Breast hypertrophy is a very common pathology nowadays. It is the excess of tissue at the mammary level, and this can be at the expense of adipose tissue, glandular tissue or both. Hypertrophic breasts are usually also ptotic (“sagging”) to a greater or lesser extent.
Breast hypertrophy is not a disease in itself, but is considered pathological in cases where it causes functional problems such as back pain, neck pain, problems with mobility, sports or normal life; also if associated with dermatological problems such as infections or dermatitis in the folds. On the other hand, and no less important, there are the aesthetic problems and the resulting complexes, which can cause psychological disorders to those who suffer from them.
RESULTS
The results are seen immediately, although the first few weeks may be somewhat swollen and the scars tender. The stitches can be removed after 2 weeks, and the scar will be cared for according to the surgeon’s instructions.
This is a surgery with a high rate of patient satisfaction (up to 97%), since it involves both an aesthetic improvement and an improvement in quality of life. Our patients often tell us after surgery that they no longer have back pain or discomfort at that level, as well as that they look much better and can dress more comfortably.
REDUCTION TECHNIQUES
There are different reduction techniques, all of which pursue the following objectives:
– Reduce the amount of breast, both its glandular and adipose component.
– Excise excess skin and reshape the breast to a proper shape.
– Reposition the areola, place it in a location generally higher than the starting point, since the starting breast is usually sagging.
– Decrease areola size, correct asymmetries if any and improve the shape, which should be circular and the two areolas should be similar to each other.
– The breast should have an appropriate shape, proportionate, rounded, with a prominent upper pole and a defined lower pole, giving an overall “drop-shaped” appearance to the breast.
– The areola should be placed at the point of maximum projection of the new breast.
– The viability of the areola, nipple and the rest of the skin surface and adipose tissue of the breast must be maintained.
– Improve quality of life, allow the patient to perform physical exercise without discomfort, relieve back pain, solve dermatological problems in folds.
Generally, in a breast hypertrophy, it is necessary to remove enough tissue to achieve an acceptable result. The pattern of reduction can vary, although the most frequent for these cases is the “anchor” or “inverted T” scar pattern. Technically, this resection is called Wise pattern and manages to remove skin and breast tissue from the lower and middle area, and the resulting flaps are used to reshape the new breast.
The areola and nipple survive thanks to the design of a vascular pedicle through which they will be nourished (it is a band of tissue that provides arterial and venous irrigation) and thanks to these pedicles we can reposition the areola to places where the nipple will not be damaged.
distant from their origin. The pedicle can be designed in different ways according to the surgeon’s preferences and the characteristics of each breast (superior, inferior, superomedial, etc.).
The procedure is performed under general anesthesia, and usually lasts about 3-4 hours. During the operation, the surgeon removes the excess tissue, reshapes both breasts, and compares them to see if the result is similar. It is common to sit the patient on the operating table for comparison.
COMPLICATIONS
Those common to any type of surgery:
-Hematoma 3%. If it is not very important, it often reabsorbs by itself, it is necessary to wear compressive garments and avoid exertion.
– Infection 2%. They are usually small skin infections or scars that are treated with ointment and/or oral antibiotics.
– Alterations in healing 5%. It is important that your surgeon monitors your scarring. If any problems are detected, he/she will be able to recommend how to treat the scars and improve them if necessary.
– Aesthetic problems such as asymmetries, contour defects. This is a very delicate surgery and the result must be impeccable. This is why we remind you of the importance of choosing your surgeon wisely.
– Necrosis areola/nipple/skin. Complications feared, in severe cases new reconstruction will be necessary. In our cosmetic surgery practice the incidence of this complication is nil, although it does exist and is quite serious.
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