cleavage mimics the buttocks.
The breast bud present at birth is sensitive to the mother's hormones; in particular prolactin and oxytocin, which can occasionally stimulate milk production from the newborn breast, the so-called 'Witch's Milk'.
In the human at puberty the breast bud responds to the female hormone, oestrogen, increasing the volume of breast tissue and thereby creating the adult breast. This is highly variable between women and even those closely related, such as mothers, daughters and sisters.
Occasionally, the breasts are very sensitive to oestrogen and it is possible to develop giant breasts, so-called 'Virginal Hyperplasia' or 'Gigantomastia', resulting in breasts weighing as much as 7–8kg (15–17lb), with the nipple hanging down well below the navel.
Excerpted from The Good Boob Bible by Miles G Berry, Dai Davies, Maxine Heasman. Copyright © 2013 Miles Berry and Dai Davies. Excerpted by permission of John Blake Publishing Ltd.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
Preface - The Ultimate Breast vii
Foreword: Knowledge Is Power ix
1 Introduction: Why Do Women Have Their Breasts Enlarged? 1
2 The Origin and Development of the Breast 13
3 The Anatomy of the Breast 25
4 Finding a Suitable Surgeon 39
5 The Consultation 55
6 Anaesthesia 67
7 Risks and Complications 85
8 The Breast Prosthesis 99
9 Preparation for Surgery 123
10 The Operation 143
11 Postoperative Recovery 153
12 Mastopexy Augmentation 173
13 Maintenance 185
14 The Patient's Perspective 193
15 Bras and Beyond 209
16 Further Information 221
17 Useful Contacts 235
18 Glossary 237
19 Further Reading 241
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