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Reduce the volume of the breasts

 

Women with overly large breasts may use “reduction mammaplasty”. This hypertrophy is defined by a volume of breasts too large in comparison to the morphology of the patient. It is estimated that for a “normal” breast, the distance between the sternum and the nipple is about 19 cm; we speak of hypertrophy when it exceeds 23 cm, corresponding to bra cups of 100 E. These are only averages and these figures alone cannot determine a need for surgical intervention.

The larger the breasts, the more they sag, due to the well-known law of gravity. Some cases of hypertrophy can be considered a disability, both psychological and physical. On a physical level, a breast hypertrophy causes pain and functional difficulties; breathing problems, neck aches, back and neck pain. Also, due to the weight of the chest, shoulders are “sawed” by bra straps, etc. In addition, this hypertrophy often thwarts the practice of exercise, encouraging a sedentary lifestyle. Women who suffer from overly large breasts also tend to slouch to hide the size of their breasts and this slouching can cause a multitude of back related problems. Too often, the hypertrophy, which forces many women to wear special bras that flatten the chest, and this also causes psychological difficulties and complexes: Women regularly say to me “The stares of others are often unbearable,” who have then the feeling of being perceived as an object. Others women believe that their large breasts actually hinder their sexual confidence.

In teenage girls, a hypertrophy of the chest is a very painful experienced, even if they have difficulty expressing it themselves. I remember a young girl who came to consult with her mother, who could not hide her suffering, explaining how much her breasts hindered her and prevented her from living a normal adolescence like the other girls her age. There was a large gap between her appearance as a woman and her real age as a young girl. If a breast reduction procedure is permitted for young girls starting at age sixteen, it is advisable to surround oneself with a maximum of precautions and guarantees, and to act in agreement with the young patient and also with their parents and possibly a psychologist. Functionally, the operation should be executed using extreme caution because the milk ducts that transport the milk to the nipple can be damaged during the surgery. The operation, however, is less traumatic in younger patients whose skin is more toned and elastic.

In cases where the patient is overweight, it is important to only perform the procedure at a time when their weight has stabilized because significant postoperative weight loss may result in a decrease in breast volume and sagging can then occur. Conversely, significant weight gain after the procedure could result in increased breast volume.

After a breast reduction, women who are overweight tend to lose weight and their figure becomes more refined. This is not a direct effect of the procedure but when women feel better in their skin, have a balanced chest and experience a reduction in back pain, they can exercise more regularly and feel better all around. Regarding pregnancy, women should wait about a year after delivery before performing a breast reduction. After the procedure, we advise women wait one year before becoming pregnant. Breast reductions that call for a removal of 300g or more per breast are covered by the French Social Security Health Insurance.

Breast reductions are performed under general anesthesia and hospitalization lasts 2 to 3 days post-op. The surgeon creates an incision on the breast following his markings previously made during the consultation with the patient. Some of the glandular tissue, fatty tissue and skin is then removed, and the remaining tissue is repositioned into place. If the areolas are too large compared to the new shape of the breast, we can reduce their diameter. The removed tissues are systematically sent for analysis to detect any abnormal cells.

After the procedure, there will always be a scar around the areola and, depending on the degree of ptosis (sagging) and the level of hypertrophy, a vertical scar in the shape of an upside-down “T”. These marks do not constitute a “bad surprise” post-op when patients remove their first bandage because they are well informed before the procedure of the placement and the length of the scar. In this procedure the skin, and the skin alone, is responsible for the shape of the breast since the breast has no muscle so the skin removal through the incision is very import to the final result and unfortunately does leave a scar.

The appearance of edema (swelling) and bruising is a normal and temporary effect of the surgery. Wearing a support bra 24 hours a day is recommended for one month post-op then during the day only, for one more month.

This operation is painful and causes discomfort in the area of the scars. The results are considered stable one year after the operation. During this period of time, the appearance of the scars evolves: they are white and thin during the first month then become red until around the fourth quarter before gradually whitening. It is absolutely necessary to protect your chest from the sun during the first year by not exposing yourself and regularly applying a sunscreen (total SPF 60, in addition to the swimsuit).

For the patients, it is gratifying to know that the results are definitive in 95% of the cases.

If the nipple has not been placed too high, and if the patient’s weight doesn’t fluctuate too much the breasts will remain beautiful.