Article published by
The cosmetic surgery clinic
Brol Medical Center
Reduction mammoplasty may solve problems caused by very big and fallen breasts, which can range from neck, ear, back pains and skin rush to skeleton deformities and breathing problems. Other smaller but present problems are the difficulty in finding bras and clothes for your size. These difficulties reflect in a negative way in woman's mind in the same way small breasts do. Breast reduction has been practiced since the '50 and since then many women have benefited from these surgery results.
Reduction mammoplasty concerns women with very big and "fallen" (ptotic) breasts. There is no physical exercise or medical treatment that can solve this handicap.
On the initial examination it is important to discuss with the surgeon your expectations because every person has a different view in regard to the size and shape of the breasts and to the scars. You should also talk about the nipple and areola position and you must understand what type of scar will result.
There is no surgery without risks. Because it is a big surgery, the risks must be discussed in detail with the surgeon and the anesthesiologist before the surgery.
Besides the risks common to any general anesthesia surgery, infections, hematomas which can make for unaesthetic scars appear. Even without these complications, the surgery leaves visible and permanent scars. The healing is difficult and with broad scars especially with smokers.
Nipple sensitivity changes can set in and seldom are these permanent. The surgery can leave you with slightly asymmetric breasts or with the nipples or areola at different heights. On very rare occasions the surgery may cause the permanent loss of breast-feeding capabilities, because it cuts through many galactofor channels.
Breast reduction is not a simple surgery but normally it is safe if is done by an experienced plastic surgeon.
- before the operation, you must undergo a mammogram or an ultrasound examination;
- do not eat and drink anything after midnight before the surgery;
- it is forbidden to take aspirin and other drugs that contain aspirin for 2 weeks before the surgery;
- usually the surgery must be done outside the menstruation period;
- you must tell the doctor or the anesthesiologist if you have medical problems (hypertension, vascular problems, heart failure, diabetes, lung problems, bleeding problems, epilepsy, neurological problems, allergies to certain drugs);
- you must tell the doctor if you wear dental prosthesis or contact lenses;
- if you smoke, plan to stop smoking for 2 weeks before the surgery and do not start smoking until at least 2 weeks have passed from the surgery;
- avoid extra exposure to sun before the surgery;
- do not keep a strict diet before the surgery because it can delay the healing;
- if you catch a cold or you have an infection of any kind, the surgery must be postponed;
Breast reduction is done under general anesthesia. Depending on the case complexity, it takes between 2 and 3 hours. There are many techniques, but the most used is the one when an anchor shaped incision is done following the natural breast curves. The extra skin is removed and the nipple and areola are moved higher following a pre made drawing. At the same time, the breast tissue is separated from the pectoral muscle, the excess tissue and fat is removed and the breast is fixed into the new position with non resorbable stitches. Liposuction can be used for the subtraction of fat from the armpit. A circular scar around the areola, a vertical scar from the areola to the breast cease and one scar in the cease will result. A small tube may be placed in each breast to drain off blood and fluids for 24 hours.
Hospitalization lasts for about 1-2 days, during which antibiotics are given to the patient. The patient will wear an elastic garment outside the normal garment. In the first days after the surgery the breasts will be swollen and painful.
After you leave the clinic the stitches are removed, 12 days after the surgery; this can also be done by your family doctor. You must wear a surgical bra for 2 to 3 months. Areola and nipple sensitivity modifications may appear but these usually disappear in the first 6 weeks. They are rarely permanent.
You can go back to work in maximum 1 week after the surgery but demanding spots must be avoided for 1 month. The surgery does not hinder breast-feeding if you have a new pregnancy but this will negatively influence the scars and the breast position.
As for the scars, by the sixth month they will have turned red and swollen. After 9 months - 1 year they will diminish and turn light. It is recommended to avoid exposure to sun for one year to prevent the darkening of the scars. We do our best to make the scars as small and inconspicuous as possible. Yet, it is important to understand that mammopexy scars are large and permanent but they can be covered by the bra or bathing suit.
You must take into consideration that the new breast position will not be permanent, the effect of gravity, pregnancy, aging and weight changes may determine the gradual reppearance of ptosis. Yet, with breast reduction you can be relieved of the physical discomfort that large breast bring on, your body will be better balanced and the clothes will fit you better and most importantly you will lose all your complexes.
With this surgery we have a big medical practice: more then 2500 cases operated on, in a 15 year period. If you have realistic expectations and you are prepared to bear the consequences which consist in a permanent scar, breast reduction is the only solution you have got.
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