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BREAST REDUCTION



This term refers to an operation wherein a plastic surgeon aims to reduce the volume of the breasts, while at the same time achieving their elevation.

In most cases, a female patient will request a breast reduction for cosmetic reasons. However, there are cases wherein breast reduction is necessary for health-related reasons. For example, a patient with very large breasts may manifest malformations in her spinal column due to the weight. These malformations can become much more extensive when combined with osteoporosis.

In addition, large breasts are difficult to check for symptoms of breast cancer. It is obviously difficult to make a diagnosis by touch, but even mastography becomes less reliable when applied to breasts of that size.
This operation is similar to breast elevation, as one of its aims is to elevate the breasts, but at the same time it involves the removal of part of the mammary gland.


REASONS FOR BREAST REDUCTION

Female patients are usually driven to undergo this procedure by the following reasons:

1.    Breasts that are disproportionally large in relation to the rest of the body, and as such pose a cosmetic problem.
2.    Breasts voluminous enough to cause back and neck pain.
3.    Breasts that, due to their volume, impede the patient’s movement in the course of their daily activities.
4.    Breasts that have undesirably increased in volume following a pregnancy.
5.    Breasts of different sizes; in this case, the aim to achieve symmetry by removing part of the mammary gland from one breast, or adding volume to the other.
6.    Skin rashes in the under-breast. This type of inflammation can be caused by the cultivation of germs when the area in question is not well aired.
7.    Difficulties in participating in sports activities due to overly large breasts.
8.    Greater possibility of developing breast cancer, and greater difficulty in diagnosing the area.




If a female patient is overweight and contemplating to lose weight, it is best to try and lose that weight before the operation. If, even after repeated attempts, this weight has not been lost and does not seem like it will be in the near future, then the operation can be done regardless of the patient’s body weight.

HOW BREAST REDUCTION IS PERFORMED

It is best for the operation to be made outside the three-day margin before or during a female patient’s period. This is due to the fact that during menstruation the blood’s ability to clot is compromised, there is a greater sensitivity to pain, and the breast is likely to be swollen to a larger size than usual. In addition, the patient should not have consumed aspirin up to ten days before the operation, or alcohol two days before.

During the operation, the plastic surgeon:

•    Will remove any excess of skin that has accumulated
•    Elevate the nipple to a higher position
•    Remove a certain amount of the mammary gland’s bulk, depending on the degree of reduction that is being targeted
•    Stabilize the gland at a higher, more elevated position.

Afterwards, he will suture the incisions.

It is possible that a number of small tubes will need to be set in place for a few days; these serve to facilitate drainage, and serve to prevent the development of haematoma. Breast reduction does not entail the use of silicone implants, as many believe, but merely the removal and redistribution of the breast’s volume.






AFTER BREAST REDUCTION

Absorbable sutures are usually employed, and as such their removal is not necessary.
The patient is usually required to remain at the clinic for approximately 24 hours.

There is usually no pain after the operation, and if there is, it is of low degree and can easily be dealt with using painkillers.

A return to work can be made after 4-6 days, provided it is office-type work. Heavier, manual labour may require up to 2 weeks of recuperation beforehand.

The breast will initially feature some edema (swelling), and as such requires some time before it takes on its final shape. The shape of the breast should be fairly satisfactory after one month, but the final shape will only appear after 6 months.

Given that only one part of the gland has been removed, breastfeeding will still be feasible, provided of course it was feasible before the operation.

Breast reduction can be beneficial to the patient’s health, as, by reducing the volume the breast, the chances of developing breast cancer are also reduced. In addition, the breast is easier to feel by hand, and present a better image in a mastography. Therefore, diagnosis is made much easier. It is best to undergo a mastography before the operation, in the event that there is a pre-existing tumor.

Given there are no fluctuations in the breast’s volume (fluctuation in body weight, pregnancies, etc.) the result can be very long-lasting. The chances of complications (infection, hematoma, necrosis, etc.) are very small, and when they do occur they are easy to correct.

As such, breast reduction is a type of operation which not only improves the overall image of a patient, but also removes a great weight that impedes their daily activities. Many patients who have undergone this procedure have expressed great relief.