Indications of breast reduction
In some women, the breast may develop excessively, resulting in aesthetic and functional problems. This excessive breast growth can occur either at a young age, or with weight gain, or due to hormonal changes that occur during menopause. This image can take the form of megalomastia or gigantomastia and usually due to the heavy weight of the breasts, intense relaxation occurs at the same time.
The aesthetic problems of the very large breast usually become more intense with age, where due to tissue relaxation there is a subsidence of the entire parenchyma with intense emptying of the upper pole, displacement of the nipple downwards, enlargement of the nipple diameter and excessive weight of the lower pole. Most women with megalomastia are forced to wear very tight bras to support the breasts and experience difficulties with clothing, finding swimsuits and also often stretching breasts ends up being the most pronounced feature of their body.
Apart from aesthetic problems, too large breasts cause many functional problems. The main problem is skeletal, because the neck and chest are severely stressed, resulting in frequent neck pain and even spondylolisthesis of the cervical vertebrae due to weight. The hygiene of large breasts is also problematic, as the submammary fold is not adequately ventilated, resulting in sweating to develop fungi and bacteria in this area cause dermatitis in the form of redness or pain; In women with megalomastia, mastitis and chronic inflammations such as hidradenitis are also more common. Due to the tight bra worn by most women with very large breasts, braces can even cause permanent groove in the shoulders and back. Megalomastia and gigantomastia can be considered a form of disability, because everyday life is very strongly affected, walking, running, sleeping and all activities.
Finally, many women with giant breasts do not have the ability to breastfeed because due to weight the milk ducts are greatly stretched and the passage of milk is prevented. Due to the weight, the nerves of the nipple are also stretched and the sensation of the nipples is limited. A big problem is the difficulty in screening for malignancies. Palpation is almost impossible and mammography cannot easily reveal the lesions due to shading from the dense and large parenchyma.
For these reasons, breast reduction is sometimes necessary, because it significantly improves the quality of life of women who suffer. In other cases, the operation is performed for aesthetic reasons, in order to better match the breast type. In any case, whether for functional or personal reasons, our goal is to offer a beautiful aesthetic result that will last for many years, without disturbing the function of the breasts.
Breast reduction techniques
There is a plethora of breast reduction techniques and the choice of the appropriate technique aims to achieve adequate reduction with the fewest possible scars and complications and to offer a result that lasts over time. The percentage of breast reduction should be such that it corresponds to body type and treats all functional problems.
Regarding scars that remain postoperatively, we distinguish two main operations: those with an inverted T or anchor scar and those with a vertical scar. The choice of incision is based on the correct assessment of the breast and excess skin. In general, scarring is not a particular problem because healing is usually excellent and after a few months most of the scars are not discernible at all.
Apart from external scarring, breast reduction techniques may differ depending on the type of removal of the parenchyma and the way the remaining breast volume is redistributed. The removal of the gland may involve the central and lower poles of the chest, or involve a large part of the lower-outer pole. The selection is based on the preoperative assessment and based on the result we want to achieve. Also , the size of the removal can vary greatly and can be 200-300grams up to over 1 and a half kilograms per breast.
The nipple and breast are mobilized in such a way as to ensure blood supply and innervation throughout the area and at the same time to be able to give the breast the natural shape of a drop. During surgery, special measurements ensure the symmetry of the breasts, both in size, shape and position of the nipples.
A great aid in breast reduction surgeries is liposuction, which can sculpt areas that are not accessible, such as the sides of the chest towards the armpit. In this way we can reduce the overall extent of the scar. In some cases, where the upper pole of the breast is too empty and flat and it is judged that by redistributing the gland we will not achieve sufficient volume replenishment, we can additionally add a small amount of fat targeted at this point, while in some cases we may even choose a small silicone implants in order to keep the upper pole of the breast full.
After breast reduction surgery
Breast reduction surgery is performed under gemera; anaesthesia and usually does not require hospitalization. The duration of the operation is about 2-2 and a half hours. After surgery, a special elastic bandage or bra is placed. Drains are not placed in most cases and the stitches are made with absorbable sutures that do not need removal.
The pain after surgery is very mild and completely subsides with common analgesics after 2-3 days. In general, breast reduction surgery does not affect daily activities much. The restrictions concern bathing for the first 5-6 days and sports activities for a few weeks, but otherwise there are no strict prohibitions and the return to work can be very immediate. In the first weeks after surgery there may be a numbness in the nipple area, which completely subsides after a few weeks.
The chest is initially a little abnormally raised and the upper pole gives the feeling that we have placed a silicone implant. This is a deliberate manipulation that is done with a calculated overcorrection, so that after 3-4 months that the breast will show some fall it will take our desired shape, that is, the shape of the drop.
