If you feel that your breasts are out of proportion with the rest of your body, or you have difficulty finding clothes that fit properly or you feel uncomfortable when you take part in active sport, an operation of breast reduction can help. Large breasts can cause back pain, postural problems, painful tightness, dermatitis in submammary region decubitus breast hypertrophic on the chest wall and discomfort for some women.
Breast reduction is an operation to reduce the size and weight of the breast, as well as to lift and give him firmness as a side effect. The areolas also possonono become smaller (the darker skin around the nipples) and move higher up to give them more projection.
Preparing to ‘intervention
The surgery should not be performed in pregnant or breast-feeding and it is preferable to avoid the period of the menstrual cycle.
Before the operation you will be asked for the reports of mammography or breast ultrasound: for they have the dual purpose of ascertaining the ‘presence of mammary tumors and to get a useful comparison for future diagnostic tests that will be carried out in the years to ‘intervention.
They should not be taken for two weeks prior to surgery or medications containing aspirin or acetylsalicylic acid, as well as taking oral anticoagulants should be adequately replaced with low molecular weight heparins agreeing everything with the patient’s GP. A month before the ‘intervention must be suspended progestogen therapy (birth control pills) in patients who use it: this to further decrease the risk of deep vein thrombosis in the legs.
If you smoke, you should stop for at least one month before surgery to reduce the chance of post-operative complications.
And ‘it recommended getting right now a bra elastic-compressive with front opening high-end, making sure to agree with the health the opportunity to change it if the size purchased was not perfectly adapted to the “new breasts”.
The night before must be done carefully cleaning shower, shaved with a razor completely the axillary region, removed the nail polish for hands and feet.
Observe the fast of at least 8 hours before the ‘intervention.
The surgery for breast reduction is performed under general anesthesia and usually stays in the hospital for one or two nights. It lasts for 2 to 3 hours depending of the ‘extent of the reduction and the technique used.
During a breast reduction Dr Grassetti removes excess fat and skin. Your residual breast tissue is then reshaped and sewn with special techniques and flaps as needed to make the small breast and raised. The nipples will be repositioned in the right place. The scars (see figure), depending on the technique used will be located around the areola, along the vertical which goes from the bottom edge of the areola to the inframammary fold, along the inframammary fold same, more or less extensive depending of removal entities. The sutures are usually made with all internal points which do not require removal.
At the end of ‘intervention it is placed a drain for each operated side, a armpit level, which will be removed after 24-72h.
Ghiandolo adipose tissue removed is sent to histological examination, so as to also implement a screening of mammary tumors unrecognized.
You may feel a slight pain in the pectoral region, easily kept at bay with standard analgesics. It regresses in any case within a few days.
You need to wear a sports bra without underwire elastic compression within 8 weeks after surgery to support the breasts while the remodeled breasts settle into their new form, in the first 4 weeks day and night, in 4 successive weeks only during the day.
A bed should rest on two pillows to keep your head and shoulders elevated.
For the first 4 days after the ‘intervention is recommended complete rest of the pectoral muscles: do not force the arms to get out of bed, do not lift weights, do not make large movements with his arms.
For the first week it will be forbidden to drive a car. Likewise, it is absolutely recommended the ‘abstaining from smoking for at least a week: it may be responsible for bleeding, necrosis of the nipple areola complex and acute exacerbation of pain. In case some cutaneous points have been positioned, these will be removed after a week. At this point it will be possible to perform the first shower (not the bathroom!)
For the first 10 days it will be recommended instead a home resting, always avoiding efforts to pectoral muscles, performing instead walks also to open air.
L ‘work can be resumed after 10 days, except in case of major manual effort.
For about a month will have to be avoided any kind of sports activity and exposure to the sun or heat (sauna, sun lamps, etc.). It must also be avoided prone position (face down) overnight.
For about six months it is good to avoid pregnancy.
Report the successful execution of the ‘intervention of breast reduction during subsequent senologiche investigations.
POTENTIAL COMPLICATIONS GENERAL
As with any surgery, albeit modest and performed on patients in good health, you may encounter:
A modest bleeding wound is normal. If important entities may require surgical reintervention.
wound infection. It is manifested by pain, swelling, warmth and redness of the skin, whether or not accompanied by fever. Any infection can usually be treated with antibiotics and local wound dressings, but may result in poor quality scars.
The appearance of a hematoma in the first hours after the surgery is rare and is treated with immediate or suction drainage (whence the importance of the positioning of a safety drainage). However, it can occur up to a week after surgery. Is manifested by severe pain and sudden increase in volume and hardness of the breast should be reported immediately to the surgeon, as well as bruising on the overlying skin in the following days. If modest it reabsorbed spontaneously. If larger may require the evacuation including by reopening the wound in the operating room.
The formation of seromas consists in ‘accumulation around the prosthesis of a yellow and transparent liquid called serum, entirely similar to that which forms in blisters and bubbles of burn victims. Small amounts are absorbed spontaneously, while gathered more conspicuous that should form when the drains are no longer present may require ‘aspiration or surgical drainage as in the case of major hematoma.
Dehiscence (reopening) of the wound is very rare and may occur in particular at ‘crossroads of the sutures, where c’ is more tension. Usually it heals spontaneously with outpatient medication; more rarely it may require a new suture. And ‘more common in diabetics, smokers and obese.
Although very rare, phlebitis and pulmonary embolism: the ‘incidence increases if the patient is not mobilized early.
POTENTIAL COMPLICATIONS SPECIFICATIONS
skin necrosis and the nipple areola complex. It ‘a very rare circumstance, but fearsome and due mostly to problems not reported at the time of the visit or to patients who smoke heavily or very large breasts and perishable. They can also result in a remote surgical treatment for the reconstruction of the nipple areola complex.
Decreased sensitivity of the nipple areola complex is planned between the sequelae of ‘surgery. Some techniques such as breast reduction based on the septum, the sensitivity is decreased temporarily and gradually can be almost completely regained, in other can be lost forever.
Necrosis of part of the adipose tissue (liponecrosi) may occur prematurely with leakage of oily liquid from the wound, or at a distance of time with possible formation of fibrous nodules, indurations and calcifications often asymptomatic.
Impossibility of breastfeeding after ‘surgery, because many milk ducts are damaged.
The improvement effect is immediately evident, although the breasts appear quite full at the upper pole and will tend to assume a more natural look only after two months. The final result must be evaluated after six months, as well as any “tweaks”: it must be said that a perfect symmetry in the volume of the breasts and in ‘teat orientation is realistically impossible to obtain.
The breast does not stop the normal aging process, so it is inevitable that with the ‘age the skin will relax or determine a new increase in breast size for deposition of adipose tissue in the event of weight gain. However, even without subsequent retouching, the appearance of the breast will still be better than you would if the ‘intervention had not been executed!
Inevitably the ‘intervention produces permanent scarring that improve over time. The horizontal scar in the inframammary fold, as needed in case of very large breasts, can go to the axillary region and toward the sternum, overflowing beyond the breast limits and resulting partially visible pertando. In addition some patients, due to excessive skin reactivity can develop reddened scars, enlarged or hypertrophic and therefore easily visible. They are treatable by surgery or require revision surgery after one year.