Daniel Casso, MD, FACS

Experience, Compassion & Results

2020 Nasa Parkway #260 | Nassau Bay, TX 77058 | Phone: 281-333-3500 | Fax: 281-333-9455 | dancasso@drcasso.com

Breast Surgery

Breast Augmentation

Breast Augmentation

Problem.

Small breasts, or asymmetrical breasts.

Who is a candidate?

  • Any woman who wants larger, more shapely breasts.
  • Women seeking to balance the size of their breasts.

Procedure description.

The breast enlargement procedure (augmentation mammaplasty) requires a small incision in one of three locations: under the breast, around the areola, or under the arm. A saline implant is inserted under the breast tissue or chest wall muscle. The surgery is done on an outpatient basis at CHRISTUS ST. JOHN HOSPITAL under general anesthesia.

Recuperation and healing.

A bulky dressing is fitted around the patient upon leaving the operating room and is removed the following day in Dr. Casso's office. Once the bandage is removed, daily showering is allowed and a sports bra may be worn. Initial discomfort is controlled with oral medication and muscle relaxers. The sutures are trimmed seven to 10 days after surgery. Light activity is fine and aerobic activity can be started in about three to five weeks. Upper extremity exercise may be resumed gradually beginning six weeks after the procedure.

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Breast Lift

Breast Lift

Problem.

Sagging breasts or abnormally large areolas.

Who is a candidate?

  • A woman with sagging breasts due to past pregnancies, genetics, or aging.
  • A woman with areolas that are abnormally large.

Procedure description.

Although design of incisions varies, incisions are usually made around the nipple-areolar complex and in the crease under the breast. The nipple-areola complex is repositioned higher on the breast and excess skin is removed. Usually, complete removal of the nipple is not needed, as it may be kept attached to underlying breast tissue while repositioned higher. This allows most women to retain sensation. The breast is also reshaped for a more pleasing contour. A breast lift (mastopexy) is an outpatient procedure performed under general anesthesia.

Recuperation and healing.

After the procedure, the patient is released with bulky dressings over the incision lines. Initial discomfort is alleviated with oral medication. The sutures are completely removed within 10 days in most cases. A soft sports bra may be worn beginning the day after surgery and light activity may be resumed in seven to 10 days.

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Mastopexy - Augmentation

Mastopexy/Augmentation

Problem.

Breasts which are sagging and too small, or assymmetrical in size and/or shapt.

Who is a candidate?

  • A woman with small and sagging breasts, due to previous pregnancies, weight loss, aging, or genetics.
  • A woman with small breasts which are significantly different in shape

Procedure description.

This procedure is performed under general anesthesia at CHRISTUS ST. JOHN HOSPITAL. An incision is made below the breast, and a saline implant is inserted. An incision is made around the areola, usually reducing its size, and allowing it to be repositioned higher on the breast. Excess skin in the lower portion of the breast is removed, and the wounds are repaired, resulting in a more youthful, fuller breast.

Recuperation and healing.

This procedure is performed as an outpatient. Sutures are removed in 10 days. Most patients can return to sedentary work in about a week. No vigorous activity is allowed for 6 weeks.

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Male Breast Reduction

Male Breast Reduction

Problem.

Abnormal development of breast tissue in a man.

Who is a candidate?

  • A man demonstrating abnormal breast growth.

Procedure description.

This procedure (correction of gynecomastia) is performed under general anesthesia at CHRISTUS ST. JOHN HOSPITAL. Incisions are made around the aerolas, and in some patients, under the breast. Excess tissue is removed and the wounds are sutured. Liposuction is sometimes used to aid in the removal of excess tissue. In cases of extreme excess, skin removal may be necessary, which results in more visible external scars.

Recuperation and healing.

The procedure is performed on an outpatient basis. Sutures are removed within 10 days.

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Breast Reduction

Breast Reduction

Problem.

Large, heavy breasts which may contribute to back, shoulder and neck pain, poor posture, bra-strap indentations, chafing under the breasts, or which may cause a woman to feel out of proportion or to receive unwanted attention.

Who is a candidate?

  • Women with large breasts that interfere with normal daily activities or exercise.
  • Women who want more attractive contour and smaller breast size.
  • Women who want relief from health problems due to excessively large breasts.

Procedure description.

Breast reduction, when indicated for treatment of medical conditions such as chronic back pain, shoulder pain, or neck pain, is often covered by health insurance. Performed under general anesthesia at CHRISTUS ST. JOHN HOSPITAL, Dr. Casso performs breast reduction surgery using incisions around the areola, extending vertically below the nipple, and in the fold under the breast. During surgery, the nipple-areola complex is moved upward and excess breast tissue, fat, and skin are removed.

Recuperation and healing.

An overnight stay is generally recommended following breast reduction surgery. Initial discomfort subsides and is controlled with oral medication. Scars usually fade somewhat within six to 12 months.

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Breast Implant Capsulectomy

Breast Implant Capsulectomy

Problem.

Breast implants have become distorted by scar tissue or have ruptured.

Who is a candidate?

  • A woman who previously had breast augmentation and who has developed fibrous capsular contracture of the breasts, who has had rupture of an implant, or who wishes to exchange her silicone gel implants for saline implants.

Procedure description.

Incisions are made at the site of existing scars under general anesthesia at CHRISTUS ST. JOHN HOSPITAL. The implants and associated scar tissue are removed and replaced with saline implants, if desired.

Recuperation and healing.

Patients go home the day of surgery. Sutures are removed within 10 days.

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Breast Reconstruction with Tissue Expander

Breast Reconstruction with Tissue Expander

Problem.

Breasts that are not similar in size or shape due to loss of breast tissue and skin following a mastectomy.

Who is a candidate?

  • Women who have had a simple mastectomy, total mastectomy, modified radical, or subcutaneous mastectomy.
  • Women who desire the restoration of a complete body image with more normal breast configuration.

Procedure description.

Breast reconstruction is covered by health insurance. Breast reconstruction using an expander requires at least two separate surgical procedures. During the first operation, Dr. Casso places an expander under the skin and chest muscles. Over a period of months, saline is injected into the expander, allowing the overlying skin to expand and grow. When enough skin is present, and the expansion process is complete, the second step is performed. Dr. Casso will remove the expander during the second procedure and replace it with a permanent saline implant. Finally, if elected, the nipple areola is reconstructed.

Recuperation and healing.

Most patients will spend one night at CHRISTUS ST. JOHN HOSPITAL, where the initial discomfort is controlled with intravenous medication. At home, patients can control the pain with oral medication. A surgical drain tube remains in place for about one week, and sutures are usually removed in 10 days.

Expansion of the expander is begun about one month after insertion, and the expansion is accomplished in four to seven, in-office expansion procedures. Light activities can be completed as tolerated, and aerobic activities can be started four weeks following either the first or second procedure.

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Nipple-Areola Reconstruction

Nipple-Areola Reconstruction

Problem.

Loss of the nipple-areolar complex due to mastectomy.

Who is a candidate?

  • Any woman who has had mastectomy with loss of the nipple.
  • The procedure is usually performed in conjunction with or after completion of breast reconstruction surgery.

Procedure description.

Usually, Dr. Casso recreates the nipple mound from local tissue flaps in the desired position. The areola is created with a full thickness skin graft from the inner groin area or by tattooing the existing skin. During an isolated or independent procedure, local anesthesia with sedation may be used. If the reconstruction is performed with a breast reconstruction, general anesthesia will be used.

Recuperation and healing.

A dressing is placed over the reconstructed nipple-areolar complex and the skin donor site. The initial discomfort from the procedure is controlled with oral medication. Non-strenuous activities can be resumed in a day or two. In most cases, the skin graft takes two weeks to heal.

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