Reduction mammaplasty

Breast hypertrophy is not a condition in itself, unlike gigantomastia. The desire that moves the patient to undergo this type of surgery is determined, however, by what an excessive breast volume entails on a psychological, social and physical level: a breast that is too voluminous and heavy is perceived as a limit to daily activities and often causes discomfort and embarrassment. The excessive weight of voluminous breasts weighs on the spine, causing pain and postural defects.

An initial consultation with the plastic surgeon will help to eliminate doubts and perplexities, to understand exactly how the operation will take place and what all the options and possibilities are suitable for your case. In order to achieve an optimal result, the possible minimal variations of the surgical procedure will be evaluated based on the anatomical characteristics and needs of the patient. The visit is not binding and gives the opportunity to receive all the information and satisfy any curiosity regarding the surgical and post-surgical program, the drugs to be taken, the analyzes and checks to be performed and the costs. At the same time as hospitalization, pre-operative photographs will be taken and the surgical site will be marked which will act as a guide during the operation.

There are two possible surgical alternatives:
• Reduction mammaplasty with repositioning of the nipple-areola complex connected with a vascular peduncle to the underlying tissues. This technique allows you to preserve sensitivity and function of the nipple.
• Torek technique in case of severe gigantomastia with grafting of the nipple-areola complex and consequent loss of sensitivity and function.

The duration of the operation is approximately 2-3 hours and takes place under general anesthesia. The skin incisions are made along the drawings made before the operation in order to isolate the areola-nipple complex and remove excess skin, subcutaneous adipose tissue and mammary gland. The operation ends with the suturing of the skin edges, reduction of the areolar diameter and higher repositioning of the areola-nipple complex. In the Torek technique, the areola-nipple complex is completely separated from the underlying tissue and grafted into the correct position at the end of the operation. Finally, a compressive bandage is applied, which, once removed, is replaced by a sports bra. The duration of hospitalization is 1 day.

Approximately 5 days after the operation, the compressive dressing is removed and replaced with an elastic sports bra which must be worn for approximately 30 days. The sutures are removed two weeks after surgery. In the first days following the operation, absolute rest and limitation of movements, particularly of the upper limbs, are recommended. In the first post-operative phase, a sensation of swelling, stiffness and slight pain in the breasts will be normal.

In the first post-operative days, the presence of slight pain, swelling, redness and bruising in the treated area will be normal. Post-operative discomfort can be controlled with normal painkillers and anti-inflammatories.

The residual scars are very little visible both at the peri-aureolar and breast level. Initially visible and red, over time they progressively become very invisible.

The result of the surgical operation depends on several factors: the patient's initial clinical condition, the healing capacity and compliance with the post-operative instructions given by the surgeon: avoid inappropriate movements, abstain from sun exposure until complete stabilization of the scars. The definitive profile will be visible after about a year, but the results and benefits will be noticeable immediately.

Complications of the operation are rare, but possible: hematomas and bleeding, infection, delayed healing of the surgical wound, hypertrophic scarring, modification of skin sensitivity. The reduction or loss of sensitivity of the nipple-areola complex can be recovered over time. Finally, breast reduction occurs by removing part of the mammary gland and, if it is not possible to preserve the vitality of the gland and the milk ducts, reduction mammoplasty involves the loss of the ability to breastfeed.