REDUCTION MAMMAPLASTY

As well as jeopardizing one’s general appearance, very large and heavy breasts usually cause physical discomfort, such as shoulder, neck and back pains. The patient will decide along with her doctor, the size and shape she wishes her breasts to have after the surgery. Additionally, she must be aware of potential risks – although uncommon – related to this type of intervention, of possible post surgical complications of the healing process. Reduction mammaplasty also corrects breast flaccidity, providing them with new consistency. The surgeon must always seek a balance between the volume of the new breast and the chest size, so that the achieved aesthetic result is more harmonious.

PREOPERATIVE PREPARATION

Besides aspirin and other medications that contain acetylsalicylic acid, the patient must refrain from taking any diet pills or diuretics during the 10 days that precede the surgery. The doctor must be informed of any change in the physical state, such as a flu or malaise.
The patient should avoid any liquor and also eat moderately on the eve of the surgery. Upon being hospitalized the patient should carry a bra, which will be worn right after surgery.

SURGICAL PROCEDURE

The several techniques used in reduction mammaplasty vary depending on the case. The current tendency is to leave smaller scars, something that depends on the size of the breasts. There can be T-, L-, I- or O- shaped incisions, always on the lower half of the breast. There is also an incision around the areola, aiming at replacing the nipple and possibly reducing its size. Excess of skin, glandular tissue and fat are removed through the incisions. Finally the breasts are reshaped and the nipples are replaced. Normally general anesthesia is preferred for this type of surgery, but in special cases local anesthesia can be used. The surgery lasts an average of three hours.

POSTOPERATIVE CARE

Hospitalization period for this surgery is normally 24 hours. The stitches are removed approximately in the second week. The patient can return to her activities gradually. The patient must avoid raising her arms above the head, carry weight or exercise excessively for three to four weeks. Swelling and a possible feeling of insensitiveness in the nipples are natural and normally disappear in the first weeks. The scars are easily hidden with the use of bikinis and low-cut blouses. Its size can be larger or smaller, depending on the breast size. In most cases the scar has good quality and tends to be imperceptible. The cicatrisation process can be divided in three evolutionary periods: the first one that goes up to the end of the first month, has scars with good appearance and that are little visible. The second, that goes from the 30th day until the 12th month, when the scar gets thicker and darker. The third, that goes from the 12th to the 18th month, when the scar is beginning to get lighter and have a more natural aspect. The final result of both cicatrisation and breast contour can only be assessed after this period. There is a series of clinical and surgical resources that are available to correct possible cicatrisation problems such as keloid, but these should only be used after the three phases of the process.


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