The Surgery of Mammary Reduction
This type of surgery is meant to reduce the volume of breast not appropriate to a patient’s morphology and which excessive weight may cause problems to the spinal column (back pain, cervical pain, shoulder indentation to hide breasts, muscular pain …).
The goal is to put the areola and nipple in a higher position, as well as to remove exceeding, fat, gland and tissue, so that the
shape and volume of breast will be more harmonious.
A reshaping of the gland and correction at the level of the areola and nipple, will give a harmonious curve to the breast.
Two types of scars are possible, according to the type of ptosis:
- − Usually, an incision in the shape of an inverted T is performed, i.e. an incision around the areola, another vertically and an incision in the underbreast fold (the scar looks like an anchor).
- − Sometimes, an incision around the areola and another vertically on the upper part of breast is sufficient.
A pre-op evaluation is necessary before surgery as well as a mammography and or echography.
Classical general anesthesia is performed. An anaesthetist doctor must be consulted at least 48 hours before surgery.
A one (or two) day hospitalization is usually sufficient.
About the surgery of Mammary Reduction:
The operation may last from one to two hours if a complementary associated surgical 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.
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 in one to two weeks.
Numbness of the nipple may be felt for a few months.
A one week convalescence must be considered and it is not advised to practice any sport activity until complete closing up, i.e. about one month after surgery.
Result will be quickly visible, the breast curve remains natural and sensible to hormonal variations. Result will be final only after a span of two to three months. This delay is necessary for the suppling up of breast. 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).
