Breast

Congenital Breast Deformities: Surgical Advances Offer Solutions

Breast development in adolescence and the teen years is an important marker in the transition to adulthood for young women. At an age typified by self-consciousness about body image, coming to terms with anomalies in breast development is particularly difficult. “Most congenital breast anomalies are not medically dangerous but can cause emotional distress”, says plastic surgeon and breast specialist Dr. Constance M. Chen. Fortunately, these conditions can usually be corrected surgically preempting long-lasting effects on self-esteem.

Breast development begins before a baby is born and while some congenital anomalies may be evident at birth, others may not become apparent until later in childhood or at puberty. While genetic factors sometimes play a role, the cause of most of these disorders is unknown.

Dr. Chen points out that many differences that may be initially worrisome – like breast buds of different sizes or breasts that develop at different rates – are part of normal development and may resolve on their own. “In these cases”, she says, “surgical intervention is best delayed until development is complete. In all cases, treatment will depend on the severity of the deformity and its psycho-social effects”.

Hypoplastic breast is a condition in which one or both breasts don’t develop normally during puberty. The result may be severely asymmetrical breasts or, if both breasts are involved, very small breasts that are out of proportion with the woman’s body. While most women with hypoplastic breasts have normal hormone levels, hormone production or regulation sometimes play a role and can affect lactation.

Treatment for hypoplastic breast is generally breast augmentation of the underdeveloped breast(s) with implants or by using a woman’s own tissue (‘autologous reconstruction’), usually taken from the abdomen, to fashion a new breast. These techniques are similar to those used for cosmetic augmentation or for breast reconstruction when a woman has lost a breast to mastectomy. When only one breast is hypoplastic, another option is to achieve symmetry by reducing the fully developed breast (‘reduction mammoplasty’).

Poland syndrome, first described by a19th-century doctor, is a congenital syndrome that develops in the first six weeks after conception and typically involves missing or underdeveloped chest muscles on one side of the body. The characteristics of Poland syndrome can vary widely and may include, in addition to an underdeveloped breast, abnormalities of the chest wall, the ribs, the arm, and the hand. Treatment is generally via reconstructive surgery and depends on the severity of the condition.

Tuberous breast deformity (also known as constricted breast) results in one or both breasts failing to develop normally during puberty. In mild cases, the affected breast may just be smaller. In more severe cases, the base of the breast may appear constricted, with less skin and volume along the crease, the crease may be positioned too high on the chest wall, or there may be bulging (herniation) of breast tissue through the areola. Treatment may include expanding the constricted breast base, lowering the crease, adding volume and skin, and reconstructing the nipple-areola complex.

Supernumerary breast tissue may develop in the embryo and cause breast tissue to be found outside its normal location on the chest, anywhere from the abdomen to the armpit. The tissue may be just a small nipple or a large amount of tissue. Treatment isn’t always necessary but depending on its location and the discomfort it causes, the tissue can be surgically removed. Polymastia (an extra breast) and polythelia (an extra nipple) can similarly be treated with surgical removal.

Correcting congenital breast deformities is often driven as much by psychological and social motivation as by medical necessity. Consultation with a plastic surgeon can help every woman evaluate her options, set appropriate expectations, and make the decision that is right for her.
Dr. Constance M. Chen

About Dr. Constance M. Chen

Constance M. Chen, MD, is a board-certified plastic surgeon in New York City with special expertise in the use of innovative natural techniques to optimize medical and cosmetic outcomes for women undergoing breast reconstruction. She is Clinical Assistant Professor of Surgery (Plastic Surgery) at Weill Cornell Medical College and Clinical Assistant Professor of Surgery (Plastic Surgery) at Tulane University School of Medicine.

Dr. Chen is frequently invited to lecture nationally and internationally on new advancements in breast reconstruction and the surgical treatment of lymphedema. She is the author of three books, five book chapters, and fifty journal articles. She has also won numerous awards for her work in plastic and reconstructive surgery at the local, regional, and national levels.

Dr. Chen has developed a reputation in the community for the personalized attention that she devotes to her patients. She is committed to aesthetic restoration of the breast and body, and enjoys helping her patients achieve overall well-being. At the end of the day, there is nothing more important to her than the joy she hopes to bring to her patients’ lives. Come into the beautiful world of Dr. Constance M. Chen.

Plastic Surgery’s Importance Underlined by Study on Asymmetry Correction in Young Women, says Dr. J Plastic Surgery

A September 24 article in Medical Xpress reports on a study by doctors at Boston Children’s Hospital which looked at the impacts of plastic surgery to correct major breast asymmetries – sometimes amounting to as much as two cup sizes – in young women.

The subjects of the study, with an average age of 18, received breast augmentation and/or breast reduction to make their breasts more similar. A few years later, the study found significant improvements in self-esteem and psychological function in the subjects that were comparable to other women their age.

Beverly Hills plastic surgeon Payam Jarrah-Nejad, M.D., F.I.C.S., F.A.C.S., better known as Dr. J, says that the procedures in the study are an example of a broad area of plastic surgery that is not so much about attracting positive attention as it is about avoiding negative or unwanted attention.

Dr. J adds that breast asymmetries are relatively rare compared to two other more common situations where breast reduction may be desired: women for whom unusually large breasts have become a problem and men with oversize breasts who may suffer from a glandular condition called gynecomastia.

The double board-certified plastic surgeon says that the issue for men is psychosocial – younger men especially can be traumatized by bullying while also being very profoundly embarrassed by having ‘moobs’. They will typically go to great lengths to make sure they are not seen bare-chested or wearing tightfitting shirts and some may begin to socially isolate.

As for women, breast reductions are typically obtained for two primary reasons, says Dr. J. Many younger women receive unwanted attention to the point where they may begin to feel defined by one bodily feature. Women of all ages are also often plagued by physical issues that can include back pain and the inability to participate in certain athletic activities,

In all of these cases, Dr. J says that intelligently planned plastic surgery can make an enormous difference in a patient’s outlook. No one, says Dr. J, should be defined by a single physical characteristic in any way. In a better world, he adds, people might not be so obsessed with body parts to the point where any departure from a perceived norm can spark cruelty.

It’s also possible for some individuals to develop self-confidence without regard to bodily features, he says. However, in the world we actually live in, breast reductions and other treatments are usually the most direct path to freedom for people who feel trapped by their bodies.

About Dr. Payam Jarrah-Nejad, Dr. J

Payam Jarrah-Nejad, MD, FICS, FACS is a double board certified Beverly Hills Plastic Surgeon. Nicknamed Dr. J by his patients and staff, he holds certifications from both the American Board of Plastic Surgery and the American Board of Surgery. Dr. J is also an active member of the American Society of Plastic Surgeons and a Fellow of The American College of Surgeons.

Dr. J first started his medical career during an internship he held in NYU. It was during this time that he also began working with hospitals around the New York area. It was in New Jersey that he completed his training and served as Chief Resident at Morristown Memorial Hospital.

Newly certified by the American Board of Surgery and the American Board of Plastic Surgery, Dr. Jarrah-Nejad received a fellowship at Beth Israel Medical Center in New York City to specialize in hand surgery. The fellowship was under the guidance of Dr. Charles P. Melone which was a big influence on the young doctor. It was during his training at Wayne State University, Detroit Medical Center in Michigan that Dr. J found his true calling working with many well-known plastic surgeons.

Years later, practicing as a board-certified plastic surgeon, Dr. J still uses the same techniques he learned in his training in his frequent operation on the face and body. He is greatly admired by his staff and patients who happily contribute positive testimonials to his website.

Dr. J is known throughout the Los Angeles Area medical community as well as beyond it, for his record of outstanding outcomes and his engaging, patient-friendly personality. He has published a wide range of papers in many prestigious scientific and medical journals and has presented his research to local, regional and national symposia.

Finally, Dr. J has performed pro-bono surgery in several countries as part of humanitarian efforts helping children with congenital anomalies. He works side by side with charitable organizations devoted to providing needy children around the world with free plastic surgeries to repair such issues as cleft lips and palates.

Come into the beautiful world of Dr. J.

‘In Depth’ Series With Laurence Fishburne Discusses Breast Cancer Awareness

Critically acclaimed actor Laurence Fishburne is given high praise for his compelling performances throughout the decades. Now the ‘King of New York (1990)’ actor is using his talents as host for public television’s ‘In Depth’ with Laurence Fishburne. The informational program highlights a large variety of globally essential topics to inform its viewing audience. An upcoming episode is to feature an issue that impacts the lives of many women worldwide: breast cancer.

In the United States, breast cancer is one of the most common types of cancer found in women. Statistically, 1 in 8 women in the U.S. will develop breast cancer in their lifetime. This type of cancer occurs when DNA changes make normal healthy breast cells cancerous.

Risk factors include a family history of breast cancer, being overweight, and women of a Caucasian or African American ethnicity have a higher chance of developing the disease. Regular self-examinations are recommended for catching breast cancer early on, as well as regular breast cancer screenings for women age 40 and up.

Breast cancer is a scary experience for any woman, which is why increased awareness of the disease is crucial in prevention and saving lives. ‘In Depth’ will reveal more details about breast cancer awareness in the new episode. The segment is expected to be distributed during October, or Breast Cancer Awareness month.

‘In Depth’ with Laurence Fishburne is carefully inspected before broadcast. The informational TV segment has accepted numerous awards for its endeavors.

Beverly Hills Plastic Surgeon Sees Marked Increased in Breast Implant Removal Procedures at his Practice

A Beverly Hills plastic surgeon says that interest from prospective patients regarding explanation (i.e., implant removal) procedures has skyrocketed since last July. That was when pharma giant Allergan issued a global voluntary recall of its Biocell textured breast implants. The recall was based on a government warning regarding a rare cancer called anaplastic large-cell lymphoma (ALCL).

Beverly Hills-based plastic surgeon Dr. Payam Jarrah-Nejad, M.D., F.I.C.S., F.A.C.S., aka Dr. J, says that, while he has never used textured implants on his primary breast augmentation patients, he has removed a very large number of them with consistently outstanding results.

The good news for women who have had textured implants and who are worried about possible health impacts or other issues is that explanation is an extremely safe procedure with an excellent prognosis on more than one level. The procedure is called En Bloc Capsulectomy. All that means is that the procedure allows us to safely remove the entire capsule without any contact with the surrounding tissues. Patients are free to make their own decision about what they would like to do next. If they feel like they prefer to do without breast augmentation, for the time being, that’s not a problem. On the other hand, they have plenty of options if they want to get new implants.
Dr. Payam Jarrah-Nejad

“Many patients take the opportunity to fine-tune their prior results by going for a larger or a smaller implant and they are typically very pleased with their final outcomes”, says Dr. J. The plastic surgeon adds that, in the absence of any immediate concerns, there is no right or wrong answer to whether women with textured implants should have them removed. However, women should understand they have the option and the procedure is not only safe but typically has a relatively short recovery time.

“At the same time, of course, it’s also important to go to an experienced and skilled surgeon”, says Dr. J. “My very strong advice is that prospective patients should seek only board-certified plastic surgeons. People don’t always realize that plastic surgery is one of the most demanding of all medical disciplines. It’s important to know that your surgeon has undergone rigorous training both in terms of physical safety as well as the ultimate aesthetic outcome”, he adds. “The safety and health of our patients is always a priority. We offer our patients a comprehensive consultation to allow them to make a well-informed decision. We have had many patients who have felt much better after explantation”, Dr. J said.