Understanding Breast Anatomy – Having Breast Surgery?

Coco Ruby Plastic Surgery- Anatomy and Glossary of Breast Image - Naked Female with Cut Orange

Having Breast Surgery? – Understand your Breast anatomy for a better result

Whether you’re considering breast augmentation, breast lift, or breast reduction, your plastic surgeon will examine your breasts and explain to you how the surgery works. Knowing more details about the anatomy of the breast and some common glossary terms will definitely help you understand your plastic surgeon better.

So, we’ve put together this article to get you more familiar with the anatomy of the breasts and everything related to breast surgery.

When do the breasts form?

Up until puberty, both boys and girls have similar breast shapes. After reaching puberty, hormonal changes stimulate breast budding and the breast parenchyma (tissue) starts to grow and change in size and shape. Throughout puberty, the breasts will become larger, the nipples will become bigger and more erect, and the areolas (pigmented skin around the nipples) will become more round and darker. Breasts usually stop growing and reach their mature size and contour by the age of 18. Throughout life, many factors can affect the shape and size of your breasts. These include ageing, loss of skin elasticity, pregnancy, breastfeeding, the menstrual cycle, weight gain or loss, and many others.

Coco Ruby Plastic Surgery- Anatomy and Glossary of Breast Image - Breast Cross section with Labels

Breasts – What are they made of?

The anatomy of breasts is a little complex. Boobs consist of three main tissue types; glandular, fat, and connective.

  • Glandular tissue: This is the area of the breast responsible for milk production (lobes). As well as the tubes responsible for carrying milk to the nipple (ducts).
  • Fat tissue: Gives the breast the bulk of its size, also called “adipose tissue”.
  • Connective tissue: Holds everything together and gives breasts their form and shape. Cooper’s ligaments ( or suspensory ligaments of Cooper) are an important part of the breasts connective tissue.

What is the anatomy of the breast?

Now that you know what breasts are made up of, let’s talk about the anatomy. Breasts overlay the chest wall muscles, known as the pectoral muscles. There are two layers of muscle here, the inner one is the “pectoralis minor,” and the outer one is the “pectoralis major,”. They sit right on your ribs. These muscles are covered by a thin layer of fibrous tissue called the “fascia”. Surgeons often place breast implants under the pectoral muscles, using the “submuscular placement” technique.

The glandular tissue is organized into around 15-20 lobes in each breast, each of these lobes is made of many smaller tissue collections called lobules. These are the glands that produce breast milk. They feel harder than the fat tissue surrounding them, and that’s how surgeons tell fat tissue from glandular tissue in the breast when operating. A network of very small ducts run between the breast glands to transport milk to the nipples. Breast cancer usually arises in glandular tissue.

Fat tissue surrounds glandular tissue and gives the breast the bulk of its size. Within this tissue run many nerves, veins, arteries, lymph vessels, and lymph nodes. Connective tissue runs through the whole breast to support its structural integrity. “Cooper’s ligaments” are the main component of the connective tissue. Think of these ligaments as being an intricate web of very thin (but tense) cords running in your breasts. Furthermore, cooper’s ligaments are crucial when it comes to keeping your breasts perky and firm, and their stretching can lead to breast ptosis (saggy boobs).

The anatomy of the breast is extremely important in understanding how your doctor is going to perform surgery. It will also help you understand the different surgical incision and implant placement options.

Coco Ruby Plastic Surgery- Anatomy and Glossary of Breast Image - Breast Cross section Sub-Fascial Image Illustration

What are breast implant placement options?

Implant placement refers to the exact location where your surgeon will insert the implants in your breasts. Your surgeon might choose one of the following options:

  • Submuscular: The breast implant is inserted under the pectoral muscle (pectoralis major).
  • Dual plane: Also known as “partial” submuscular. The upper half of the implant is covered by the pectoralis major muscle, while the lower half is covered only by the breast tissue.
  • Subfascial: The breast implant is inserted between the pectoral muscles and the thin layer of fascia covering them.
  • Subglandular: The breast implant is inserted between the pectoral fascia and the glandular tissue

Your plastic surgeon will choose one of these approaches for breast augmentation, Depending on your anatomy. Subglandular placement is usually only possible in women who naturally have a good amount of breast tissue to cover up the implant. The advantages include an easier procedure and less recovery time, however, the upper edge of the implants might show if you don’t have enough breast fat. This is why most plastic surgeons prefer submuscular placement.

Submuscular placement is preferred by experienced plastic surgeons even though it’s a slightly longer and more technically demanding surgery. This location provides better implant coverage and more natural-looking breasts in the long term. The upper pole of your implant will be covered and hidden by your pectoral muscles, which gives your breast a smooth and natural slope. Moreover, submuscular placement is associated with fewer capsular contractures, less risk of breastfeeding and nipple sensitivity problems, and does not interfere with mammograms. The disadvantages of submuscular implants include a slightly longer recovery time and, sometimes, obvious wrinkling when the chest muscles contract.

What are the different surgical incisions in breast augmentation?

There are several surgical incision techniques that your doctor might choose from depending on the surgical approach;

  • Periareolar technique: An incision is made on the edge of the areola (pigmented skin around your nipple). The leftover scar usually blends with your pigmented skin and fades away with time – not commonly performed.
  • Inframammary technique: An incision will be made along the crease under the breast. This is usually the most sterile and most preferred incision type. The scar will be along the crease under your boob (inframammary crease). In other words, it will be practically unnoticeable.
  • Axillary technique: Or more commonly an “Asian boob job” (due to its popularity in East Asia). Unlike the above, the surgeon creates an incision in the armpit. This makes the procedure perfect for women who want a scarless breast augmentation. However, this is not suitable for everyone.

Coco Ruby Plastic Surgery- Anatomy and Glossary of Breast - Breast Surgery Incision Illustrations

Important cosmetic breast surgery glossary

Whether you’re just researching breast augmentation surgery or you’re preparing to get a boob job soon, these are some terms that you will probably come across during your research with a simple explanation of each:

  • Areola: The skin around your nipple
  • Axilla: This is the medical term that means armpit
  • Asian boob job: Breast augmentation with an axillary (armpit) incision
  • BIA-ALCL: Short for Breast Implant-Associated Anaplastic Large Cell Lymphoma. An extremely rare type of immune cell cancer, that has a correlation to textured breast implants only.
  • Capsular contracture: This is a complication that happens when fibrous tissue forms around the breast implant and leads to deformity
  • Cooper’s ligaments: This is the network of ligaments that extend through the breasts and they’re responsible for maintaining their shape and structural integrity
  • Inframammary crease: The skin crease under the breast.
  • Mammoplasty: Cosmetic surgery of the breast
  • Mastectomy: The surgical removal of the breast
  • Mastopexy: Breast lifting
  • Nipple areola complex (NAC): The term used to refer to both the nipple and areola at the same time
  • Saline implants: Refers to implants that are mainly full of saline (water and salt)
  • Silicone implants: Unlike the above these implants have a silicone gel filling.
  • Smooth implants: Implants that have a smooth surface outer coating
  • Textured implants: Implants that have a rough (textured) surface outer coating
  • The tail of Spence: Also known as the axillary process or the axillary tail. It’s the extension of breast tissue that extends towards the corner of your armpit

Breast conditions that Plastic Surgery can correct include;

  • Breast Ptosis: This is the medical term for saggy or droopy breasts. It is a natural part of the ageing process and one of the common indications for breast lifting (mastopexy).
  • Asymmetric breasts: This is when your breasts are disproportionate to each other. In other words, their size and/or shape is noticeably different. We can treat and improve breast asymmetry with breast augmentation surgery.
  • Pigeon chest: Also known as Pectus carinatum, which is a medical condition where the chest bones protrude forward. Plastic surgeons can help mask this deformity using breast augmentation surgery.
  • Macromastia or Gigantomastia: Abnormally large breasts that can cause neck pain, back pain, breast pain, and skin inflammation. Breast reduction is the best way to treat the symptoms of heavy breasts.
  • Symmastia: Is a congenital deformity. As the breasts grow they attach to each other with no clear cleavage line between them.
  • Tuberous breasts: This is a medical condition in which not enough breast tissue develops during puberty, which leads to cone-shaped breasts with pointy nipples. Our surgeons offer tuberous breast correction surgery to improve their appearance.
  • Capsular contracture: This is a complication of breast implants where the breast tissue tightens causing breast deformity, pain, and firmness.

Cosmetic breast surgery is, of course, not only for women who have specific medical conditions. If you are unsatisfied with the shape, size, or symmetry of your breasts, breast augmentation is definitely for you.

What are the different cosmetic breast surgeries?

So now that you know the basic anatomy, the different placement sites, the different incision techniques, and the general lingo, you can understand cosmetic breast surgery more easily:

Breast augmentation with implants

breast-augmentation-dr-geoff-barnett-before-and-after-melbourne

This is the most common cosmetic breast procedure. First, your plastic surgeon will make one of the three skin incisions (periareolar, inframammary, or axillary). Then, using surgical tools, he/she will separate the chest wall (pectoral) muscles from the breast tissue and create a space or pocket were for the breast implant. The pocket can be either submuscular, subglandular, or subfascial as explained above. Surgeons most commonly use silicone implants, which provide a more natural look and feel. After the implants are in the correct position the surgeon will close the different layers of tissue, and then close the initial skin incision with fine sutures.

Breast augmentation with fat transfer

fat grafting to breasts using liposuction

Autologous fat transfer is an excellent and popular technique that makes your breasts larger without implants. In this procedure, your plastic surgeon harvests fat from other parts of your body through liposuction. Your surgeon then purifies the fat and strategically injects it into your breasts. This outlines them, improves their contour, and also creates more upper pole fullness. Fat transfer does not leave any scars and provides excellent results with the extra benefit of contouring and sculpting other parts of your body as well.

Composite breast augmentation

A Composite Breast Augmentation combines both silicone implants and fat together. The Implants will give you a larger size and a natural feel, while fat will fill any defects and perfect your breast and cleavage contours.

Breast lifting (mastopexy)

Lift, before and after

Ageing, menopause, breastfeeding, and weight change can all give you droopy and sagging breasts with nipples that face south. A breast lift repositions your nipples and breasts and pulls your skin tighter to restore a healthy and perky look.

Breast reduction (reduction mammaplasty)

reduction

Women who have large heavy breasts can suffer from a lot of physical issues, including one or a

combination of the following;

  • Shoulder pain.
  • Neck pain.
  • Back pain.
  • Mobility restriction.
  • Rashes and infections, under the breasts.

The above are just some of the issues large breasts can cause. Women with large breasts may also find that their breast cause lifestyle restrictions. In other words, they can’t find clothes that fit properly or they are unable to lead an active life because physical activities cause breast pain. Reduction mammaplasty not only offers relief from these symptoms, thanks to a more proportional breast size but also gives women a new lease on life.

Combining procedures

It should be noted, that you can combine most cosmetic breast procedures together (depending on each woman’s case). If you have deflated and saggy breasts, for example, you might benefit from a breast augmentation combined with a lift.

Our Surgeons

Coco Ruby Specialist Plastic Surgeons

Our surgeons are some of the best plastic and reconstructive surgeons in Australia. Not only do they have the experience to perform these surgeries but they are also unwavering in their dedication to help their patients reach the outcome they desire. In addition to a very wide variety of cosmetic surgeries, our surgeons have extensive experience in breast augmentation surgery, tuberous breast correction, breast reduction surgery, breast lifts, fat transfer, and other cosmetic breast surgeries.

So, if you are thinking about breast surgery call us to set up an appointment with one of the top plastic surgeons in Australia to discuss your needs.

Sources:

Last updated: 19/02/2021
Author profile image
Dr Craig Rubinstein - MBBS, FRACS (Plast)
Dr Craig Rubinstein MBBS, FRACS (Plast), a Specialist Plastic Surgeon, is one of Australia's most respected Melbourne Surgeons for Breast Augmentation, Breast Lift (Mastopexy), Breast Reduction surgery and Abdominoplasty procedures. Using advanced surgical techniques to gain better body contouring and natural-looking surgical results, Dr Rubinstein is highly regarded by peers and patients for best-practice Clinic Patient-care and patient education strategies. He published a chapter on corrective surgery for Breast Asymmetry. Qualifications/Training Fellow of the Royal Australasian College of Surgeons (FRACS) The Australasian Society of Aesthetic Plastic Surgery (ASAPS) The Australian Society of Plastic Surgeons (ASPS) The Australian Medical Association (AMA) American Society of Plastic Surgeons (ASPS) The International Society of Aesthetic Plastic Surgeons (ISAPS) Founder: Cosmetic Surgery for Women and Men - Plastic Surgeons Group Bio Page: https://cocorubyplasticsurgery.com.au/dr-craig-rubinstein-plastic-surgeon/