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BREAST REDUCTION

BREAST REDUCTION

When we say ‘‘woman’’ we visualize many attributes, everyone has a different woman figure in his mind however the breasts which are indispensables of our women will definetely have an important place in this figure.

The breast of a woman which makes her a woman and is the principal organ of her femininity and motherhood, unfortunately brings trouble on them many times. The fact that we have many information about breast diseases and now there are specialists in many places who deal solely with breast diseases must be again due to the importance of breast. The breast unfortunately has a large group of diseases including infections, cysts, benign and malignant tumors.

Breasts, of which a large one is trouble and small one is another trouble, cause actually unexpected damages sometimes too. The back pain which is one them and the breast reduction operation as its sole solution are the most notable complaints with which women consult to us.

Breast growth with adolescence, weight gain and pregnancy are frequently encountered problems.So, it should not be forgotten that beside young ladies who feel mentally uncomfortable and aesthetic concerns, this is not only an aesthetic problem but also might cause severe back pain, postural disorders and irreversible diseases on spine. Additionally, complaints like unpleasant odor may occur due to itching, infection, hygiene problem and erythema under skin. Well, do you have such problems ? Are you worried about what to do?  Then you should get support from a Plastic, Reconstructive and Aesthetic Surgeon.

Aesthetic surgeons will help you about reshaping breasts both in healthy sizes and in good shape and without losing anyhting of their appeals. In patients with such complaints, it should primarily be investigated whether hormonal problems exist and breast growth has stopped and there is a lump or infection in breasts. If such complaints exist these should be intervened first, but if the breast growth has stopped and complaints are only about back pain and aesthetic concerns, the operation technique to be used is decided after detailed investigation of  breast sizes, mamary glands, fat tissue of breast, breast skin and nipple position and learning about the age of patient and her will to have a child in future.

General laboratory examinations of patient are investigated prior to breast reduction operation. Measurements and drawings are made before the operation in accordance with the operation technique decided to be used, and at this stage, patient’s opinion on the aesthetic form of a future breast is considered by all means. Breast reduction operation is performed under general anesthesia. The more frequently preferred method is the so-called vertical mammaplasty technique where a straight-line incision is made which runs from nipple to the lower area. In addition to this, the so-called Reverse-T technique, where there is a horizontal incision line under breast, is common.

Duration of operation varies between 2 and 3 hours depending on the technique used. In the operation, nipple is repositioned to the place where it supposed to be; upper loge of breast is usually emptied in a sagged breast(especially after extreme weight losses and gains), this area is filled during reshaping, the breast which has expanded towards armpit, is enclosed in a more narrow area and thus a better form is obtained. During these procedures breast tissue and skin are removed to be reduced and lifted as the desired sizes. Duration of hospitalization following the procedure is one or two days. You are allowed to get up and eat within 4-5 hours after the operation. Drains, which will collect the blood and serum leakages that might occur on the operated area, are used for first few days. These drains are removed after one day depending on the collected quantity. Removing or leaving the stitches postoperatively depend on the method that will be used by the surgeon.

It is advised to use a sports bra in the postoperative one-month period.

Breast reduction operations have some different characteristics depending on the technique used. In some limited breast reduction operations healing is fast and there is an immediate return to normal activities while this process may take longer in very large breasts depending on the condition of the tissue which is removed. Similarly, the position and length of scars also vary according to the technique. Surgical scars are more apparent within the first months but they change positively from the 6th month.

Due to the lactation function of breast, breast tissue and nipple should be protected during the operation by all means . Moreover, due to breast sensation and its indisputable importance for women, operation techniques should primarily be preferred where breast sensation and the relationship between nipple and milk ducts do not deteriorate. However, operations techniques, at which this relationship deteriorates; may be preferred in some large breasts. Though nipple losses are not very common in operations where extremely large breasts are reduced, the technique should be decided upon together with the patient.

If the form of breast is good but large, and is considered as a result of lipoidosis, breasts can be reduced to a certain extent only with the method of fat suctioning through vacuuming(liposuction). But if it is necessary to give a form along with the reduction procedure, then the above-mentioned surgical interventions are inevitable.

The problems that can be encountered postoperatively, can be divided into two as problems occuring in the early and late periods.In the early period, problems such as bleeding, infection and wound site healing are very rare. Problems in the late period may come up as problems due to the scar or shape. Scar markedness, erythema and itching might frequently be seen in some dark-skinned people in the early period and may necessitate drug therapy. Shape-related problems are rather size-related. Therefore, the desired breast size should be discussed clearly between the patient and surgeon taking into account also other body characteristics before the operation.

I also want to briefly mention another common problem. Due to extreme weight losses or breastfeeding after birth a significant emptiness and sagging may occur in the upper loge of breasts. In such cases breasts can resemble a big, deflated balloon. Though they do not disturb as a mass, these kind of breasts should definetely be considered to give them a form again because they have lost their appeal. Breasts are lifted in such patients and if there are enough tissues left, a form can be obtained by transferring these tissues to the upper loge of breast; but if there aren’t enough breast and fat tissues left under the breast then use of breast prostheses will create the desired form.