In a world obsessed by the beauty of the female anatomy the eye is focused on the breast. The breasts have superseded any other aspect of the body needing to be in perfect condition.

To this end this web site and the corresponding documentation have been researched and written by a plastic surgeon, his speciality being breasts. He has written this to help you understand the options available to you.

He did extensive research on the blood supply of the breast, presenting many papers at local and international congresses and was awarded the prize for the best special topic paper for 2016 by the most highly cited journal in the world on plastic, aesthetic and reconstructive surgery namely P R S.

Even though the breasts are of great importance, he warns that it must be guarded against a woman not be seen as an appendage of her breasts.
For more about the surgeon complete the form below

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In South Africa Cosmetic and Reconstructive Breast Surgery should only be done by a qualified plastic surgeon registered with the Health Professions Council of South Africa (HPCSA) and preferably a member of the Association of Plastic and Reconstructive Surgeons of South Africa (APRSSA) and/or an International Society of Aesthetic, Plastic and Reconstructive Surgery.

BREAST ENLARGEMENT (Augmentation Mammaplasty)

This operation is indicated for the patient with small breasts (breast atrophy). The prosthesis used for this purpose consists of a silicone bag filled with either silicone gel or saline (saltwater) and is introduced by an incision underneath the breast or around the nipple or from the armpit. The prosthesis can be placed beneath the glandular component (sub-glandular) or under the muscle (submuscular/subpectoral).

The major potential complication of the procedure is excessive connective tissue formation around the prosthesis causing hardening of the breast (capsular contracture). Another potential complication is the loss of nipple sensation which is more likely to occur if the implants are very large. Taking into account that the average size of a breast varies between 150 and 300 cc, it is considered unwise to exceed the normal breast size when enlarging a breast with prosthesis.

Anaplastic large cell lymphoma have been described associated with silicone breast enlargements.

The latest development in breast enlargement is fat grafting or lipofilling which in future might significantly replace the use of silicone prosthesis once the technique is perfected.

BREAST LIFT (Mastopexy)

This operation is indicated for droopy breasts and can be performed under general or local anaesthesia. If the breasts are small the scars can be limited to the areola. Alternatively it will be vertically below the areola and in very droopy breasts in the fold below the breasts as well.

In patients with good quality skin satisfactory results can be obtained.

However, the long term result may be disappointing, hence the remarks of a leading USA plastic surgeon, Dr. J Grotting, "At present all mastopexy techniques are imperfect and we await the development of a suitable internal mesh to use". In this regard internal breast support with mesh offers a solution.

BREAST REDUCTION (Reduction Mammaplasty)

Enlarged breasts (breast hypertrophy) may be the cause multiple symptoms like poor posture, back, shoulder and neck ache, numbness or the sensation of pins and needles in the hands and arm (paraesthesia), rashes underneath or between the breasts (intertricho/fungal dermatitis), ulceration of the skin on the shoulders and/or underneath the breasts, pre-menstrual pain in the breasts or chronic breast pain, pain or discomfort during or after participating in physical activities like sport and enlarged areolas.

The symptoms can be relieved by reducing the breast size with an operation called a reduction mammaplasty which will also improve the shape of the breast and elevate the nipple to the normal height.

The operation should preferably be done under general anaesthesia, lasting approximately 150 minutes depending on the size and droopiness of the breast. The resulting scars may be limited to the nipple or may extend below the nipple (lollipop scar) and in the fold beneath the breast (anchor shaped). The extent of the scars can be predicted by your plastic surgeon pre-operatively after evaluating the breast size, elasticity and redundancy of your skin.

Post-operative recovery is 2-3 weeks and vigorous activities can be resumed after 6 weeks. Post operatively patients experience greater self-confidence and improved self-esteem. They are free to wear the clothing of their choice and participate in physical activities without any problems

For better cosmetic results it is advisable that the BMI (Body mass index) should be normal (20 to 25).

Smoking must be stopped 3 months prior to surgery.

To see more results of breast reductions click here (galary)

Internal breast support with mesh (Reconstruction of the Ligamentous Suspension)

In patients with poor quality skin or those in need of a long term good result a biocompatible mesh can be implanted beneath the skin to support the breast internally.

The procedure is more painfull then the convential techniques and more expensive but the results speak for themselves.

The technique is difficult to master and the outcome of the operation depend on the expertise of the plastic surgeon, excellent workmanship and insertion of the mesh in a perfect correct position under strict aseptic conditions.

For more about the procedure contact Dr. van Deventer on the form at the bottom of the page.

Breast reduction and internal breast support with mesh

A 38 year old patient (BMI=23) with severe breast ptosis and poor quality skin who had a mastopexy and reconstruction of an internal breast support system (IBSS) with biocompatible, non-absorbable mesh to replace the supportive function of the ligamentous suspension and a post operative result at 5 months and follow up 3 years 8 months later with adequate upper breast fullness, good nipple projection and inconspicuous well located, short scars. Although the patient gained weight after the surgery the result is still satisfactory without recurrent ptosis.

A 32 year old patient (BMI=21) who had a breast reduction and reconstruction of an IBSS with mesh. A mass of 160 g was excised from the right breast and 180 g from the left. The post operative result at 10 months and follow up at 3 year 4 months.

A 55 year old patient (BMI=23) who had a mastopexy and reconstruction of an IBSS with mesh and a 2 month post operative result and a follow up at 3 year 6 months. Note the skin creases in the lower pole of the breasts in the early post operative stage and improvement as result of skin shrinkage with time.

A 48 year old patient (BMI=20) who had a conventional inferior pedicle reduction with unhappiness due to loss of upper breast fullness and slight pseudo ptosis. A re-operation with reconstruction of an IBSS with mesh was done to solve the problem and a 3 year post operative result shown.

Pre- and post operative photos of a 39 year old patient who had a mastopexy and reconstruction of a IBSS. Bending fore wards illustrate the supportive function of the mesh to counteract the effect of gravity.

Long term follow up of a 33 year old patient (BMI=27) who had a breast reduction, excising 300 g from each breast, and reconstruction of an IBSS with mesh to replace the supportive function of the ligamentous suspension. Note a decrease in the areola diameter from 1 year onwards.

A 39 year old patient (BMI=21) with breast ptosis who had a mastopexy and IBSS reconstructed with mesh and a 6 months post operative result. She subsequently lost 10 kg body mass over a period of 1 year 3 months and despite reduction in breast volume did not develop recurrent breast ptosis as can be seen on the photo on the right.

For surgical technique of the different procedures contact dr. van Deventer at or using the form here.


For optimal results in cosmetic breast surgery it is best to choose an experienced qualified plastic surgeon, registered with the HPCSA and a member of APRSSA who has a special interest in breast surgery because there are SPECIFIC TECHNIQUES TO SOLVE DIFFERENT BREAST PROBLEMS.

Some patients might not benefit that much from the internal breast support to warrant the extra cost. On the other hand, especially in breast lift procedures, it might not be worthwhile undergoing the procedure unless it is combined with internal mesh support. Once a breast operation was performed with a dissatisfying result the next surgeon would be reluctant to re-operate due to the damage that might have occurred to the blood supply during the first operation.

A breast lift or breast reduction should preferably be a once-off procedure with a result that lasts. Therefore it is most important to make a correct decision initially in that regard.

For further details regarding cosmetic breast surgery contact Dr. van Deventer's rooms in Hermanus on 028 0501308


Surgery is performed in a safe and quiet environment at the Hermanus Medi Clinic as well as Hermanus Day Clinic in the Western Cape, South Africa.
17 de Goede Street, Hermanus, Western Cape, South Africa

Mondays - Thursdays 08h00 - 17h00, Fridays 08h00 - 13h00

028 - 0501308

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You can contact Dr. van Deventer by completing the form below.