Reasons for surgery
– I have very large breasts and I want to reduce them in size.
– My breasts feel heavy and they give me pain in the back, neck and shoulders.
– My body image looks disproportionate.
– I suffer irritation and rashes due to rubbing the skin under the breasts.
– The skin on my shoulders has grooves caused by the straps of the bra.
– I feel limitations to perform physical activities.
How do we do it?
The concept of this surgery is to reduce and elevate the breast. The nipple-areola complex is also repositioned. If it is necessary to increase the breast volume in the upper pole or give more projection to the breast, an implant can be used. The surgery is performed under general anesthesia and can last approximately 3 hours. It is an outpatient procedure, so you return home the same day. I do not leave drains nor do I have to remove stitches because I use absorbable sutures to close the incisions. I place adhesives over the incisions to improve healing. We left a surgical bra to reduce swelling.
BREAST
FREQUENT QUESTIONS
The surgery is not painful. The anesthesiologist through general anesthesia uses pain medication, in addition long-lasting local anesthetics are placed and the patient takes common analgesics to minimize postoperative discomfort.
Breast reduction leaves permanent scars, although they are hidden under underwear or a bikini. Over time, the scars will become less noticeable. Scarring problems are more common in smokers.
In the postoperative period, most discomfort is well controlled with common analgesics. Drainage tubes are not left nor do we have to remove stitches because they are resorbable. You have to wear a bra for a few days. It is not necessary to be in bed, but it is advisable to rest 2 to 3 days before resuming normal activity and work. You can shower the day after surgery and drive a car. It is normal to have a feeling of inflammation during the first few weeks. Manual lymphatic drainage improves symptoms and speeds recovery. After the month of surgery you can do physical activity of any kind. Controls are carried out in the office until the final medical discharge around the postoperative month.
The level of risk varies according to the surgical technique used for the reduction mammoplasty. Sensitivity is usually well preserved. In some cases, the loss of sensation may be temporary, and less frequently there are cases of permanent loss.
In general, the function is well preserved, although the possibility of losing the ability to breastfeed exists, and depends on the degree of breast reduction that is performed.
A breast reduction can often be combined with other operations as long as the combination of the operations can be performed in a reasonable amount of time. Breast surgeries are usually combined with body contouring surgeries, but any combination is possible.
There are two main forms of breast reduction:
VERTICAL REDUCTION, leaves a periareolar and vertical scar:
Vertical breast reduction allows the removal of a small to moderate amount of tissue creating a taller and smaller breast. This operation is called a “vertical reduction” because most of the resection of the breast tissue occurs through the vertical incision that lies below the areola. In all breast reduction operations, there is also an incision around the areola that allows repositioning of the nipple to the proper location. The advantage of this technique is that it only uses a vertical incision and therefore there is no transverse scar in the submammary fold. The disadvantage of vertical reduction is that a more limited amount of breast tissue is removed due to the smaller incision. Sometimes the use of liposuction is required,
ANCHOR REDUCTION, leaves an inverted T scar:
This operation has different names… Weiss pattern, inverted t or anchor all mean the same thing. The scars are similar to vertical reduction with the addition of the transverse scar in the inframammary fold. This scar is the least apparent as the rest of the breast tissue tends to cover this scar when the patient is in a standing position. While the addition of the scar below the breast may seem like a disadvantage, this incision allows greater access to more breast tissue and therefore this operation is capable of removing more tissue in very large breasts. Many patients complain of breast tissue on the side of the chest and toward the armpit. This breast reduction allows direct removal of this additional tissue in women with very large breasts.
Once the reduction surgery is performed, the breasts will always remain smaller. However, patients who gain weight become pregnant or take hormones after breast reductions may notice an increase in size due to a natural increase in breast tissue. Also, the effects of age and gravity can cause the breasts to sag over time.
Surgery is a safe and effective procedure to relieve neck and back pain, as well as other problems with very large breasts. In most cases, it is recommended that adolescent girls wait until they are fully developed before undergoing surgery. However, when symptoms make it difficult to perform activities of daily living or interfere with quality of life, breast reduction may be continued even if development is not complete. In that case and if the breasts have not yet finished developing, there is the possibility of requiring a second operation later.