Breast reduction surgeries

One of the types of surgical breast correction is reduction mammoplasty, that is, surgery to reduce the size of the mammary glands.

The purpose of such an operation is to reduce the volume of breasts that are too large and disproportionate to the rest of the body.

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Reduction mammoplasty: indications and contraindications

First of all, indications for plastic surgery to reduce large breasts include perceived physical discomfort: when owners of a large bust feel constant pain in the back due to increased load on the spine and prolonged tension in the muscles that straighten the back and lift the scapula. This negatively affects posture, forcing you to slouch under the weight of your breasts. In addition, bra straps with large breasts often cut into the shoulders, squeezing the blood vessels and nerves leading to the neck and head. So not only the back, but also the head can hurt.

Also, breast reduction is used in cases of constant problems with the skin under the breast with mastoptosis (sagging breasts). Under the heavy glands that lie on the chest, moisture and sweat secreted by the skin evaporate poorly. This causes maceration, that is, loosening of the stratum corneum of the skin. As a result, the epidermis of the over-moistened areas can peel off, causing skin inflammation.

Among the indications for reduction mammoplasty, specialists name hypermastia (abnormally large breasts) and asymmetry of the mammary glands (when one breast is larger than the other). Plastic surgeons can reduce the breasts of men with gynecomastia.

However, breast reduction surgery has the following contraindications:

• presence of respiratory infections at the time of surgery;
• any oncology;
• diabetes;
• severe forms of obesity;
• undiagnosed formations in the mammary glands;
• heart failure and circulatory disorders;
• chronic somatic diseases in the acute stage;
• decreased blood clotting;
• pregnancy and lactation;
• age under 18 years.

Preparing for surgery

The surgeon who will perform the surgery will provide patients with detailed information about what preparation for breast reduction surgery involves.

A mammologist examination and a complete history of gynecological and general diseases, ultrasound or X-ray of the mammary glands, as well as an ECG are required.

It is necessary to take blood tests: general, biochemical, for sugar, for RW and hepatitis, for coagulation (coagulogram).

As a rule, in case of obesity, patients are advised to first get rid of extra pounds and the operation is postponed until the weight is reduced.

Two weeks before the scheduled operation, you should refrain from drinking alcoholic beverages, especially red wine; it is prohibited to take anticoagulants and antithrombotic drugs (Acetylsalicylic acid, Dicoumarin, Warfarin, Fibrolysin, etc.).

After a shower, which is mandatory on the eve of the operation, you cannot apply cosmetics, use deodorant, cream, perfume, etc.

To make it easier to tolerate anesthesia, you should stop eating and drinking any liquids 5-6 hours before your scheduled breast reduction surgery.

Types of Breast Reduction Surgeries

Today, such types of mammary gland reduction surgeries as reduction (reduction plastic surgery) of mammary glands and mastopexy are performed. If the essence of mastopexy is only to lift sagging breasts by excising skin, then during reduction, a part of glandular and fatty tissue of the breast, previously designated by the surgeon, is excised through an incision, as well as a segment of skin that becomes redundant after reducing the volume of internal tissues. In addition, the areola and nipple - with partial or complete separation - are raised and sewn higher.

All this is done under general anesthesia. After the stitches are applied to tighten the edges of the postoperative wound, it is drained (with the drainage tube brought out), then a sterile bandage in the form of a gauze bandage is applied around the upper part of the chest. The duration of the entire operation ranges from three to five hours (depending on the volume of tissue removed and the size of the skin flap that closes the wound).

With a large volume of fatty tissue in the mammary glands, breast reduction can be performed using liposuction. But this is not suitable for all women. As noted by specialists in the field of plastic mammology, liposuction for breast reduction is possible with fatty degeneration of the glands with the onset of menopause, as well as to correct the asymmetry of the breasts to one size. But with pronounced mastoptosis, fibrous strands in the breasts, low nipples and loss of skin elasticity, liposuction is contraindicated even for minor reduction of the mammary glands.

Consequences and complications of surgery

The doctor warns each patient about the short-term and possible long-term consequences of the surgical intervention, and also provides detailed instructions regarding the postoperative period (changing dressings and cleaning drainage tubes) - in order to avoid complications.

Consequences of breast reduction surgery:

• discomfort and pain (painkillers will be required to reduce it);
• hyperemia and swelling of the mammary glands and adjacent soft tissues;
• numbness or changes in sensitivity of the nipples;
• itching around the incisions on the chest and a feeling of increased hardness of the tissues in the mammary glands (lasting from several to three months after surgery);
• swelling of the hands and limited mobility (from six to ten weeks).

The long-term consequences are that in many cases the ability to breastfeed is lost, and the sensitivity of the breasts and nipples is irreversibly reduced.

The most likely postoperative complications are the formation of hematomas; wound suture divergence; bleeding; wound infection and suppuration; deformation of the shape of the mammary glands; inflammation of the nipple or areola; formation of rough keloid scars at the site of postoperative scars.

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Rehabilitation period

It is important to consider that the duration of recovery after surgery – the rehabilitation period – varies depending on the individual characteristics of each patient. And with extensive excision of breast tissue, this period will always be longer.

Usually, after the operation, the stay in the medical institution is no more than three days, and on the third day the bandage and drainage are removed. However, if the wound is sutured with non-absorbable suture material, the stitches are removed on the 8-12th day. And before their removal, proper care of the stitches is required: they must be treated with medical alcohol and only a sterile bandage must be used.

In advance, you need to purchase a compression bra specially designed for such patients, which must be worn for two months - around the clock.

It is necessary to sleep and rest lying on your back, with the headboard raised to a height of 30-45°. And to avoid turning on your side in your sleep, it is recommended to place pillows on both sides of the body.

Physical activity, except for walking at a leisurely pace, is absolutely contraindicated for at least three months. Hot showers and baths are prohibited for at least a month: only warm showers (and only after the stitches have been removed). You should seek shade from ultraviolet rays (i.e. sunbathing is contraindicated).

You should also increase your fluid intake (preferably water), and avoid foods and drinks containing salt.

By following the doctors' recommendations, you can see real results of breast reduction surgery in about six months.