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Indications:

  • Big breast(s) with large volume.
  • Aesthetically unpleasing shape of the breasts
  • Chronic neck, shoulder and back pain.
  • Upper extremity problems of sensation or numbness,
  • Postural problems due to bending of the spine with heavy breasts.
  • Bra strap grooves in the shoulders due to breast weight.
  • Dermatological disorders in the inframammarial folds.

Anesthesia: General anesthesia.

Duration: 3 – 3.5 hours.

Before Operation: Bilateral Breast Ultrasonography and if over the age of 35, Mammography is necessary for screening and as a precaution.

Inpatient/Outpatient:

One-day stay at the hospital is required. Breast reduction is not a very painful procedure. A drain may be placed in each breast and drains are usually removed after 1-5 days. However, placing drains depends on the situations during surgery; it is not as a rule.

Procedure:

Before the operation, the breasts of the patient are marked after detailed evaluation of the size and sagging of the breasts. Breast reduction technique is chosen as inverted-T, vertical, horizontal or B technique. Excess breast and fat tissues are removed symmetrically from the lateral, medial and inferior/superior parts of the breast, excess skin is resected and draped, nipple-areola complex is elevated onto its new place and fixed with sutures.

Recovery:

  • Pain is trivial and moderate discomfort for one week.
  • Patients wear a supportive garment for 4 weeks.
  • Return to work after 7 days, but no strenuous activity for 3-4 weeks.
  • Swelling at the surgery site may persist for 1-3 months especially in the armpits.
  • The patient may remain in the hospital overnight or be discharged the same day. Pain control is managed with pain killer tablets. If drains are used, they are removed.

When the drainage drops below 30 ml/day. Many surgeons will leave a patient on oral antibiotics (Penicillin or Cephalosporin containing) for a few days postoperatively. If drains are used, they may continue the oral antibiotics until the drains are removed. The sports bra should be worn day and night for 8 weeks. Patients should avoid heavy lifting and strenuous activity for 1 month after their surgery. A new baseline mammogram should be performed approximately 6 months postoperatively in all patients over the age of 35.

Result:

The resulting contour is permanent, provided there is no subsequent weight gain or loss. Weight should be in a normal range and have stability.

Risks:

  • Asymmetry, contour irregularity.
  • Infection, bleeding, fluid collection
  • İschemia in the nipple-areola and crusting, prolonged wound healing, especially in the smoker patients.
  • Bad wound healing and hypertrophic scars.
  • Very big and very droopy breasts are sometimes difficult to operate to achieve a 100% symmetrical result.
  • Small revisions may be required but trivial procedures.

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