The words of breast surgery

A teardrop-shaped implant with a more cohesive gel, whose shape remains stable. It is used to shape a breast: young breasts with tight skin, malformed, asymmetrical or slightly sagging breasts. In cosmetic surgery it is reserved for specific cases.

An areola that is too wide and bulging, found in particular in tuberous breasts. It can be corrected by an areola reduction.

Removal of breast implants and replacement with fat. Total conversion replaces the implant entirely with fat; partial conversion combines fat with a smaller implant.

Breast reconstruction using only the patient’s own tissue: flaps or fat transfers. When exclusive, it rebuilds shape and volume through several fat transfer sessions, with no implant or flap.

Continuous external expansion used in exclusive autologous reconstruction, to increase fat graft take and reduce the number of sessions.

Breast volume out of proportion with the figure, often accompanied by ptosis, with a cup size from D to F, G or H. It is treated by breast reduction.

Insufficient development of the breast gland, often genetic in girls and young women. It is the reason for primary breast augmentation.

Sagging of the gland and areolas, often after pregnancies or weight changes. It is graded in three degrees according to the position of the nipple relative to the inframammary fold.

Hardening of the fibrous envelope, or capsule, that forms naturally around an implant. It is unpredictable and is one of the reasons for replacing implants.

The combination, in the same operation, of a breast implant for volume and a fat transfer to shape the breast, in particular the cleavage.

The combination of a breast lift and added volume, with an implant or a fat transfer, when reshaping the gland alone is not enough.

A three-dimensional reconstruction of the chest from three photographs, used to visualise an augmentation — shape and volume — before deciding. It is a decision aid, never a contractual commitment.

Breast reconstruction carried out some time after the mastectomy, once treatment is over — it can be considered 9 to 12 months after the end of radiotherapy.

Cover requested from the manufacturer when an implant has ruptured within ten years. Assessed case by case, it covers the implants and the clinic fees, according to the terms of the purchase contract.

Reconstruction with a rectus abdominis flap performed as a free microsurgical transfer, which preserves the muscle and takes only the main vessel. Dr Azencot does not perform it and refers suitable patients to a specialised team.

An implant position in which the upper half is covered by the pectoral muscle and the lower half by the gland. This is how the retromuscular pocket is made today.

An implant with a round base and a soft, elastic gel that follows the body’s position, standing as well as lying down. Its shell is nanotextured. It is today the implant most often offered.

The proportion of transferred fat that survives: part of it is resorbed in the first months. Dr Azencot states a take rate of around 70%.

Internal fibrosis typical of tuberous breasts, which prevents the gland from growing and spreading. Treatment consists in breaking this ring and lowering the inframammary fold.

Abnormal growth of the breast gland in men, most often in adolescents and young men, and most often without a known cause.

Rebuilding the breast during the same operation as the mastectomy. The breast skin can often be preserved.

The crease beneath the breast. It is the landmark used to grade ptosis, and the site of the inframammary approach.

A sterile device that eases the passage of the implant through a small incision while preserving the tissues. It is used in the Preservé technique.

An abnormal retraction of the nipple, which is little or not developed. It hinders breastfeeding and is corrected by a short operation.

A scar combining a vertical part and a horizontal part. It is the most common scar in breast reduction; the horizontal part is shorter the smaller the excess of skin.

A device used for a “no touch” insertion of the implant: one of the steps the surgeon takes particular care over, as part of the very strict aseptic measures of implant placement.

A collection of fluid around an implant, occurring long after the operation and showing as swelling of the breast. It should prompt a consultation.

A reconstruction technique that brings a thick, well-vascularised back muscle to the reconstructed breast, with or without an implant.

Fat is harvested by liposuction where it is in excess, prepared, then reinjected into the breast. On its own, it can enlarge the breast by half a cup to one cup per operation.

Reshaping of the breast to correct ptosis: the gland is tightened and lifted, the stretched skin removed, the areola repositioned.

The introduction of pigments into the dermis to restore the colour and outline of the areola. This is how the areola is rebuilt at the end of a breast reconstruction.

A meeting of surgeons, oncologists and radiologists that approves in advance a reconstruction plan, surgery on the opposite breast or a prophylactic mastectomy.

The areola and nipple together. In reconstruction, it is rebuilt about three months after the breast mound: the nipple by grafting half of the opposite nipple, the areola by dermopigmentation.

Medical analysis of the tissue removed during an operation. In a breast reduction, the gland tissue removed is always sent for pathology examination.

Chest-wall deformities that can be treated by reshaping with fat injection, sometimes combined with breast implants or silicone implants on the sternum.

The space created by the surgeon to hold the implant, under the gland or under the pectoral muscle.

A one-sided malformation, increasingly rare: an underdeveloped gland, a very small areola placed high and to the outside, and absence of the lower part of the pectoral muscle, creating a visible notch towards the armpit.

Minimally invasive breast augmentation: the implant is placed through a two-centimetre incision, and its pocket is created with an inflatable balloon that preserves the tissues — hence its name.

A session of fat injection into the chest to be reconstructed, before reconstruction with an implant, to add volume and improve the quality of the tissues.

Removal of the breast gland in a high-risk patient, before a lesion appears, with reconstruction in the same operation. The decision is taken by a board.

A reconstruction technique that transfers to the chest a mass of skin and fat taken from between the navel and the pubis.

An implant that works mainly on volume, often with a softer gel. It suits a wish for full, rounded breasts, a breast with supple skin that is already well formed, and implant replacements.

A fat transfer offered from three months after an implant reconstruction, to improve its natural appearance, its suppleness and the concealment of the implant.

The surface of an implant shell: smooth, nanotextured or microtextured. Since 4 April 2019, the French medicines agency (ANSM) has banned macrotextured surfaces as a precaution.

A template placed in a trial bra during the consultation, to see the size of an implant before choosing it.

An implant position under the fascia of the pectoral muscle, in front of the muscle fibres. It replaces the subglandular plane and, with today’s soft implants, is used more and more.

The implant’s point of entry, and therefore the site of the scar: inframammary, in the breast fold; periareolar, on the lower edge of the areola; axillary, in the armpit.

Surgery on the opposite breast — too small, too large or sagging — to match the reconstructed breast. It is performed at the same time as the reconstruction whenever possible.

A juvenile breast malformation: the gland fails to develop because of an internal fibrosis that prevents it from growing and spreading. Often unrecognised.

The upper part of the breast, that is to say the cleavage. Hollowing of the upper pole is a frequent consequence of ptosis; fat transfer is used to fill it.