The purpose of this the surgical procedure (also known as Reduction Mammaplasty) is to reduce the size and volume of the Breasts considerably large and heavy (Mammary Hypertrophy), that usually present with varying degrees of Breast fall (Mammary Ptosis) and compensatory enlargement of the areolas.
This condition is often divided based on the severity into two types, Macromastia (Mammary Hypertrophy) and Gigantomastia (Giant Breasts).
Hypertrophy of the Breast tissues may be caused by increased histologic sensitivity to certain hormones such as female hormones, prolactin and growth factors. Breast Hypertrophy was first scientifically described in 1648.
Some resources distinguish between Macromastia where excessive breast tissue is less than 2,5 Kgs and Gigantomastia where excessive breast tissue is more than 2,5 Kgs.
The enlargement can cause muscular discomfort and over-stretching of the skin envelope, which lead in some cases to ulceration. Ptosis of Breasts has 4 degrees described.
When is necessary the Reduction Mammaplasty?
This type of Breast can produce or aggravate injuries of the spine by their excessive weight, as increased dorsal Kyphosis, osteo-spinal damage and herniated disc.
These lesions can cause varying degrees of paravertebral muscle cramps and spams, and also, at the level of the shoulders, and skin irritation by rubbing and accumulation of secretions and moisture in the inframammary folds (Dermatitis and local infections by viruses, fungi and bacteria).
The excessive weight and volume of breast produce eczema, breast pain, muscle tension, vascular congestion, edema and swelling and sensitive skin disorders (paresthesias).
The operation consists of a volumetric reduction of breast tissues to reduce the weight and size of the breasts, removing excess of skin, fat and gland from the breasts.
A breast Lift (Mastopexy) is usually requires and the technique depends on the degree of fall of the breasts (ptosis), as well as a reduction of areolas to leave them symmetrical and harmonious with the new breasts size (compensated areoloplasty).
How this Operation is performed
The operation is performed in an authorized operating theatre, under general anesthesia, with duration of 3 or 4 hours on average depending on each particular case, and can be done as an outpatient basis or with hospitalized patient.
In selected cases, we must use the help of mammary prostheses to harmonise the final result, placed below the muscle, moderate size and high profile to achieve a proper form and reaffirmation of the breasts.
Usually is placed a drain in both breasts, can be a drain of latex type Penrose or an aspiration drainage by vacuum type Jackson Pratt, Portovac or Hemovac.
The Plastic Surgeon will decide which cases should be used the breast implants.
The resulting Mammary scars will depend of the complexity of the technique employed, they can be:
- T upside-down or an anchor scar
- Vertical scar
- Circumareolar scar (around the areolas, no more)
In selected cases, we must perform a Liposuction with no obvious scars in the tail of both breasts (Spencer Tail) associated with breast reduction and breast lift surgery.
Among the complications that can occur in a very small number of patients, are the following:
- Dehiscence of the surgical incisions
- Anomalous healing (keloids, hypertrophic scars)
- Muscle contracture
- Suffering of surgical incisions by ischemia and necrosis (rare)
- Temporary loss of sensitivity at areoles and incisions.
However, with proper care and control, evolution tends to be very satisfactory.
The recovery is fast, with very satisfactory final outcome. The patients can make their normal lives after the first week, but must wait 8 weeks for exposure to the Sun, heat, go to beaches or physical exercises.
The pain or discomfort is mild and easily manageable with common painkillers. The drainage will be removed by the Plastic Surgeon in the office in painless way on the fifth day of postoperative time in average.
The patient must wear an orthopedic Bra for 15 days in the postoperative period and receive for that same period of time, lymphatic drainage massages.
After that, the patient will use a Moulder Bra Style or Anatomical Contour Bra that will give the final shape and ideal Breast location until 8 weeks of postoperative evolution.
Without complications, a reasonable time of approximately 2 months is required to appreciate the excellent final result, permanent and very rewarding.
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