Reduction mammoplasty is a surgical intervention conceived to solve several problems associated with excessively big and plunging (hanging) breasts. The big breasts can occur because of the excessive development of the gland tissue or of fat normally found in the breasts. The increase in size and the weight of breasts determine the stretching and relaxing of ligaments that sustain the mammary gland, causing the falling of the breast (mammary gland ptosis) and the loss of feminine shapes.
This condition reflects negatively over the woman’s psychic in the same way that the little breast determines uneasiness and dissatisfaction feelings. There are also physical problems associated with the big-sized breasts – discomfort, pains in the spine, neck, shoulders and back that become prevalent. The participation at a normal social life is confined, the patients with mammary hypertrophy avoiding to dance, the aerobic gymnastics or different other activities that produce the swinging of the body and the disgraceful movement of the breasts.
If this condition is not removed until maturity it can affect the posture (muscular compensatory contracture determines distortions of the spine). As well, the big-sized breasts do not allow the normal aeration of inframammary groove and the maceration of the skin can occur, accompanied by bacterial and fungal secondary infections). Other problems, minor but however present are the need of special linen for sustention (extra large bra) and difficulties in finding adequate clothes.
The treatment of this condition is not new and is practiced of over 50 years. The goal of this operation is to reduce the volume and weight of the breasts and to settle them in a normal position. That involves removing of mammary tissue and reestablishing of the normal contour, by keeping the proportions with the rest of the body. It is also required the repositioning of the complex areola nipple in accordance with the new shape of the breast.
Preoperatively, besides the ordinary analyses it is required a mammography in order to know the possible problems present in the hypertrophic gland tissue and to adapt the therapeutic plan accordingly.
Being a large operation (practically the most difficult intervention of aesthetic surgery) it is recommended that you are in as good as possible health condition, to do not catch cold, to be not in the period or in convalescence after other condition. Any treatment with aspirin or contraceptives should be stopped 2 – 3 weeks before surgery. You have also to stop smoking 2 – 3 weeks before and 1 week after the surgery. In the day of the operation you should not eat or drink anything.
The operation is carried out under general anesthesia and takes 2 – 3 hours to complete.
The scar will have an anchor shape, descending from the mammary areola in vertical direction to the inframammary groove where is localized a horizontal incision, with an arm to the breast bone region and the other one to the lateral region of the breast. Anyway there will be scars and even if they are hidden in the natural contour lines, the majority will improve spontaneously in a 6 months period. The position of these scars and other questions you want to get answers to will be largely discussed during the consultation.
In order to prevent the blood accumulation in the operated area and the occurrence of some complications in connection with these ones, you will have a drain tube on each side of the body, for a day or two. When through these tubes doesn’t flow anything they can be removed and you can go home. The sutures are performed with dissolvable stitches of the best quality, so that the scar can be as small as possible. On the skin surface is applied an adhesive spray and a special dressing that allow the optimal healing. It is recommended a control a month later and six months afterwards.
It is required to remain a night or two within the Clinic. Postoperatively you will receive a medication consisting of antibiotics, vitamins and pain-killers administered intravenously, with the progressive resuming of the normal nourishment in the first 24 hours. The antibiotic treatment shall be continued by oral route for 5 days. If it is established an anaemia condition, you will also get an iron supplement by oral route.
The post-operative pain is moderately and can be controlled with pain-killers administered each time they are required. After the operation a protective dressing will be applied and it will be changed daily for 7 days. In order to prevent the occurrence of a postoperative discomfort and to assure the optimal conditions for a cicatrization as aesthetic as possible, it is recommended to avoid for 6 weeks the difficult physical activities and to wear permanently the bra.
It is not recommended the exposure to the sun or solarium in the first 3 months after the surgery. It is required almost 1 year for scars maturation in order to the breasts reach the definitive shape.
Apart from the general complications, common for every surgical operation (allergic reactions, haemorrhagia, hematoma, infection, soft tissues necrosis) some complications specific for this kind of operations can occur.
After this operation, the possibility of nursing can be sometimes afflicted. If you intend to get pregnant again, postpone the surgical intervention because a new pregnancy will modify again the shape and the size of breasts and a part of its aesthetic result is lost.
It is recommended that the mammary reduction be performed only 6 months after nursing interruption, because after this interval the breasts have returned to a neutral condition from functional point of view.
The sensitivity of the areola can be partly or completely lost depending on the technique that has been performed. Sometimes a sensation of numbness can occur in the scars areas. It is unwished, but a lack of symmetry of the breasts can be possible after the surgery. However, taking into account that either in normal situations the two breasts are not identical, the obtainment of a perfect post-operative symmetry is an unrealistic wish.
Rarely the scars that result are large, being required a subsequent operation revision. The results of this operation are extremely good and full of satisfactions for the patient.