Breasts: reduce and place

It is not a simple aesthetic issue, in many cases we find patients who have been suffering for years from back pain and limitations in their social activities due to breast hypertrophy, that is, excessive increase in breast volume, well above their normal proportions. These are women who are looking for an urgent functional improvement.

Types and repercussions of disproportionate breast enlargement

To begin with, it should be made clear that breast hypertrophy does not respond to a single patient pattern. It can occur, for example, at puberty and as a result of hypersensitivity to female hormones. We are then talking about virginal breast hypertrophy, which affects girls under 19 years of age with the breast development of a woman of 50. In these cases and taking into account the age of the patient, it will be essential to have the agreement of the family, the senologist and the psychologist to intervene.

In older, adult patients, hypertrophy is usually due to an increase in fatty tissue that invades the mammary conjunctive tissue. The consequence is a large, inelastic breast with vascular problems. These are women with more functional than aesthetic motivations, in some cases with real indentations in the shoulders due to the weight supported by the bra strap, in addition to other discomforts and injuries.

A double intervention treatment: reduction mastoplasty and mastopexy.

Both profiles of women are candidates for breast reduction or reduction mastoplasty. The first thing to bear in mind is that this is a major operation and, as such, the patient must undergo a prior medical examination and general anesthesia. The objective will be twofold: to reduce the size of the breast and, at the same time, to elevate the areola and the nipple.

In fact, in almost all cases, it will be necessary to combine two surgical techniques. Reduction mastoplasty and elevation surgery. That is to say, the procedure to lift the breast. And a very large breast will never be up, it will have fallen with the passage of time or by its own weight.

At this point, we can not fail to mention the scars. They are the fundamental handicap of any cosmetic surgery and, if possible, even more so in breast surgery by the dimensions that sometimes must have. Not in vain, we are talking in some cases of a change in size, position and shape of the breast.

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Depending on the degree of sagging – or technically, ptosis – the scars will be of three types:

  • The smallest is the so-called periareolar, which follows the entire rim of the areola. It will only be possible in cases in which the fall or ptosis of the breast is not very large; a characteristic that occurs in very few cases of hypertrophy.
  • The next stage would be that of a scar like the previous one added to another one, of vertical trajectory and that would go from the aureole to the submammary fold.
  • In the last option, when the sagging is really very large and there is a large excess of skin, the surgeon should opt for the classic scar: the one that surrounds the areola and adds an inverted T from the areola to the fold to end up running along it. It is, in any case, a scar that hides perfectly under the underwear or bathing suit.

Postoperative period following reduction mastoplasty

Once the wounds have healed, and already in the postoperative period, it is essential to take care of the scars very intensely. They depend on each person, on the skin of each patient, on genetic factors that are not known.

To conceal them as much as possible, the medical team of Clínica Planas recommends following a protocol specially designed for this purpose. It consists of wearing adhesive silicone sheets over the scars, with a certain compression on them. Sometimes we even add a reinforcement in the bra to make a selective compression. The healing process is very long, so I like them to follow the protocol for 2 or 3 months, if possible. The protocol includes rest periods, during which it is advisable to massage the scar with some essential oil, such as rosehip oil.