Breast reduction is the procedure where excess fat, glands and skin are removed to reduce the size of the breast. It is indicated in people with very large breasts as compared to the body that often causes back pain, neck pain and intertrigo( redness and infection under the breasts.
How much size can be reduced?
It depends upon how large the breasts are and what patients are desiring. suppose a woman has EE or FF size breasts they can reduce to D or Full C cup. a very small breasts may not look proportionate to the body and most importantly has risks of loosing nipple vascularity and or sensation.
What are the chances of scar after breast reduction?
Scar depends upon the type and extent of breast reduction, individual skin type and healing capacity.
There are three main incisions for breast reduction:
- Classical anchor incision: The incision is around the nipple than vertically down and a horizontal incision under the breasts.This in fact gives the best shape, the horizontal incision allows to reduce the distance of nipple to submamary fold and remove excess skin. The vertical incision is necessary to remove the horizontal excess of the skin, reduce the base size of breast and support the breasts like a brassier The incision around the nipple allows to lift the skin up and reduce the size of the areole.
- Lollipop incision or vertical short scar: In this technique the indian is around the nipple and areole and there is a vertical incision running down to the submamary fold. this can be done in younger patient with good skin quality and when the breast sagging is grade 2 and less.
- Peri areolar breast reduction: It is indicated in very young patient with grade one or two ptosis or sagging. this is not an ideal surgery as the shape of breast is more flatter and the areola tends to stretch over time.
The quality of scar can be improved by following technique
- fine subcuticular sutures
- reasonable breast tightening and skin lift
- avoid smoking
- good postoperative care
- postoperative scar management
What is the procedure involved?
Breast reduction is performed mostly under general anaesthesia. in selected individuals it can be performed under local anaesthesia and IV sedation.
Planning and marking
- This is the most important part of the surgery. Marking is done to identify the correct location of nipple, amount of skin and breast removal and final placement of the stitches.
- Procedure – Infiltration of local an aesthetic solution is performed in the breast tissue that ensures bloodless field and postoperative pain free recovery.
- If possible some of the fat tissue is removed by liposuction, it also helps in improving the shape of the breasts. Adequate amount of the breast glands are removed. a modified form of internal brassier is formed using the dermis of the skin and used to support the breasts.
The wounds are carefully closed with fine sutures. Sometimes a small pen rose drain is inserted to prevent excessive swelling and bruising.
What is the postoperative care and recovery?
After the surgery a dressing is placed for first 24 hours. they stay in hospital overnight and are discharged after removing the drains and dressings. they are advised to wear a surgical garment for 3-4 weeks. Patients return to work in 7-10 days.
Can I breast feed after breast reduction surgery?
It will depend upon the amount of reduction. If More glands are removed there is less chances of breast feeding.
What are other risks of surgery?
The potential complications of breast reduction or reduction mammaplasty are bleeding, infection, hematoma and very rarely wound dehiscence , skin loss , loss of sensation or nipple loss. The complication rates are high among chronic smokers who do not stop smoking prior to surgery and post operatively.