Over-sized and/or ptotic breast is a condition which is a major problem among women after the fourth decade. Previous pregnancies, overweight and inheritance seems to be the major causes. Large breasts are cosmetically unpleasing as well as the effects on axial skeleton leading to a disturbed posture and pain. Dermatoses under the breast is also a problem in such cases. It is also not easy to detect cancer by physical examination and mammography in larger breasts. Although these mentioned reasons make this procedure a medical necessity rather than a cosmetical procedure, this surgery has many cosmetical targets. Breast reduction surgery must take care of four important parameters:
If you are not happy about the size of your breasts and want them to be smaller you are a good candidate.
Smokers will have many wound healing problems and may patially or totally loose the nipple and/or areola. Underlying medical conditions are also important.
The patient must get prepared for the scar. Inverted-T or vertical depenting on the size of the breast. Otherwise breast reduction is a satisfactory procedure. The patient must also get prepared to the idea that she may not be able to breast-feed in the future. So its wise to get operated after pregnancy if breast-feeding is desired.
Nipple areolar perfusion problems and loss is a very rare complication but a fearsome one. Nipple sensory loss is also a risk. Haematoma, infection and thromboembolic complications might be observed but very rare. We send the removed tissue to pathology lab and seach for an incidental breast carcinoma. The patient must be informed by the incidental risk of breast carcinoma.
Smoking must be ceased at least 2 weeks prior to surgery. Underlying anemia mıust be known (blood count for hemoglobin) because blood loss during surgery might have importance in anemic patient.
The patient generally stays one or two nights at the hospital. We use vacuum drains in order to withdraw blood from the surgical site. Generally they are removed on the first day postoperatively. We advocate the usage of special bras for 1 month postoperatively in order of the comfort of the patient. Postoperatively we also care for the scars and use some products in order to decrease scar formation.