Aesthetic and functional causes can make women develop an exaggerated breast size (Hypertrophy) and therefore seek Plastic Surgery. Aesthetic causes that can strongly alter your self-esteem. It can make you feel unattractive, embarrassed, shy and can determine whether you want to go the beach, gym and can even cause the loss of sexual attraction and femininity.
Funcional causes can produce physical discomfort, pain in the neck, back and shoulders. They can also change your posture because it is normal to let your shoulders move forward in order to hide the large breast size. Breast pain is also common and there is risk of infection and a bad smell below the breast.
Generally the patients have a lot of difficulty finding attractive clothes. Therefore Reduction Mammaplasty is the only treatment that can help these patients. The advantages are in the loss of weight, which improves posture and at the same time making the body more elegant.
INDICATIONS:
Plastic surgery is for patients who:
- Are between 17 and 60 years old.
- Have very large and heavy breasts.
- If your breasts cause pain, weight on your back, neck and shoulders.
- Have bad posture that affects the spine.
- Have marks on the skin from the bra.
- Always try to hide the size of their breasts using bigger clothes.
CONTRAINDICATIONS:
We will not operate if we believe that your objective is not realistic. IT IS IMPOSSIBLE TO OPERATE ON PEOPLE WITH EXAGERATED OR FANTASY EXPECTATIONS. I recommend you read the chapter “Psychological Aspects of Plastic Surgery” of this website.
- If you have poor health, above all cardiovascular and mental disorders we cannot operate.
- Those patients who smoke should stop completely at least one month before the operation because this operation may produce the loss of tissues.
- Patients who are addicted to drugs or alcohol.
- Patients who worry too much about small defects that in reality are very minute.
- Patients who will not accept the final scaring. ALL OF THESE OPERATIONS LEAVE SOME SCARING AND THE QUALITY OF THESE SCARS DEPENDS ON MANY UNKNOWN FACTORS.
SURGICAL OBJECTIVES:
- Skin removal and excision of fatty tissue and excess breast parenchyma.
- Improve firm and attractive breasts.
- Obtain a good relation between the height, position, size and symmetry of the breasts.
- Preservation of the sensibility.
- The least amount of scaring possible.
PLANNING THE SURGERY:
BEFORE THE OPERATION:
First you must undergo a complete medical examination. Then we will be able to give you in writing, the modifications that are suitable for you. We always do a photo session as a fundamental part of evaluating your case.
WITHOUT PHOTOS WE DO NOT OPERATE. IT IS ALSO VERY IMPORTANT THAT YOU REMEMBER THAT ALL THE INFORMATION YOU RECEIVE IN WRITING, SHOW AN ESTIMATION OF THE FINAL RESULT.
Between you, the patient and me the Plastic Surgeon, we should agree on the results that we are able to achieve.
- We ask for blood tests regularly.
- We always ask for a mammograms.
- If you have the flu or are menstruating, please communicate 3 days beforehand.
- Do not drink alcohol at least 24 hours before operating.
- Do not take ASPIRIN 15 days before operating
- Organize your activities so that you are able to rest after the operation.
- Do not drive your car for at least 30 days after the operation.
- Only begin physical exercise gradually 2 months after the operation.
ANESTHESIA:
- The first choice is General Anesthesia.
PROCEDURES:
The technique depends of the individual case. It is important:
- Skin removal
- Excision of fatty tissue and excess breast parenchyma.
- Areas and volume of breast resection.
- Areas of lateral and abdominal fullness
- Scar length and placement
- Preservation of breast function and nipple areola sensation, size and position.
- Mild Hypertrophy: The Arie technique.
- Moderate Hypertrophy. The Pitanguy technique.
- Large Hypertrophy: Reduction based on Inferior Central Pedicle.
- Large Hypertrophy and Ptosis: Reduction based on Inferior Central Pedicle.
- Surgery time is normally around 2 to 4 hours and the patient is outgoing.
- Optional drain.
RECOVERY:
- It is an outpatient surgery.
- 24 hours of bed rest.
- After these first 24 hours you may be able to start to walk around.
- Eat well, food high in protein and lots of vitamin C.
- You must keep the sterile tapes in place for 24 hours.
DO NOT WORRY IF IN THE FIRST DAYS YOU HAVE:
- Bruising and swelling, which can be more prominent on the second day.
- Some discomfort when lifting your arms.
- Generally you do not need drainage.
- If you are in pain, take analgesics, BUT NEVER TAKE ASPIRIN, BECAUSE IT CAUSES BLEEDING.
- We give antibiotics to prevent infection.
- Full showers can be taken from after 2 to 3 days.
- Stitches can be removed from 7 days after the operation.
- Sterile tapes and or bandages are to be changed every 3 days during a 2 week period.
- For 30 days a special elastic bra is to be used.
- From 2 weeks onwards we indicate 10 lymphatic drainage sessions to help the recovery process, eliminate toxins and improve the circulation.
- As the days go by you will begin to feel better and better but be careful, this does not mean you are ready for intense physical activity. Take extra care with the arms as you can easily make the stitching come undone.
- You should be able to return to everyday activities 2 weeks after the operation and drive a car 1 month after.
- Intense physical activities can be taken up again some 60 days after the operation.
- Full recuperation of your sensitivity can take place within a few months time.
- The scars will be hidden behind your bra o bikini top. Generally they get better throughout 1 and 2 years, but they are permanent. Inframammary scars can be seen. Periareolar scars are not as visible. THERE ARE MANY UNFORESEEN AND INDIVIDUAL VARIATIONS (such as wide and hypertrophic scars, depending on many factors such as the genetics of the patient).
- Sun bathing should be avoided for at least 3 months.
- Any increase in fever or if the area becomes red, or if there are any other unusual signs, contact your doctor or plastic surgeon immediately.
- Naturally, because of ones anxiety to see the final result, the first couple of days one can be somewhat depressed. But this is temporary. BEING PATIENT IS FUNDAMENTAL.
- After 6 months you will be able to get a good idea of the final result. Nevertheless the scars maintain some coloring and continue getting better until 1 to 2 years after the operation.
FINAL RESULTS:
Generally the results obtained are similar to what was planned.
More than 95% of women are happy with the long term results. They feel a lot better with their new image, proportional breasts, better form and volume, self-esteem and happiness.
With the techniques mentioned earlier, the physiology of the breasts is preserved, including breastfeeding and the sensation of the nipple.
YOU WILL NOT SEE YOUR FINAL RESULT UNTIL 12 TO 18 MONTHS AFTER THE OPERATION.
POSSIBLE COMPLICATIONS:
They are rare, BUT REMEMBER, THERE IS NO PLASTIC SURGERY WITHOUT RISKS OR POSSIBLE COMPLICATIONS (even if they are minimum, they still exist). SMOKERS HAVE A HIGHER RISK FACTOR.
- · HEMATOMAS: Occurs between 0.5 – 3 %. If not reabsorbed, it shall be removed.
- · INFECTION: Occurs in 2.2% of patients. Generally due to Staphylococcus Epidermidis. We always give antibiotics during the operation and for 5 to 7 days afterwards. Local culture is recommended, followed by antibiotics, draining and occasional removal of the implant.
- · NIPPLE-AREOLAR PROBLEMS: Due to blood supply and changes in the sensation.
- · WIDE AND HYPERTROPHIC BREAST SCARS: 1.4%
UNSEEN COMPLICATIONS: Will be corrected later, also seeking the planned final result.
