Reduction Mammoplasty

(Breast Reduction Surgery)

A reduction mammoplasty is a surgery performed to diminish mammary volume through the elimination of skin, which leads on to aesthetic betterment.

A mastopexy (breast lift) is the name we use for breast surgeries aimed at correcting ptosis (sagging breasts) when there is no need to reduce their volume. Through this procedure, breasts are repositioned, thus achieving a better aesthetic result without reduction in size.

A reduction mammoplasty implies necessarily performing also a breast lift. It is one of the most difficult plastic surgery operations, given the degree of precision required to make both breasts symmetrical – something that nature itself has not been able to do in most cases.

It is important to know that breasts are not naturally symmetrical and, after the operation, they will not be, either. That is the reason why we need to take things easy and not worry about any slight difference existing in the postoperative period. Such a difference will improve in the near future.

Who are candidates for a mammoplasty or a mastopexy?

Candidates for these procedures include women with the following features:

Large, sagging or heavy breasts with nipples pointing downwards or not
Breasts of adequate volume but whose nipples point downwards
Asymmetric breasts
Backache of variable intensity
Skin lesions around the breast as the result of their breasts’ exaggerated volume
Alterations of psychological nature as the result of not feeling uncomfortable or not being content with the shape of their breast.

How long will the operation take?

Normally, this surgery may take between four to five hours. Depending on the technique used, it may take a bit longer or shorter.

What type of anesthesia is required?

This procedure is performed under general anesthesia.

What will the scars be like with this type of surgery?

This is one of the most preoccupying aspects for patients when they decide to undergo surgery. There are several techniques, which are to be previously discussed with your surgeon, as he will be the one deciding what the techniques that he will apply may be.
Depending on breast size, volume and shape, the color of the skin, the history of scaring in previous surgeries and how demanding the patient may be, a scar around the areola is left, which can be easily concealed due to the contrast between the color of the areola and the rest of the breast. Vertical scars, as well as L-, J- or C-shaped incisions are made in those cases where a breast lift is combined with the placement of an implant in order to help pull up the nipple-areolar complex, or in cases where the excess of skin is reasonably large. A T-shaped incision is made in patients with breasts that are too large or too sagging, that is to say, those cases where no other technique can be applied.
The way to stitch up the incisions is very personal. Currently, several types of approach are used to reduce as much as possible the size of the incisions made and the possibility of scar formation.

When will my scars look better?

That is also something that varies: this time is substantially different in each patient. In general terms, we have:

In the immediate aftermath (up to thirty days): the scar may redden, with a slight reaction to sutures and adhesive tapes.
In the medium-term aftermath (thirty days to one year): the scar may go from pink or red to a brown nuance, with a tendency to become even clearer.
In the late aftermath (after one year): the scar is no longer consistent, turns soft and whitish and, in some cases, it becomes imperceptible to the naked eye.

I have heard that some patients are left with visible scars...

We have to make a difference between hypertrophic scarring and keloids. Hypertrophic scars are skin thickened areas resulting from skin lesions, bad suturing and infections in the scar area. They can be removed with by performing a resuturing of the scar, which is made under local anesthesia and in very short time as an out-patient procedure. Keloids, in turn, provided there is a genetic predisposition to develop them, will appear in any place where you have a scar. In these cases, it is convenient to apply beta-blocker therapies within the first forty-eight hours after the operation. If you have a genetic predisposition to keloid formation, you must tell your doctor, so that he can take the necessary precautions.