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WOMEN : Breast
Reduction
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Reduction mammoplasty is a surgical procedure, which involves reduction of the breasts. A lot of elderly women choose to get a mammoplasty done in order to feel more comfortable and at ease.
Pre-surgery:
Planning and Preparing
Here are a few things your surgeon will do before the operation:
He will take a mammogram x-ray so that he can rule out the possibility of a mass or lump. He will also take another mammogram a few months after surgery for comparison.
Mammaoplasty is the removal of large amounts of breast tissue, full of blood vessels and capillaries. As a result you might be asked to donate 2 units of blood before the operation just in case transfusion is necessary.
The Operation
The surgery will probably last 4 5 hours. The surgeon will first mark you breasts to ensure which parts you want removed and where the scar should be.
Your surgeon will weigh the amount of tissue removed from each breast to keep the reduction equal.
Final size and shape of the breast will depend on what's left behind.
After removal of tissue your surgeon will make a cosmetic tuck so as to move the nipple and areola into their new position. He will then begin to close the skin around the breasts.
Sometimes after tucking one breast appears bigger than the other. Your surgeon might then decide to further remove some tissue and improve the match.
Tip: The most important part of the surgery is the initial marking. Anywhere other than the tip of the breast, the areola and nipple would look unnatural. Your surgeon will also have to anticipate the "dropout" effect that will occur as the breast slowly settles into place. If anything does go wrong it can only be corrected by additional surgery. This condition can be corrected by additional cosmetic surgery, but only with difficulty.
Post-surgery
The surgery invariable takes its toll on the nipple and the areola. Your surgeon will check the colour soon after surgery to make sure all is well. If the surgeon has any reason to suspect a problem during surgery, a fluorescein dye may be injected to trace the movement of blood through the breast.
You will probably leave the hospital in 2 or 3 days and will be asked to wear a brassiere 24 hours a day for the next 2 weeks.
Nipple Grafting
This procedure involves removing most of the breast, reshaping the remaining tissue, and grafting the nipple and areola back onto the new breast. The nipple and areola are removed and placed on a saline sponge while the surgeon quickly removes the breast tissue. The skin is then gathered around the new breast and sutured. The nipple and areola are then placed and sutured as well.
Advantages: Nipple grafting enables the surgeon to remake the breast from scratch. This kind of surgery requires brief anesthesia and minimal blood loss. This procedure is best for women with really big breasts because during mammaplasty the pedicle (tissue that holds the breast longitudinally) might be damaged.
Disadvantages: The major concern during surgery is the possibility of amputating too much breast tissue and thus having too little left over to create the new breast.
The nipple and areola might not survive and their colour might fade away. This poses a problem for dark skinned women.
The nipple might lose all sensation and will probably fail to become erect when stimulated.
Breastfeeding is impossible since most of the milk ducts have been rearranged if not completely removed.
N.B. The above procedure is considered preferable for reduction in elderly women. Surgeons do not recommend this procedure in younger women, unless they have really big breasts.
Breast Lift (Mastopexy)
Mastopexy is the name of the procedure that lifts the recently reduced breast into its new position of course it can also be used to counteract the effects of time and gravity even when no surgery is done to alter breast size.
The procedure itself takes about 3 hours and is performed with local anesthesia in an outpatient facility. Nipple placement is the most crucial part of this procedure and the surgeon invariably marks the new position of the nipple before surgery.
Mastopexy unfortunately cannot eliminate the constant pull of gravity and some sagging will take place 6 months after surgery. Normally in anticipation the surgeon lifts the breast tighter. If the breasts start sagging right away or if the sagging is excessive, the surgeon can do a minor revision there and then.
The surgery requires you to wear a brassiere 24 hours a day for 6 weeks. The breasts initially might look strange with the nipples pointing downwards but gradually this situation will correct itself.
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