Breas-t Reduction

Breas-t Hypertrophy or macromastia is a condition where there is an excess of skin, fat and breas-t parenchyma, compared to the person’s body habitus. Patients suffering from macromastia present with a myriad of symptoms, both psychological and physical. Psychological effects are seen in young girls. They manifest as self-consciousness, social withdrawal, lag in social skills and sports etc.

 

Physical effects of breas-t enlargement include neck and back pain, skin changes like grooving in the shoulders, intertrigo and in extreme cases, paresthesia in hands. 


Breas-t hypertrophy can develop in three different stages of a woman’s life.

  1. Pubertal age (12-18), where breas-t tissue can overdevelop in comparison to the rest of the body.
  2.  Pregnancy & lactation:  It is common for breas-t size to increase during this period but sometimes the breas-t size may not regress resulting in permanent hypertrophy.
  3. Obesity related breas-t hypertrophy usually occurs later in life.


Breas-t reduction surgery is a wonderful procedure that can not only ameliorate the physical and psychological ill effects of breas-t hypertrophy but also bring an aesthetic improvement to the body.
The ideal patients are healthy, not pregnant and breas-t feeding currently, whose weight is stable and free of psychological disorders.

Procedure

Over the past few decades, many different types of breas-t reduction techniques have been developed. The latest generation of procedures are known as vertical scar techniques with supero-medial pedicle or inferior pedicle. This procedure allows for minimal scaring (circular scar around nipple and vertical scar below the nipple). Other techniques include the inverted “T” scar technique, SPAIR technique, breas-t augmentation with free nipple graft etc.


1. Breas-t reduction is typically performed under general anaesthesia. Operative time is about 3 hours. The procedure is performed as per detailed per-operative markings, to get the desired breas-t volume and shape. Drains may be used as per the surgeon’s discretion in which case, they are removed after 48hrs. 
2. The patient is put on supportive garments for 4 weeks, antibiotics and pain medication for a week. Daily activities are allowed from day 1. Sports and other strenuous activities can be taken up after a week.
3. The patients can expect a reduction in nipple sensation temporarily.
4. Patients who expect to get pregnant and breas-t feed in the future can give a trial of breas-t feeding. Approximately 70% of women can lactate successfully following pedicled procedures. The aesthetic results are maintainable for many years provided the patients do not subject themselves to weight fluctuations, pregnancies etc.

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