• You are physically healthy and maintain a stable weight,
• You do not smoke,
• You have realistic expectations,
• You are bothered by the feeling that your breasts have lost shape and volume,
• Your breasts are elongated or hang down,
• When unsupported, your nipples are positioned below the breast crease,
• Your nipples and areolas point downwards,
• You have loose skin and enlarged areolas,
• One breast is lower than the other.

• The reason why you want to undergo surgery, your expectations and the desired result;
• Medical conditions, drug allergies and medical treatments;
• Current use of medications, vitamins, natural medicines, alcohol, tobacco and drugs, including steroids;
• Previous surgeries;
• Family history of breast cancer and results of previous mammograms or biopsies.

• Assess your general health status and any pre-existing health conditions or risk factors.
• Examine your breasts, take detailed measurements of their size and shape, analyze the quality of the skin and the position of the nipples and areolas,
• Take photos for your medical record,
• Discuss your options and recommend treatment,
• Discuss the expected results and any potential risks or complications,
• Discuss the type of anesthesia for the procedure.

Before surgery, it may be necessary to:

• Take laboratory tests or medical evaluation,
• Take certain medications or adjust your current medications,
• Have a baseline mammogram before surgery and another after surgery to help detect any future changes in your breast tissue,
• Quit smoking as well before surgery,
• Avoid taking aspirin, anti-inflammatories and natural medications, as they can increase bleeding.

• What to do on the day of surgery (fasting time, medications, bath),
• Post-operative care.

The procedure must be carried out in a safe and comfortable place for the doctor and the patient, in a surgical center authorized by the Health Surveillance, with equipment and trained staff for any complications.

Be sure to ask someone to accompany you and stay with you for at least the first night after surgery.

The decision to undergo breast augmentation surgery is a personal one and it is up to you to decide whether the benefits will be in line with your goals and whether the risks and possible complications are acceptable.

Your plastic surgeon and/or team will explain, in detail, the risks associated with the surgery. You will be asked to sign the consent form to ensure that you fully understand the procedure you will undergo and any potential risks or complications.

• Surgery may interfere with diagnostic procedures,
• Breast and nipple piercings may cause infection,
• Breast surgery does not interfere with pregnancy, but if you are planning to have children, you should be aware that the breast skin may stretch, You may lose the results of mastopexy, with the possibility of difficulty breastfeeding after surgery.

The procedure must be carried out in a safe and comfortable place for the doctor and the patient, in a surgical center authorized by the Health Surveillance, with equipment and trained staff for any complications.

What happens during breast augmentation surgery? Mastopexy can be performed using a variety of incision techniques. The right technique for you will be determined based on:

• Size and shape of the breast,
• Size and position of the areolas,
• Degree of sagging of the breast,
• Quality and elasticity of the skin, as well as the amount of excess skin.

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedure. Options include intravenous sedation and general anesthesia. Your doctor will recommend the best option for you.

Step 2 – Incision

There are three common incision patterns:

– Around the areola,
– Around the areola, vertically down the areola, towards the breast crease,
– Around the areola, vertically down the areola, towards the breast crease, and horizontally along the breast groove.

Step 3 – Reshaping your breasts

After the incisions:

• The underlying breast tissue is lifted and reshaped to improve the firmness and contour of the breast,
• The nipple and areola are repositioned,
• If necessary, enlarged areolas will be reduced by excising surrounding skin,
• Excess skin is removed to compensate for loss of elasticity.

Step 4 – Closing the incisions

After remodeling, excess skin is removed and the incisions are closed. Some incision lines are hidden in the natural contours of the breast, however, others are visible on the surface of the breast. Scars are permanent, but most of the time, they can improve significantly over time. Sutures are placed deep within the breast tissue to support the newly shaped breasts. Sutures, skin adhesives and/or surgical tape may be used to close the skin

Step 5 – Results

The results of your surgery are immediately visible. Over time, post-surgical swelling will decrease and the incision lines will become less marked.

If you experience shortness of breath, chest pains, or an abnormal heartbeat, seek medical attention immediately. If any of these complications occur, you may need hospitalization and additional treatment. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve the best results with a single surgical procedure, requiring a new surgery.

Following your doctor's recommendations is essential for the success of the surgery. It is important that surgical incisions are not subjected to excessive force, abrasion, or movement during the healing time.

After the procedure, bandages will be placed over the incisions. You will need to wear an elastic bandage or bra to minimize swelling and support the breast.
A drain may be temporarily placed under the skin to drain any excess blood and fluid that may accumulate after surgery.

• Where will I remain in recovery after the surgery ends?
• What medication will I be given or prescribed after surgery?
• Will I have bandages after surgery? When will they be removed?
• Will the stitches be removed? When?
• When can I resume normal activities and physical exercise?
• When will the return appointment be?

The final result of your breast will appear over the months, with a more pleasant shape and position of the breast. The scars are permanent, but most of the time, they improve significantly over time.

Over time, your breasts may continue to change due to aging and gravity. The results will last longer if:
• Maintain your weight,
• Maintain a healthy lifestyle.

Surgery does not usually affect breastfeeding function, however, if you are planning to become pregnant, talk to your plastic surgeon. The changes that occur in the breasts during pregnancy can minimize the results of surgery. Likewise, weight loss plans should also be discussed.

The cost may include:

• Surgeon's fees;
• Hospital and surgical center costs;
• Anesthetist's fees;
• Prescribed medications;
• Post-operative meshes;
• Medical exams.

When choosing a plastic surgeon for gynecomastia surgery, remember that the surgeon's experience and your good relationship with him or her are just as important as the final cost of the surgery.

• Areola: Pigmented skin around the nipple.
• Breast augmentation: Also known as breast augmentation, breast augmentation through surgery.
• Breast lift: Also known as mastopexy, surgery to lift the breasts.
• Breast reduction: Also known as reduction mammoplasty, reducing the size of the breast through surgery.
• Excision: Removal of the skin.
• General anesthesia: Drugs and/or gases used during surgery to relieve pain and reduce consciousness.
• Hematoma: Accumulation of blood beneath the skin.
• Intravenous sedation: Sedatives given by injection into a vein to help you relax.
• Local anesthesia: Drug injected directly into the incision site during surgery to relieve pain.
• Mammography: X-ray image of the breast.
• Mastopexy: Surgery to lift the breasts.
• Sutures: Stitches used by surgeons to hold skin and tissue together.

• Are you a specialist by the Brazilian Society of Plastic Surgery?
• Have you been trained specifically in the field of plastic surgery?
• How many years of plastic surgery training have you had?
• Is the installation of the procedure room in your office authorized by the Health Surveillance of your city?
• Am I a good candidate for this procedure?
• What is expected of me so that the best results are obtained?
• Where and how will the procedure be performed?
• What is the shape, size and texture of the surface? What incision and placement site is recommended for me?
• How long can I expect to recover and what kind of help will I need during my recovery?
• What are the risks and complications associated with my procedure?
• How are complications treated?
• Will breastfeeding be harmed?
• How will the surgery evolve over time? After pregnancy? After breastfeeding?
• What will my breasts look like if I choose to remove/replace the implants in the future?