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Breast Reduction

Contrary to a popular belief, large breasts are not always favorable for women. Women with large, heavy breasts can suffer from back, neck, and breast pain, indents on the shoulders from bra straps, irritation of the skin underneath the breasts, or breast asymmetry. Often women experience not only physical discomfort but also severe psychological distress. In such cases, breast reduction surgery is recommended.

A breast reduction procedure is not recommended for women who intend to breast-feed. It is difficult to predict if a woman after surgery is able to breast-feed because during breast reduction surgery, the milk ducts leading to the nipple might be severed.

 

How Is the Surgery Performed?

The surgery is performed under general anesthesia and takes about 3 hours on the average.

Breast reduction is a surgical procedure that helps reduce large breasts and improve their shape by removing the excess skin and tissue underlying under it. During this surgery, the areola (dark brownish area around the nipple) can be reduced in size, which becomes enlarged over time as the breasts develop.

Incisions are usually placed around the areola, downward in a vertical line, and in the crease under the breast. During the surgery, the surgeon removes excess skin and breast tissue, repositions the nipple and the areola to their anatomical location on the breast, and reshapes the breasts into a more esthetic shape. The surgery is completed by placing the drains, which are removed the next day after the surgery.

Then, the plastic surgeon removes excess fat, skin, and tissue and repositions the remaining skin and areola.

 

Postoperative period:

  • The first postoperative day should be spent in the clinic;
  • The stitches are removed after 10–14 days;
  • Most patients resume their daily routines within 1–2 weeks;
  • Strenuous physical activities and sports are recommended not earlier than 3 months after the surgery;
  • After 7–10 days, it is possible to return to wok and resume routine activities
  • A special surgical bra should be worn for 4–6 weeks after the surgery (22–23 hours per day);
  • Since the nipple is partially separated from the surrounding breast tissue and innervation is slightly altered during the surgery, nipple sensation is reduced, which improves over time.
  • The final outcome is seen after 4 months when the breasts settle in.
  • The postoperative scars should be protected from direct sunlight for a period not shorter than 1 year to make them less noticeable. The scars usually fade within 2 years.

 

Post-operative period

  • The first postoperative day should be spent in the clinic;
  • There are not stitches to be remove, as they are dissolvable;
  • Most patients resume their daily routines within 1–2 weeks;
  • Strenuous physical activities and sports are recommended not earlier than 3 months after the surgery;
  • After 7–10 days, it is possible to return to work and resume routine activities
  • A special surgical bra should be worn for 4–6 weeks after the surgery (22–23 hours per day);
  • Since the nipple is partially separated from the surrounding breast tissue and innervation is slightly altered during the surgery, nipple sensation is reduced, which improves over time.
  • The final outcome is seen after 4 months when the breasts settle in.
  • The postoperative scars should be protected from direct sunlight for a period not shorter than 1 year to make them less noticeable. The scars usually fade within 2 years.

 

Possible complications

Despite the highest level of precision, there is still a risk of post-operative complications, such as:

  • Post-operative haemorrhage (including several days postoperatively) is possible. A haemostatic surgery may be needed according to the situation;
  • Wound healing disorders are possible, particularly if significant descent of the nipple was observed preoperatively. These problems are usually overcome easily, however, they may damage the cosmetic effect and subsequent scar correction surgery may be necessary;
  • Breast skin and nipple numbness occurs because cutaneous nerves may be damaged. Usually numbness disappears gradually;
  • The feeling of pain and tension is usually significant during the first post-operative days and might sometimes last longer than expected;
  • Circulation and wound healing disorders in the margins of the wound are possible. In occasional cases, tissue necrosis may occur and lead to extensive scarring. Rarely, vitality of the skin surrounding old scars of prior surgeries may impair. In such cases hospital stay is extended, additional operations may be needed and desired  cosmetic effect may be damaged;
  • Wound infection which may cause persistent and painful phlegmons (abscesses and fistulas) requiring surgical treatment is possible;
  • Occasionally – formation of thrombi is possible. They may cause pulmonary thrombi embolism in case of a thrombus reaching pulmonary arteries. This condition is life-threatening, therefore specific treatment is needed. Prolonged immobility increases the risk;
  • Very occasionally – necrosis of the nipple and areola due to circulation disorders if breast augmentation surgery was combined with breast lift. Additional surgeries may be needed.
  • Scarring disorders. The scar may expand if it develops under tension. In cases of individual predisposition, thick, fleshy, different in colour, painful and itchy scars may appear (scar hypertrophy, keloid). Timely scar treatment (as soon as the scar changes are noticed) allows to avoid corrective surgery;
  • Slight breast asymmetry may be observed postoperatively (especially, if breast asymmetry was observed pre-operatively).

 

Things to consider after the surgery

Your post-operative cooperation is very important in order to achieve long-lasting results. Please follow these instructions:

  • To avoid excessive tension of the sutures, specific bed position during the first post-operative days is necessary: the upper part of the torso has to be slightly lifted.
  • Do not smoke for at least two weeks postoperatively.
  • Do not take alcohol when using pain medications.
  • To avoid thrombosis, start getting up from bed on the very first day postoperatively.
  • To stimulate venous circulation, move your feet often. You should do respiratory exercises as they improve lung ventilation.
  • You can have shower under doctor’s permission. Usually you are not recommended to have shower for 3 days postoperatively, depending on the type of sutures.
  • Wear a special brassiere for 6 weeks after you are discharged.
  • Do not do active sports for about 2 months.
  • Do not drive, do not sleep on your stomach, avoid lifting your hands over the head, and avoid lifting heavy objects until the pain is gone and you feel comfortable.
DMC Firewall is developed by Dean Marshall Consultancy Ltd