Plastic Surgery is a medical specialty that seeks to improve physical
function or to minimize disfigurement or scarring resulting from accidents,
disease or birth defects. The word plastic is derived from the Greek
meaning molding or giving form. Plastic surgery includes aesthetic surgery,
which can reshape facial and bodily features, and improve an individual's appearance.
Breast reduction, or reduction mammaplasty, is a surgical procedure to reduce the size and contour of large breasts. It can allow more comfortable physical activity, relieve weight-bearing pain in the breasts, shoulders, neck and back, and improve an individual's overall appearance.
Pre operative considerations.
A consultation with a plastic surgeon is the first step an individual should take if considering reduction mammaplasty. You should discuss candidly your expectations regarding the size and contour of your breasts following surgery, while keeping in mind that the desire result is improvement, not perfection.
The surgeon will conduct a routine breast examination and, depending on your age and family history, may determine that mammograms, or breast x-rays, are required. After examining you, the surgeon will discuss other variables that influence the decisions involved in reduction mammaplasty, such as the size shape and skin tone of your breasts. Since the ability to breast-feed following reduction mammaplasty is unpredictable, you should discuss the matter with your plastic surgeon at this time.
During the initial visit, the surgeon will explain specific details of your case, including the surgical technique to be used, the anaesthesia, where the operation will be performed, and what the surgery realistically can accomplish. Additional factors to consider before undergoing reduction mammaplasty, such as risk and cost, should be discussed during the consultation.
Thousands of reduction mammaplasties are performed successfully each year. nevertheless, you should be aware of the potential risks of surgery and specific complications associated with reduction mammaplasty. Postoperative complications, such as delayed healing, infection or localized collections of blood are uncommon. Poor healing may necessitate subsequent scar revision. Risk of complications can be minimized by closely adhering to your surgeon's advice on follow-up care during the healing process.
Fees and operation facility costs of reduction mammaplasty vary widely depending on the length of complexity of the operation. Additional expenses will depend upon the anaesthesia and where the operation takes place.
Since reduction mammaplasty usually is performed for the relief of physical discomfort, the surgeon's fees and other costs may be partially or even fully paid by your insurance carrier. However, if surgery is carried out on an elective basis solely to improve appearance, most insurance plans normally do not offer coverage. Determination is based n the amount of breast tissue removed in proportion to your body build. Fees for elective surgery usually are paid prior to the operation.
The Surgical Procedure
Reduction mammaplasty typically is performed to reduce disproportionately large, sagging breasts. It also can reduce the size of the areola (the dark pink skin surrounding the nipple) which frequently becomes enlarged as the breast develops. (fig.1.)
The extent of the procedure depends on what changes are desired and what your surgeon deem appropriate.
Although you may be operated on in an outpatient surgical facility, reduction mammaplasty is generally performed in a hospital. A general anaesthetic usually is administered.The most commonly employed technique, called brassiere pattern skin reduction, involves both horizontal and vertical incisions that follow the contour of the breast. The vertical incision creates a key-hole-shaped pattern above the areola. (fig.2.)
Working through the incisions, the surgeon excises excess tissue, fat and skin on the sides of the breast (shaded area, Fig.3.)
Skin is removed from the area within the vertical incision and around the areola. The nipple, areola and underlying tissue are moved through this space to a new highly location. (Fig.3.)
Another technique involves completely detaching the nipple from the breast before relocating it. Since the transplanted nipple loses all sensitivity, this approach is performed only when deemed necessary for patients with extremely large breasts.
After the nipple is repositioned, skin on both sides of the breast is moved down and around the areola and then brought together to recontour the breast. (fig.4.)
Sutures close the wounds under the breast and around the nipple area. (Fig.5.) Following surgery, a gauze dressing may be applied to the breasts, or the patient may be placed in a surgical brassier.
Depending on the extend of the surgery, the procedure usually lasts three hours or longer.Link to St Marks Breast Centre Online