Breast

Mr Fattah is highly skilled to perform a number of breast surgeries following his super-specialty breast fellowship training. The most common procedures are breast augmentation, breast reduction, mastopexy, and male breast surgery for gynaecomastia.

Breast Augmentation

Breast augmentation is the surgical placement of breast implants and is one of the most common cosmetic surgery procedures in women. It is typically performed as day case surgery meaning that you can go home the same day. There are numerous options in breast augmentation from what incision can be used, whether the implant should be above or below the muscle and what kind of implant should be used. A great deal of time will be spent with you in your consultation to explore your aims and explain your options in order to tailor a breast augmentation procedure that best meets your needs.
The care and advice I received. Both post and prior to my procedure was excellent. I am delighted with the results and would recommend both Renacres [Hospital] and Mr Fattah for this procedure. Mr Fattah took extra time and care due to my athletic physique to ensure the outcome was exactly as I have hoped for. Recovery was quick with no complications. To sum up I now feel “complete”. Thank you!

PW, Breast Augmentation

9 weeks have passed since my breast augmentation with Mr Fattah and I am so happy with the results. I never thought I’d be body confident and I also never thought I’d have symmetrical breasts! It was the best decision I’ve ever made, I wish I would of done it sooner.

NM, Breast asymmetry correction

Mastopexy

Most ladies requesting breast surgery want improved fullness to the breasts. Dissatisfaction with the breasts is common after having children when the increase in breast size stretches the skin. Once the breasts decrease in size again, there is an excess of skin, which consequently causes the breast tissue to lose support and sag (ptosis). This can also occur due to the aging process. Possible surgical options include using a breast implant to correct the ptosis and increase the volume of the breast. This can be a good option, but in some cases it will make the breasts too large relative to your silhouette. The other option, mastopexy, removes and tightens the skin that is left behind and involves repositioning the nipple onto the new breast shape. Mastopexy is performed as a day case procedure and drains are not often required.

Mastopexy Augmentation

This procedure gives an uplift to the breast in combination with a breast implant to give a fuller breast shape. It is more complex than either procedure alone and is especially powerful in ladies who have breast fed or lost large amounts of weight leaving minimal breast tissue behind and large amounts of loose skin. Detailed consultations to determine suitability and advise regarding risks and complications will help you decide whether this procedure is for you.

Breast Reduction

Breast reduction is the surgical removal of breast tissue to reduce the overall size of the breast. It is essentially the same as a mastopexy that removes breast tissue. A breast reduction is often requested on medical grounds such as back & neck pain, pain from the weight of the breasts and soreness under the breast. This operation is very effective at dealing with these symptoms and it still available on the NHS in some regions of the UK.

I am extremely happy with the results of my operation. I have not had any problems with aftercare, if fact I have seen a great many health improvements psychologically and physically: – I am much happier. I’ve not had a migraine since. My posture is greatly improved gaining ¾” on my height. Arthritis pains in the hip and knees greatly reduced. Shoulder pains gone. My smaller breasts compared to large heavy breasts are fabulous, although I am favouring my right breast. You have changed my life. Thank you so much.

NM, Breast reduction
*This procedure is not designed to produce such results but it is heartening to see some patients can achieve so many benefits.

My surgeon Mr Adel Fattah and all his team were superb. The information prior to my operation was first class. I have my operation on the 6th August 2016 at Renacres Hospital, again high praise, so caring professional and efficient. Mr Adel Fattah is by far an outstanding surgeon the result of my breast reduction is amazing. He reduced the size from a 38DD to a 38B moving both nipples upwards. The scarring is healing so well, barely visible around the nipples. I look so youthful and the weight issue has improved my posture. There are photographs available. My overall experience was all positives. Thank you: that sums it up perfectly.

DA, Breast reduction

Areolar reduction

This surgery can be performed under local anaesthetic as a day case and aims to alter the size and shape of the areolar in either men or women. Depending on the size of the breast the diameter of the areolar should be roughly 4.5cm. If you are unhappy with the size of the areolar it can be altered leaving a scar at the junction between the coloured areolar and the surrounding skin. The surgery involves removing a circular or ‘doughnut’ shaped area of the outer areolar leaving a circular areolar of the desired diameter that is in proportion with your breast.

Depending on how much skin is removed it can have a tightening and lifting effect on the breast skin. Soluble sutures are used for the majority of the procedure but a deeply placed permanent suture is used to counteract the natural tendency for the areolar to widen over time. You will normally take it easy for a week or so after the procedure but would be able to return to light deskwork within a couple of days, meaning for most people there is little down time.

Nipple Reduction Surgery

Prominent nipples can make wearing certain types of clothing challenging for both men and women. The procedure is short and low impact and can be offered on a “see and treat” basis. It involves removing a small wedge of the nipple and folding the remaining nipple down to create a new lower profile nipple shape and concealing the scar. Discomfort is minimal and dissolving sutures are used, most people are back to work in a day or so.

Inverted Nipple Correction

This is a minor procedure that can be offered on a “see and treat” basis under local anaesthetic. Inverted nipples are very common and surgery is an option if non-surgical methods such as the nipplette device have been tried and failed. The surgery involves making a small incision in one corner of the nipple and dividing the breast ducts that tether the nipple inwards. Once these are released, a dissolving suture is used to hold the nipple out while the tissues heal. A padded dressing is used for a few days afterwards to stop the bra from pushing on the nipple. The recovery is fast and most people return to work within a day or two. There are few complications associated with this quick minor surgery, but dividing the breast ducts directly impacts breast-feeding so may not be suitable if you plan to breast feed in future.

Male Breast Surgery: Gynaecomastia

Gynaecomastia (often referred to as ‘man boobs’) is the condition where a male’s breasts swell to become larger than normally expected. It is most common in teenagers, but can happen at any age. Severity can range from small amounts of breast tissue around the nipple area, to prominent breast formation. Surgery for this condition is one of the most common procedures Mr Fattah performs on the NHS.

 

Options for treatment include surgical removal of the breast tissue, liposuction or a combination of the two. The size and type of gynaecomastia determines which is the best option. If there are significant amounts of fat then liposuction is the best option, but if there is a significant amount of firm breast tissue surgery may be more appropriate. Surgery for gynaecomastia involves a smile shaped incision placed at the border of the nipple in order to hide the scar. Through this scar, the breast tissue and associated fat can be removed in addition to any excess skin. Both are typically performed as a daycase and surgical drains are not used.

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Frequently Asked Questions

What are breast implants made from and are they safe?
Breasts implants are made of a silicone shell containing a silicone gel ‘elastomer’. The consistency of this in modern implants is very much like jelly cubes. This means that if the shell is damaged, silicone gel does not leak out, but holds its shape: this is why it is often called a cohesive gel. Until recently, silicone implants were banned in the USA, but the wealth of safety data that has accumulated over the years lead to the FDA allowing silicone implants to be used. Before this saline implants were used; these feel much less natural than the modern silicone implants. Mr Fattah only uses the most established brands of implants such as the Nagor Impleo, Allergan Natrelle and Mentor implants all of which come with “lifetime” warranties that are provided by the manufacturers.
Will my nipples change and will I be able to breast feed after augmentation?
Most patients notice a temporary numbness to the nipples after surgery that usually resolves over the following weeks to months. Sometimes, the nipples have heightened sensitivity and may change their erectile behavior. In some cases, breast feeding will be affected meaning you may find it difficult to breast feed.
What scars will I have following a mastopexy?
A mastopexy can be performed using a variety of different techniques that leave different scars. The least scarring is periareolar – a scar around the areolar of the nipple. This is a good option in patients whose nipples are a different color from the surrounding skin as this colour difference hides the scar well. This kind of mastopexy, is limited in the amount of uplift that it can achieve, but can be a good option in selected cases.

Another option is a vertical scar mastopexy, this involves a scar around the nipple and a scar running from the nipple to the crease under the breast: the infra-mammary fold. This type of scar allows the surgeon to perform a full uplift within a limited scar. The downside is that in the early post-operative period the breasts can have an unaesthetic shape and the scar can looked wrinkled. This is only temporary until the breast falls into its more natural position over the weeks and months to come.

Finally, a full Wise-pattern (anchor-shaped) scar is the same as that of a vertical scar mastopexy with an additional line in the infra-mammary fold. This allows significant uplift of the breast and the full range of uplift manoeuvres can be performed with this method. In your consultation, you will be given the information to help you decide which technique best suits your lifestyle and expectations.

Can my breasts continue to sag after mastopexy surgery?
Yes they can. It may be best to think of a mastopexy as resetting the clock, but the aging process will still continue. Techniques are geared toward long lasting results but everybody is different with factors such as the quality of the tissues, smoking and age all playing a role. An honest opinion regarding longevity will be part of your face to face consultation with the consultant plastic surgeon.
Can I remove implants and have an uplift without needing a replacement implant?
Yes you can. A straightforward removal of breast implants leaves the stretched breast tissue behind causing sagging and has an unattractive appearance in the majority of cases. More and more ladies are requesting the removal of their breast implants because they are too big or they no longer want them. Mr Fattah has performed a large number of removal and uplifts that reshape the breast but necessarily leave it smaller after the implant has been removed.