Women may decide to undergo plastic surgery to enlarge or reduce their breasts, to achieve a balance in size or shape for their breasts, or to reconstruct one or both breasts after mastectomy. Whatever the motivation, breast surgery is safer and easier now than ever before. Please review the list of services we provide to help you make an informed decision and achieve the most satisfying results.

Breast augmentation is the most frequently performed cosmetic surgery procedure in the U.S. It can give women with small or unevenly-sized breasts a fuller, firmer, better-proportioned look through the placement of implants in the breast. Women may elect to undergo breast augmentation for many different medical and aesthetic motivations, including balancing breast size and compensating for reduced breast mass after pregnancy or surgery. The procedure may be combined with others such as a breast lift for more satisfying results.

Implants are silicone shells filled with saline (salt water) and are placed behind each breast, underneath either breast tissue or the chest wall muscle. The procedure lasts one to two hours and is typically performed with general anesthesia. After surgery the patient's bustline may be increased by one or more cup sizes. For more detailed information, click here.

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Breast reduction, or reduction mammoplasty, is a procedure performed for women with large, pendulous breasts. Most commonly patients complain of back and neck pain, skin irritation under the breasts, and bra strap grooving on the shoulders. There are also patients who are unhappy with the cosmetic appearance of their breasts. Large breasts make the body disproportionate and can cause problems with daily activities such as exercise, work, social interaction, or clothes selection.

The procedure removes fat, glandular tissue and skin from the breasts making them smaller, lighter, firmer, and perkier. Breast reductions are done on an outpatient basis in the hospital under general anesthesia. Very large reductions may require a one-night stay in the hospital. The procedure usually takes three to four hours depending on the extent of surgery needed. Patients are up and able to move the day after surgery. The tenderness in the breast area lasts for a couple of weeks. Most patients will return to work and social activities in about one to two weeks. Full exercise is usually allowed after four weeks. For more detailed information, click here.

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Breast Lift In Manhattan (Mastopexy)

A breast lift, or mastopexy, is performed to return youthful shape and lift to breasts that have sagged as a result of weight loss, pregnancy, loss of the skin's natural elasticity or simply the effects of aging and gravity. The procedure can also reduce areolar size (the dark skin surrounding the nipple), and it can be combined with breast augmentation for added volume and firmness. It is usually done under general anesthesia, and lasts from one to three hours.

Breast reconstruction is an important consideration for any patient planning to have a mastectomy. Breast reconstruction is usually performed at the time of the mastectomy. A variety of techniques are available. The ideal reconstruction involves using the patient's own tissue to make a breast (autologous reconstruction). Implant reconstructions are also very common.

The most common technique for using the patient's own tissue in breast reconstruction is called the DIEP (or tummy tuck) Flap. In this operation excess skin and fat from the lower abdomen is transferred to the mastectomy site and used to sculpt a new breast. No muscle is taken.  Drs Karp and Choi specialize in this procedure. They have incorporated all of the latest technology in the preoperative planning of this surgery.  This includes 3D imaging of the breast to very accurately define the anatomy of the breast and CT angiography to define the blood vessel anatomy.  These techniques have resulted in better surgical outcomes in less operative time.

For those patients who are not candidates or do not desire autologous breast reconstruction, implant reconstruction is performed. The first stage of implant breast reconstruction is also performed most commonly at the time of the mastectomy. An empty balloon or tissue expander is placed under the skin and muscle of the chest wall. The skin is allowed to heal, and in a series of office visits the expander is gradually inflated with saline to the desired size. When the expander is fully inflated, a second outpatient operation is performed to remove the tissue expander and place a permanent implant. The permanent implant most commonly is filled with silicone gel, but saline filled implants are also available. In some cases the implant reconstruction can be done in one stage, without needing to place the tissue expander.  Drs. Karp and Choi will decide which technique is best for each individual patient during the initial consultation.

Almost all mastectomies are performed with a skin-sparing techniques.  In some cases, nipple and/or areola sparing mastectomies are performed.  The type of incision that is used is made by the breast oncologic surgeon in consultation with the plastic surgeon.

Dr. Nolan Karp and Dr. Mihye Choi specialize in Breast Plastic Surgery. Please feel free to read more detailed information about breast reconstruction. You may contact Dr. Karp or Dr. Choi by using the contact form on this site or by calling the office at 212-355-5779 for a consultation.

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Gynecomastia comes from the Greek words gyne meaning "woman" and mastia meaning breast. In practical terms, this means abnormally large breasts on men. The condition is relatively common in adolescent boys, and often disappears with time. When the condition persists, there often is social handicap, shame, and embarrassment.

There are several potential causes of gynecomastia including puberty, drug use, or other medical problems. Often no cause is found for the disorder and the gynecomastia persists. In these cases, surgery is frequently the best solution. The procedure can be performed using liposuction or direct surgical excision depending on the kind of excess breast tissue that is present. For more detailed information, click here.

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