Surgery of breast/breast reduction

Surgery of breast/breast reduction

What is it?

The surgery of breast reduction is done aiming the reduction and - if neeeded - the raise of overstrethced breasts. It can also be utilized for raise the mammary fall.
The volume increase is hereditary, and can be accentuated during the adolescence. The mammary fall occurs due to the break of the relation content/continent of the breast. The breast's content is formed by the mammary gland and the fatness around it. The continent skin wrapper and subcutaneous tissue. It is helped in the sustentation for two faint internal ligaments, that set the breast to the chest muscle and to the collarbone.
Among the causes of the fall are:
The action of the gravity (that relaxes the skin and the faint mammary ligaments)
The hypertrophies (that facilitate that action)
The diminution of the quantity of gland and the increase of the fatness (breast's natural process of ageing)
The pregnancy and the breast-feeding, that generate periods of increase and diminution of the volume of the breast
The obesity, followed by weight of loss

Increased volume with fall

Fall grade IV (grave) with none or
small increase of the volume

How the surgery is done?

After anesthesia, an incision is done to remove the excess of breast's skin. The removal of mammary tissue is done when necessary. The gland is repositioned and its fixation is done. The bloody veins are cauterized. A prudent suture is done, reconstructing the tissues.
The final result can be a periareolar scar added of a reversed T, a reversed L, an I one, or only the periareolar scar, depending on the volume of the breast and on the skin flaccidity.

For who is appropriate?

For people who:
Have overstretched brest - increase of the volume (light, moderated or severe), with or without fall, since after 3 to 4 years from the first menstruation.
Mammary regression postpartum or breastfeeding, with fall more accentuated, that can not be corrigible through insertion of prosthesises, or when the patient does not desire to do this procedure.
Mammary fall, with or without hypertrophy (increase).
Differences of size between the breasts (light, moderated or severe), with or without fall.

How is the anesthesia?

The anesthesia can be local, epidural, between ribs, or local with sedation. The choice depends on the breat volume: as big it is, as big is the need of a more comprehensive anesthesia (general or epidural).
It lasts approximately the time of the surgery.

How long does the surgery take?

Between 2 and 3 hours, according to the breasts volume.

How long does the admisison take?

Habitually, 12 hours. It can extend until 24 hours, if the breasts are more voluminous.

How is the post-operative?

In general, it is well tolerated. Rarely it is aching. The patient should avoid any effort for 30 days. The orientation of rest with the arms must be observed, so will not occur the opening of the scars. The arms movement will be very limited in the first month, and liberated gradually. bandages in the breast are done for 2 months, and the use of an appropriate bra is needed also for 2 months. The practical of sports will be able to to be resumed after 2 months.

Is there any complication?

The complications that occur soon after surgery (of 5 to 7 days) are the wound and infection. The rates are very reduced, when observed all the prescribed post-operative cares.
Subsequently, can occur the opening of the scars that is straightly connection to the rest with the arms. Beyond that, rejection can occur to the stitchs, creating abscesses as ingrowing hairs, easily cured by the doctor.
Reddish and high scarscan occur. They are reactions of each person, being able to be treated by the doctor.
As all the surgeries, the anaesthetic and sistemic risks still exist. They have to be well should researched in pre-operative phase. Those complications has been less and less frequent with the evolution of the techniques and of the medicine.

How is the definitive result?

Around a month occurs the reabsorption from 80% of the swelling, giving good notion of how the breast will stay.
From the 30th day to the 6th month, the breast earns bigger harmony and better consistency by the accomodation of the tissues and the scar.
The scars are only considered as definitive after the 12th month.

Post-operative recommendations

1. Food:
The food after surgery should be gentle to avoid nauseas. The next day, the diet is normal.

2. Positions:
The rest is relative, being bigger in the first day. Subsequently, are just necessary small walks inside home.
Upon sleeping: of belly for top, with a high pillow or cushion under the head. The arms must stayed always next to the body. If necessary, tie a streak of dressing gown to the around of the waist. (during 1 month).
Upon raising itself: with help, without support the arms for raise (in the first 15 days).
In the first 30 days, maintain the elbows always next to the waist.
After the first 30 days, the elbows will be able to to be raised up to height of the shoulders.
After 60 days the movement of the arms will be able to be normal.
Do not it carry weights, in the first 15 days

3. Baths:
The bandage surgical will not be able to be wet in the first 7 days, so that the bath in this period should be taken of little shower and with humid compresses.

4. Girdles and bodices:
Should be uninterruptedly used by, on average, 60 days. If necessary wash it, withdraw them in position laid down and like this remain, to that the they be found dry to be put again.

5. Medication:
They will be prescribed common painkillers, by a medium period of 5 days.

6. Returns:
The returns are weekly for 30 days and monthly to the 4 th month.
Those frequencies can be altered according to the clinical need.