Breast Procedures


From an aesthetic standpoint there is no question that breasts are in a class of their own. Women desire a fuller, youthful appearance but for some,  breasts may not develop naturally or others may lose the breast volume post pregnancy or breast feeding or massive weight loss. Breast enhancement with implants is designed to restore and enhance their figure, self-image and self-confidence. If volume loss is associated with sagging of tissues then a breast lift is indicated as an additional procedure.


Some women are encumbered by, large, heavy breasts which are too big for their frame and can be associated with neck pain or rashes. These patients may benefit from a breast reduction. Large breasts are not limited to women – some men also suffer from Gynecomastia. Common causes are pubertal growth which never involutes, obesity, certain drugs and medical problems. An estimated 40% or more men may be afflicted by this condition and can benefit from breast reduction surgery.


Breast augmentation is one of the most frequently performed cosmetic surgery procedures in the U.S. and one of our most popular services. Breast augmentation can give women with small or unevenly sized breasts a fuller, firmer, better-proportioned look through the placement of saline or silicone implants in the breast.


Our patients elect to undergo breast augmentation for many different medical and aesthetic reasons, including balancing breast size, compensating for reduced breast mass after pregnancy or surgery, and correcting a congenital breast defect. Under Dr. Niazi’s expert care, patients enjoy great-looking, natural-feeling breasts that are one or more cup sizes larger after the operation.


Breast implants are silicone shells filled with either saline, silicone gel or cohesive silicone gel. All implant types are very safe, and each offers its own advantages. The recent advent of Cohesive silicone gels (non-liquid) or the so called “gummy bear implants” and the structured saline or “IDEAL” implants has meant that patients have more options to choose from.                                                                        

We will help you decide which kind is right for you. During surgery, we will place the implants behind each breast, underneath either breast tissue or the chest wall muscle.


Modern surgical technology makes it possible to construct a natural-looking breast after mastectomy (breast removal) for cancer or other diseases. The procedure is commonly begun and sometimes completed immediately following mastectomy, so that the patient wakes with a new breast mound instead of no breast at all. Alternatively, reconstruction may begin years after mastectomy.


Women whose cancer seems to have been eradicated with mastectomy are the best candidates for breast reconstruction. Those with health problems such as obesity and high blood pressure and those who smoke are advised to wait. Others prefer to postpone surgery as they come to terms with having cancer, consider the extent of the procedure, or explore alternatives.


The reconstruction itself consists of multiple operations, the first of which involves creation of the breast mound and is performed during or after mastectomy in a hospital under general anesthesia. Later surgeries, if necessary, may be done in the hospital or an outpatient facility, with either general or local anesthesia.

There are several ways to reconstruct the breast, both with and without implants; Dr. Niazi will work together with you in deciding which is the best for you.


With aging or weight loss or post pregnancy and breast feeding, breast involution can occur leading to droopiness of the breast along with volume loss in the upper poles for some patients. In these patients the breasts can be lifted to a higher, normal location of the chest as well as creating fullness and cleavage. In some patient additional volume can be added by placement of breast implants (this is referred to as Augmentation mastopexy). As with the straightforward breast augmentations, a patient has similar options in the type of implants she can choose i.e. saline, silicone gel, cohesive silicone gel or the so called “gummy bear implants” and the structured saline “IDEAL”. 


Men are not immune from having Breast related problems. In fact 40% of men over age 40 are reported to suffer from enlarged breasts. Breast enlargement in men starts in puberty due to hormonal influence and in some this persists beyond puberty. In others it is associated with certain diseases and as a side effect of certain medications.


Management includes identifying the cause and treating it. For the unfortunate boys and men in whom the medical management is unsuccessful or the gynecomastia does not resolve, surgical excision or liposuction correction are required. Additionally, liposuction of chest wall or axillae may be needed to get the best possible result. A compression garment is worn for 6-8 weeks post-operatively.


Some women develop large breasts in puberty or the breasts become larger during pregnancy or with weight gain and are associated with upper back or neck pain and rashes in the folds. The breasts become ptotic or droopy with some patients showing significant striae distensiae or stretch marks in the breast skin. It is fairly typical for women to present with a slouched posture to hide the size of the breasts. Patients usually have difficulty in exercising or daily activities, need special bras which are expensive, get grooves in the shoulders from the bra straps. 

A breast reduction inherently entails a breast lift but also need a reduction in vertical and horizontal dimensions. Most insurances require that at least a pound of breast tissue be excised from each breast. It is common for Dr Niazi to recommend getting down to or closer to an ideal body weight prior to surgery as weight changes after breast surgery will negatively impact the results of the breast surgery.


Many women are born with breasts that are uneven in size and shape, which may or may not be noticeable to others. These differences in breasts are often undetectable to patients themselves, causing no problems at all, while other women can have obvious asymmetry, which can cause both an unbalanced appearance and emotional distress.


Asymmetric breasts can be corrected through surgery that either enlarging the smaller breast or reducing the larger one. An implant can be placed in smaller breasts or a breast reduction can be performed on larger breasts. If the nipples appear at different heights, surgery can relocate one or both of the nipples.


All of these options produce breasts that are more similar in appearance, working with each woman’s unique body to achieve the best possible results. Creating a more balanced appearance can help improve physical balance, self-confidence and body image.


Breast augmentation surgery (breast enlargement / breast enhancement) carries many of the same risks associated with other types of surgeries, such as adverse reactions to anesthesia, post-operative bleeding (hematoma), infection, swelling, fluid accumulation (seroma), redness, and pain. However, there are short- and long-term complications specific to breast implants that all breast augmentation patients should be aware of.


As with any cosmetic surgery, the results of breast augmentation may not meet your expectations. Reasons for feeling dissatisfied may include implant size, scarring, wrinkling, asymmetry, and implant displacement (shifting). These results can be minimized with pre-surgical counseling, careful surgical planning, and possible correction with additional surgery. Talk to Dr. Niazi before you undergo breast augmentation to ensure that you have realistic expectations for your implant.


Because breast implants are prone to these and other complications as well as simple wear and tear over time, it is incredibly important that all breast augmentation patients have check-ups every few years after surgery to ensure that their breasts and implants are healthy. These should include physical examination as well as imaging with ultrasound, MRI or mammography. In addition, most augmentation patients will need follow-up surgery at some point in their lives to replace their aging implants with new ones.