Updated 24 April 2014

Are you a breast surgery candidate?

Are you considering breast surgery? If so, read this first to see if it is a good idea or not.


Very few little girls will grow up to have breasts that look anything like those alien bulges they’re familiar with on their Barbie dolls. Or, for that matter, like the freakishly perfect examples continually thrust at them in the media. Breasts are almost as distinctive as women themselves, and, therefore, hardly ever conform to society’s popular ideal.

Thus it’s not surprising that most women are dissatisfied with their breasts to a certain degree. For some women, though, that dissatisfaction becomes so great that it starts to seriously impact on their quality of life. If you fall into this group, then you may be considering plastic surgery to alter your breasts.

There are essentially four types of plastic surgery available to enhance the breasts: enlargement, reduction, lift and reconstruction.

Breast enlargement

Breast enlargement surgery, also known as breast augmentation or augmentation mammoplasty, involves the insertion of an artificial implant behind the breast to increase its size.

This procedure is done primarily done for cosmetic reasons. A woman may feel her breasts are disproportionately small in relation to the rest of her body, or that one breast is noticeably small compared with the other.

Many women have reduced self-esteem and feel sexually inhibited or less feminine because of their small breasts. Although it can be argued that having breast enlargement done is giving in to societal pressure to conform to ideals of beauty and sexuality, for some women, concern over their breast size can have a major negative impact on their quality of life.

Breast reduction

The goal of breast reduction surgery, or reduction mammaplasty, is to give a woman smaller, shapelier breasts that are in proportion with the rest of her body.

Very large breasts can make some women feel acutely self-conscious, and embarrassed that her breasts are attracting unwanted attention. Apart from cosmetic considerations, women with very large, heavy breasts may experience related medical problems, such as back and neck pain, skin irritation and breathing difficulty.

Breast lift
Breast lift, or mastopexy, is an operation to raise and shape sagging breasts. The breast skin is tightened and lifted, the nipple is positioned higher on the breast, and the excess skin is removed. This procedure may be combined with breast reduction or enlargement surgery.

Breast sag occurs as part of the normal aging process, and factors such as pregnancy and breastfeeding can also contribute to loss of the breasts’ original shape and firmness. Women who have breast lifts are usually seeking a more youthful look.

Breast reconstruction
Breast reconstruction involves surgery to create a breast that has been lost, most often through mastectomy (surgical breast removal) as a result of cancer. The new breast is usually created by the insertion of an implant, or sometimes by using a skin flap and tissue from other parts of the body.

Losing one or both breasts can have a devastating psychological impact, and modern breast reconstruction is a very successful procedure in helping to restore a woman’s self-esteem and her identity as a sexual being after mastectomy.

Who qualifies for breast surgery?
Dr Shane Barker, a plastic surgeon at Constantiaberg mediclinic in Cape Town, says part of qualifiying as a good candidate for breast surgery means being realistic about the results of the procedure:

“These procedures can certainly improve a person’s quality of life – the psychological benefits are considerable. But you have to recognise that there are limitations to the surgery, and you can’t have unrealistic expectations. For example, the patient needs to accept that there will be a certain degree of scarring.”

Apart from having the right mindset and attitude, Dr Barker explains that there are various other important factors that a surgeon takes into account before agreeing to go forward with surgery. These are fairly major operations, and the patient needs to be medically fit to undergo the surgery. Surgery may not be appropriate in some cases, for example in adolescent girls whose breasts are still developing.

The patient discusses the desired outcome of surgery with her doctor, and together they go through all the pros and cons of an operation, as well as the different options available. Your surgeon will explain which techniques are most appropriate in your case, based on factors such as your age, general health, and the condition of your breasts and skin tone.

Don’t rush the decision
Charl Hattingh, a sex therapist in private practice in Cape Town, says that if you feel confused or unsure about why you want to have breast surgery, it might be an excellent idea to talk to a therapist about the issue first, or in addition to your consultations with your plastic surgeon:

“A woman’s breasts and how she feels about them play an important role in her sexuality and self-confidence, and surgery might be appropriate and beneficial in some cases. But it’s an illusion to think you can fix your inside self simply by changing what’s on the outside. You might feel temporarily happier, but the effect won’t be lasting unless you’ve also paid enough attention to resolving the underlying issues.” Olivia Rose-Innes, Health24

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