Reduction mammoplasty is plastic surgery aimed at reducing and redesigning breasts that are too big and ptosis or correct pathologies such as gigantomastia. The shape and dimensions of the breast are influenced by many factors – genetic, hormonal, pregnancy, breast-feeding and body weight – and may change during the years.
Why undergo this surgery?
Differently from gigantomastia, breast hypertrophy is not a real disease. What makes someone want to undergo this kind of surgery is that very large breasts imply psychological, social and physical issues since they may be heavy, limit daily activities and often cause embarrassment and discomfort. Excessively heavy breasts have a consequence on the spine, causing pain and postural disorders.
What needs to be done before surgery?
Speaking to the plastic surgeon before surgery helps eliminate doubts and perplexities and understand exactly how the surgery will be made and all options suitable for one’s case. In order to achieve the best result, all possible variables to the surgery procedure will be taken into account depending on the patient’s physical characteristics and needs. The consultation is non-binding and gives one the possibility to have all the information regarding the surgical and post-surgery programme, the medicine to take, analyses and check-ups to do and costs. At the moment of hospitalization, all preparation photos will be taken and the surgical site will be highlighted in order to have a sort of guide for the surgery.
How is the surgery performed?
There are two possible surgery options: - Reduction mammoplasty and repositioning of the nipple linked to the tissue below through the vascular pedicle. This technique allows the woman to preserve nipple sensitivity and function. - Torek technique in case of severe gigantomastia, which includes grafting of the nipple and its consequent loss of sensitivity and function. The surgery is done under general anaesthesia and lasts about 2-3 hours. Skin incisions are made following the lines drawn before the surgery in order to isolate the areola-nipple area, remove the skin, subcutaneous fat and excess mammary gland. The surgery ends with the suturing of the skin margins, reduction of the areola diameter and upper repositioning of the nipple. When using the Torek technique, the nipple is completely separated from the tissue below and returned to its correct position at the end of the surgery. A compressive dressing is applied; this will then be replaced by a sports bra. Hospitalisation lasts one day.
What happens after the operation?
The compressive dressing is removed after about 5 days from the surgery and replaced with a sports bra that must be worn for about 30 days. The stitches are removed after about two weeks. In the first days after surgery, absolute rest and limited movements are advised, especially for the upper limbs. Swelling, stiffness and light breast pain are normal in the first period after the surgery.
Patients normally suffer pain, swelling, reddening and bruises in the treated area during the first days following the surgery. Post-surgical issues can be kept under control using normal painkillers or anti-inflammatory drugs.
Scars are not very visible. They are located at periareolar level and on the breast. Visible and red at first, they then become not very visible after some time.
A good outcome of the surgery depends on many factors: the patient’s initial clinical conditions, her healing capacity and compliance with the doctor’s post-surgery indication, i.e. avoid inappropriate movements or sun exposure until complete healing of the scars. The final profile will be achieved after about one year, but the outcome and benefits will be immediate.
What are the possible risks?
Rare although possible risks are hematomas, bleeding, infection, late healing of the surgery wound, hypertrophic healing, change in skin sensitivity. Reduced or loss in nipple sensitivity is recovered after some time. Finally, breast reduction is achieved by removing part of the mammary gland. If it is no longer possible to preserve gland vitality and that of the mammary duct, breast reduction implies the loss of breast-feeding ability.