Reduction Mammoplasty is a surgical procedure that simultaneously allows the reduction of breast volume and the revision of its shape. Mammary hypertrophy, or disproportionate increase in breast volume, is often associated with osteoarticular symptoms and signs (pain and deformity of the cervical spine) and, in certain cases, neurological symptoms as well (upper limb pain, carpal tunnel syndrome).
The psychological component of symptomatology is perhaps one of the most important, with significant limitations in social, professional and intimate life. By removing excess skin and breast parenchyma, it is possible to improve the quality of life of these patients. Another important aspect is the contribution to reducing the risk of breast neoplasia: on the one hand, by eliminating breast tissue, and on the other, by medical analysis of the removed tissue sample.
Reduction Mammoplasty is, in many cases, a necessary surgery. The results are very gratifying because they make a difference in patients' lives.
When is reduction mammoplasty indicated?
We can think of a Reduction Mammoplasty when the following problems are presented:
- heavy breasts with nipple and areola pointing downwards;
- significant breast asymmetry, one breast being significantly more bulky and / or pendulous than the other;
- loss of self-esteem due to the unaesthetic appearance conditioned by excessive volume and / or breast "weight”.
How is reduction mammoplasty performed?
The surgery goal is the removal of the excess breast parenchyma (fat and glandular tissue). Surgery always involves 2 to 3 incisions, or scars. One of these is invariably located around the areola and nipple, since this set (the areolo-mamillary complex) transits to a higher / projected site in the breast which underwent surgery. The size of the areola may be reduced if indicated.
How is reduction mammoplasty performed?
The breast size and shape, as well as the magnitude of the reduction the patient intends to achieve, are essential factors that help the Plastic Surgeon to determine which technique best suits each patient. In some cases it is possible to avoid the scar that is usually located in the inframammary fold. Rarely, in cases of extreme volumes, the nipples and areolas can be truly "transplanted" to a higher position. Another less common option that is appropriate for a small group of patients is liposuction itself. But all these aspects are very personal and each case is discussed in detail between the patient and Dr. Ana Silva Guerra.
What can I do to help healing?
The healing process occurs according to well defined and known steps. However, there are a number of factors and characteristics that can interfere with healing. Thus, it is important that you do not smoke as tobacco interferes with healing. If you are a smoker, you should stop at least 6 weeks before the intervention until at least 4 to 6 weeks after it. One should also be careful concerning the treatment of scars, after fully epithelialized, with silicone (gel and / or sheet) associated with compressive massage on the scar. The use of compressive clothing (specific bras for postoperative reduction mammoplasty) and the use of manual lymphatic drainage by experienced professionals, oriented to the postoperative follow-up of this type of intervention, are other essential aspects for a better result.
What precautions should I take in the preoperative period?
The period before surgery deserves special attention. There is some care and or precautions to take into consideration. Preoperative exams should be performed. Above all, it should be a preparation period in which you will be closely monitored by your Physician and her team. Be calm and do not hesitate if you need any clarification.
What will the postoperative look like?
The post-surgery is a period of questions and anxiety that requires close monitoring by the Surgeon and her team. If all the main reasons for questions and concerns are previously addressed and clarified, the post-surgery will become much easier and peaceful.
No caso de uma re-intervenção, a cirurgia é mais custosa? Há cuidados especiais?
If you have already undergone a procedure similar to this one with another medical team, it is important to provide Dr. Ana Silva Guerra and her team with all the data related to the procedure that was performed (medical reports, previous photos, etc.). A surgical review of a Reduction Mammoplasty is not necessarily more painful. Surgery, however, becomes smore complex. As it is a region that has already been treated, scarring from already manipulated tissues can lead to an increased risk of hemorrhage, seroma or scar retraction (tissues become less elastic or complacent). There is one aspect that is essential to clarify: in a reduction mammoplasty there is nipple and areola repositioning. If a revision is performed, it is essential to know which part of the breast tissue is the "vehicle" for the movement of the nipple and the areola, that is, which part of the breast tissue guarantees the viability of the areolomamillary complex. If this information does not exist or if it is wrong, there is a risk that by manipulating the breast tissue again, a separation may occur between the tissue that ensures the areola and nipple viability. When this happens, there may be loss of some or all of these structures. A reintervention is an excellent time to make corrections, or to detail some aspect that has been neglected. You must therefore inform Dr. Ana Silva Guerra about your concerns so that they can be duly clarified. Sometimes it is not possible to meet the patient's expectations for several reasons that do not depend on the surgical intervention.
O que pode acontecer numa mamoplastia de redução?
Fortunately, complications resulting from a Reduction Mammoplasty are unusual and the degree of satisfaction is often very high. However, a Reduction Mammoplasty is a surgical procedure and the patient must be prepared for the intervention and for the recovery period.
ImportantAny breast surgery should be preceded by an exhaustive breast study (breast ultrasound and mammography, at least). It is important to inform Dr. Ana Silva Guerra of your medical history, namely in what regards the breast. You must inform Dr. Ana Silva Guerra of any breast interventions you have previously been subjected to (biopsies, punctures) as well as any previous follow-up that has already been done and clinical attitudes that have been taken. The family history of breast diseases is especially important in this context (diseases of 1st and 2nd degree-relatives). Suspected mammographic findings (nodules, masses) are constraints to this surgery.
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