MAMMARY PTOSIS

The Surgery of Mammary Ptosis

The operation is meant to reshape a breast which aspect or volume has been altered because of pregnancy or important lost of weight giving way to an unbecoming reduction of breast and showing a mammary ptosis (drooping).

The purpose is to obtain harmony in volume and shape by making the areolas and nipples higher, and by removing the excess of skin.

According to the ptosis case, two types of scars are possible:

• − Usually, an incision in the shape of an inverted T has to me made, i.e.; an incision around the areolas, another vertically and one in the fold under the breast (the scar then looks like an anchor).
• − In some cases an incision in the lower part of the areola is sufficient.
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A pre-surgery evaluation is mandatory, also mammography and or mammary echography are often necessary. Classical general anaesthesia is most often performed. An anaesthetist doctor must be consulted at least 48 hours before surgery.

A one day hospitalization is usually sufficient.

About the surgery of Mammary Ptosis:

The operation may last from one to two hours if a complementary associated surgery act is necessary.

So that blood and collected secretions may be evacuated, it is usual to leave a drain (Redon drainage) in each breast until the day after surgery.

Threads will be removed between two and three weeks after surgery.

Post surgery effects:

This type of surgery usually is not painful.
After 24 to 48 hours, the first dressing is removed and replaced by a bra giving a good support (sports bra style).
Ecchymosis will fade away within one to two weeks.
Nipples may feel numb for some months.

A convalescence of one week is to be considered and it is not recommended to practice any sport activity before complete closing up, that is to say about one month after surgery.
Results can be quickly appreciated : the breast curve remains natural and sensible to hormonal variations ; for definitive results two to three months are necessary, this is the time required for the suppling up of breasts. 

Breast aspect will change according to hormonal modifications and variations in weight. 

Complications

After any kind of surgery, complications may occur, some due to the medical and or cosmetic act itself, others particular to mammary plasty. Good security practices can limit risks but do not suppress them. Some risks, very exceptional hopefully, cannot be anticipated and may endanger the vital or functional prognosis (emboly, paralysis, septicemy…). 

Anesthesia carries its own complications which will be explained to you when you meet with the anaesthetist doctor.

Risks specific to mammary hypertrophy surgery: 

Even if the post surgery effects are usually very simple, some of the possible complications linked to mammary ptosis must be known : 

Bad evolution of scars: it is normal that scars get thicker and redder during the first month. This aspect, linked to the inflammatory reaction of any closing up, takes twelve to eighteen months to get better and stabilize. Closing up may follow an abnormal evolution with thickening and swelling going on over a year. We speak of hypertrophic, even cheloid scars (they occur more often on black skins). They may occur in an unpredictable fashion and require specific treatment. It must be known that scars usually fade away and get less visible but don’t disappear. 

Infection: most often contamination of a wound, scar or drain opening is not serious. Very scarcely are antibiotics necessary, but infection can be treated with frequent dressings. 

Haematoma: post surgery bleeding is almost unavoidable and gives way to ecchymosis (bruises) on the skin for one to two weeks. It may cause an haematoma with swelling and painful tightening. Sometimes there is a need for additional intervention to evacuate the haematoma and treat its causes. If bleeding is important, a blood transfusion may be necessary. 

The alteration of nipple sensitivity is almost unavoidable, it will gradually get back within a few months. 

Necrosis: it is the lost of a more or less large skin zone that can affect cosmetics results (lost of skin, lost of the nipple). Tobacco smoking may be aggravating. This is why it is most recommended to stop smoking at least three weeks before and after surgery. In case of necrosis, an additional complementary surgical act may be necessary afterward (one year).