Breast aesthetic surgery at Sheikh Khalifa Medical City

The surgeon

Dr Thomas Colson is Head of the Department of Plastic Surgery at Sheikh Khalifa Medical City. He has eighteen years of experience and is double board certified by SOFCPRE, the French Board, and by EBOPRAS. He holds an MD Magna Cum Laude from the Université de Lorraine in Nancy, after medical studies at Claude Bernard University Lyon 1, and completed his residency at Nancy University Hospital, a Level I trauma centre. He is a member of ISAPS, SOFCPRE and SOFCEP, and is licensed by the Department of Health Abu Dhabi under licence GD47532.

Where the surgery takes place

Surgery is performed inside Sheikh Khalifa Medical City, a government tertiary hospital within the SEHA network, on Karamah Street in Al Tibbiya, Abu Dhabi. Anaesthetic, imaging and inpatient support are on site. In the UAE, consultations and surgery are performed exclusively at SKMC.

Reconstruction of the breast after mastectomy is a separate practice with a separate pathway, and is covered on the page for breast reconstruction. Body contouring is covered on the page for body contouring.

Choosing between the procedures

Breast surgery addresses three distinct questions: volume, position, and the difference between the two sides. Most consultations start by separating them, because the answer determines the procedure and not the reverse.

The four procedures most often asked about

Four operations account for most consultations in breast aesthetic surgery with Dr Colson at SKMC in Abu Dhabi: breast lift, breast augmentation, revision surgery with or without implant removal, and breast reduction. Each is summarised below and set out in full on the dedicated breast surgery site.

Breast lift (mastopexy) in Abu Dhabi

A breast lift, or mastopexy, applies where the breast has descended after pregnancy, breastfeeding, weight loss or with time, while its volume remains sufficient. The usual sign is a nipple that sits at or below the level of the breast fold. A breast lift changes the position and the shape of the breast. It does not by itself change its volume.

The operation repositions the nipple and areola, reshapes the gland and tightens the skin envelope. Dr Colson uses three scar patterns, chosen according to the degree of descent: around the areola, vertical, and inverted-T. The more the breast has descended, the more skin has to be removed and the longer the scar. Scars are an intrinsic part of a mastopexy; they do not disappear, and they mature over twelve to eighteen months.

A breast lift can be performed with or without implants. Where position and volume both need to be addressed, Dr Colson performs the lift and places the implant in a single stage, an operation called augmentation-mastopexy. Where the existing volume is sufficient, the lift is performed alone.

After a breast lift, altered nipple sensation is common in the first months and usually improves. Stopping smoking around surgery is a condition of the operation, because nicotine reduces the blood supply on which the nipple and the wound edges depend. Breast lift surgery is performed at Sheikh Khalifa Medical City in Abu Dhabi, with anaesthetic, imaging and inpatient support on site.

Scar patterns, candidacy and risks are detailed on the page breast lift (mastopexy) with or without implants: scar patterns and risks.

Breast augmentation in Abu Dhabi

Breast augmentation applies where the breast lacks volume, either constitutionally or after pregnancy or weight loss, and where its position is satisfactory. Where the breast has also descended, a lift may be combined with the augmentation.

The implant is chosen according to the anatomy of the patient, not from a standard size. Dr Colson uses Mentor and Motiva implants, smooth or nano-textured. The implant pocket is chosen from the thickness of the soft tissue that will cover it: a dual-plane pocket, partly under the muscle, where the cover is thin, or a pocket in front of the muscle where the cover is sufficient. Three incisions are available: in the breast fold, around the areola, and in the armpit.

In many patients Dr Colson combines the implant with the patient’s own fat, an approach called hybrid or composite augmentation. The fat softens the transition at the edges of the implant and addresses the natural difference between the two sides, which an implant alone does not correct.

Breast augmentation at SKMC is day-case surgery. A regional nerve block placed before the operation reduces the need for strong painkillers afterwards, and some discomfort is usual in the first days. Breast implants are not lifetime devices: a proportion of patients will need a further operation during their lifetime. Most women can breastfeed after augmentation, although this cannot be assured, and the radiologist must be told that implants are present before any breast imaging.

Implant choice, pocket, incisions and risks are detailed on the page breast augmentation with implants: implant choice, pocket and risks. Augmentation that combines an implant with the patient’s own fat has its own page: hybrid breast augmentation with implant and fat grafting.

Revision breast surgery and implant removal

Revision breast surgery applies where an implant is already in place and something needs to change. The usual reasons are a breast that has become firm, distorted or painful, which suggests capsular contracture; an implant that sits too high, too low or too far to the side; a breast fold that has dropped; visible rippling; a suspected rupture; or a wish to change size or to have the implants removed.

The operation is adapted to the problem and is not a single routine. For an established capsular contracture of grade III or IV, Dr Colson removes the implant and its capsule together, a capsulectomy, usually with an exchange of the implant and with fat grafting to restore the soft-tissue cover. An implant that has moved, or a fold that has dropped, is corrected by repairing the pocket, a capsulorrhaphy.

Breast implant removal without replacement is also possible. The breast is then smaller and looser than it was before the first operation, and the skin may not retract fully. A breast lift, fat grafting, or both can be combined with the removal, and the likely appearance is discussed frankly beforehand.

When a capsule is removed it is sent for histological examination. This is how breast implant-associated anaplastic large cell lymphoma, a rare lymphoma of the capsule described mainly with textured implants, is identified. Any new swelling on one side around an implant should therefore be assessed and not watched. Revision is generally considered six to twelve months after the previous operation, once the tissues have settled. It is more demanding than a first operation, and it is performed at SKMC in Abu Dhabi within a full hospital setting.

Capsulectomy, implant exchange, fold repair and risks are detailed on the page breast implant revision and removal: capsulectomy, exchange and risks.

Breast reduction in Abu Dhabi

Breast reduction applies where large, heavy breasts cause symptoms: pain in the back, neck and shoulders, grooves left by bra straps, skin irritation in the breast fold, or difficulty with exercise and daily activity. The indication is often functional as much as aesthetic.

The operation removes gland, fat and skin, and repositions the nipple and areola on a lighter breast. For most patients Dr Colson uses a superomedial pedicle, in the manner described by Hall-Findlay, which keeps the nipple on its blood supply. For very large breasts, a condition called gigantomastia, he uses the Thorek technique, in which the nipple is transferred as a free graft. This entails a lasting loss of nipple sensation and excludes breastfeeding, and it is proposed only where the alternative carries a higher risk to the nipple. The scar is vertical for smaller reductions and inverted-T for larger ones.

The tissue removed is sent for histological examination as a matter of routine at SKMC. Nipple sensation is commonly altered in the first months and usually improves. Breastfeeding is more often affected after a reduction than after a lift. Wound healing can be delayed where the scars meet, and this is markedly more common in smokers.

Where the symptoms are documented, the indication may be functional, and a request for pre-authorisation can be made to the insurer, assessed case by case. Breast reduction is performed by Dr Colson at Sheikh Khalifa Medical City in Abu Dhabi, within the hospital, with anaesthetic, imaging and inpatient support on site.

Pedicle technique, candidacy and risks are detailed on the page breast reduction surgery: technique, functional indication and risks.

Symptoms and concerns after breast augmentation

Three educational guides on the dedicated breast surgery site describe changes that can occur after augmentation with an implant: a breast that becomes firm, a suspected rupture of the implant, and pain in the weeks or years after surgery. Each guide sets out what is usual, what needs assessment, and how it is examined.