Breast Reduction Surgery ( Reduction Mammoplasty)
What is Breast Reduction?
Breast reduction surgery is a procedure where breast is reduced by removing unwanted skin, fat and breast tissue. In this surgery the surgeon cuts around the nipple, from the nipple down to the underside of the breast and across beneath the breast. Nipple is always moved upwards to place it near about it’s original position after removal of unwanted breast tissue and skin.
Who will Opt for Breast Reduction Surgery?
Women with large breasts ( Macromastia) undertake breast reduction surgery to achieve reduction in pain , skin infection, repeated breast infection and also for improved self- image, improved confidence, or an increased ability to take part in physical activity.
Men may also go for breast reduction as a treatment of gynaecomastia (abnormal enlargement of the male breast).
What Surgeons Perform Breast Reduction?
An aesthetic (Cosmetic) Breast surgeon will usually perform this type of surgery with better results.
What Kind of Surgery it Is ?
Breast reduction surgery is a major surgery. Reduction mammoplasty is comes under cosmetic surgery but can be performed as a part of breast cancer surgery ( In Breast conservative/ breast Oncoplastic procedures).
How Much is the Duration of Surgery?
The breast reduction operation will usually last between 4-6 hours.
How Many Days are Required for Admission?
After a breast reduction you will stay 3-5 days in the hospital where your procedure took place.
What Kind of Anaesthesia is Given in This Surgery?
Reduction mammoplasty is usually carried out under general anaesthesia ( anesthesia of full body).
After your breast reduction surgery it depends on person to person, ranges from 7 days to 15 days. Full physical activity can be resumed after 6 weeks to 8 weeks.
Swelling and brusing will ease after a few days.
Patient will have follow up appointments for the removal of stitches and bandages two weeks after breast reduction surgery.
What are The Common Risks after Breast Reduction Surgery?
Common risks when having breast reduction surgery include.
Difficulty in breastfeeding after the procedure. In order to avoid breastfeeding problems we will advice patients to go for reduction after completion of their family..
Necrosis of the nipple- complete or partial. Later on can be corrected by secondary suturing and tattooing
Decreased sensation in the nipple and surrounding area following the surgery
Adverse reaction to the medicines or anaesthesia.
Breast enlargement ( breast implant): to get almost permanent breast enlargement which is natural looking is possible with breast implants. It is one of the leading breast surgery undertaken by womens in today’s era.These implants are available in different shapes and sizes.
Doctor Shilpy Dolas uses good quality FDA approved implants guarented for 10 years.
IMPLANT SHAPE: Breast implant can be of two types:
ROUND IMPLANTS: For breast augmentation most familiar implant shape is round, which looks like a compressed sphere. They are also silicon filled and saline filled. They come in different type of projections ranging from high to low. Women who wish to have more fullness in the top part of the breasts will probably consider the round implant to be a better choice.
Patient choose round implant for breast lift , breast cleavage and for the fullness. Round implants are exactly not round always because in standing position due to gravity more volume will come at the base and less at the top along with fall of breast tissue also. While in lying down position they look round which is like natural breasts in sleeping position.
Since the implant is round, it is symmetrical, and implant rotation is not an issue. The implant can be chosen with either a textured or a smooth surface, and tends to cost less than the teardrop implant.
ANATOMICAL IMPLANTS: Anatomical implants are also called “ Teardrop” or “waterdrop”implants. They are in more like a shape of a drop, with a sloped contour that fills out more on the bottom than the top. Upper part of teardrop implants are not filled as round implants even though they give greater projection as compared to round implants with the same volume Women who are seeking a breast enhancement that appears more natural, teardrop implants might be the right choice.
As they are in drop shape problem happens when implant rotates. Preferred teardrop implants are textured one to avoid slipping and rotation
Between the teardrop and round breast implant shapes, it is usually the teardrop that costs more, which is definitely something to think about for those worried about financial expcome. They also comes in various projections.
Again two types – in front of the pectoralis muscle and behind the muscle.
In front of the muscle(SUBMUSCULAR) implants are placed in atheletes and womens with certain breast volume.
Behind the muscle (SUBPECTORAL) implants are placed in thin built patients with small breasts. This kind of placement will avoid feeling of implant in the upper part which is possible if implants are in submuscular plane.
SCARS: There are three types of scars by which implants can be placed- axillary, periareolar or transareolar and submammary. An areolar scar is likely to cause a loss of sensitivity in the area of that breast
Consultation / visit before surgery- we will decide size of the implant in 2 visits normally. Mammograms and ulatrasound of the breasts are required before any augmentation procedure. Sometimes MRI breast is required in certain cases.
Patient is planned for surgery after assessing all Blood and urinary investigations.
Smoking needs to be stopped 6 months before surgery. A good chest is a key to success for a good painless breast augmentation.
Procedure is performed under general anaesthesia. It usually lasts in 2 hours.
Patient is advised to take rest and antibiotic prophylaxis for few days. Vigrous exersises are not to be advised for 6-8 weeks
Definitive shape and volume of the breasts will be determined in 3- 6 months after surgery. Patient has to come for few regular followups.
1. Breast Lump
Localised swelling that feels different from surrounding breast tissue are called breast lumps. approximately 10% of breast lumps ultimately lead to a diagnosis of breast cancer.
Types of Breast Lumps
Fibroadenoma abnormal growths of the glandular tissue in the breast. They occur most frequently in women between the ages of 15 and 30. They usually feel round and firm and have smooth borders. Approximately 90% of fibroadenomas are less than 3 cm in diameter. However, these tumors have the potential to grow reaching a remarkable size, particularly in young individuals. They can be single or multiple. A fibroadenoma is usually diagnosed through clinical examination, ultrasound or mammography, and often a needle sample of the lump. Fibroadenomas >5 cm are called GIANT FIBROADENOMA .Treatment is either excision biopsy or lumpectomy.
Fibrocystic breast disease: is a condition of breast tissue affecting an estimated 30-60% of women and at least 50% of women of childbearing age. Some studies indicate that the lifetime prevalence of FBC may be as high as 70% to 90%. They are noncancerous breast lumps which can sometimes cause discomfort, often periodically related to hormonal influences from the menstrual cycle.
Fibrocystic breast disease:
Fibrocystic breast disease is a condition of breast tissue affecting an estimated 30-60% of women and at least 50% of women of childbearing age. Some studies indicate that the lifetime prevalence of FBC may be as high as 70% to 90%. They are noncancerous breast lumps which can sometimes cause discomfort, often periodically related to hormonal influences from the menstrual cycle.
Breast cysts are fluid-filled sac in the breast. They generally feel smooth or rubbery under the skin and can be quite painful or cause no pain at all. Cysts are caused by the hormones that control the menstrual cycle and are rare in women older than 50 years. Treatment options are cyst aspiration, biopsy and excision
Sebaceous cyst is a non-cancerous, closed sac or cyst below the skin that is caused by plugged ducts at the site of a hair follicle. Hormone stimulation or injury may cause them to enlarge. Treatment is removal of the cyst.
Breast Abscess are non-cancerous pockets of infection within the breast. They can be quite painful and cause the skin over the breast to turn red or feel hot or solid. Abscesses of the breast are most common in women who are breast-feeding.
Galactocele are cyst containing milk or milky products. They occur in women during or shortly after lacation. They present as a firm mass, often subareolar, and are caused by the obstruction of a lactiferous duct. sometimes It may get complicated by a secondary infection and result in abscess formation.
Fatty lumps :
a. Fat necrosis: a condition in which the normal fat cells of the breast become round lumps. Symptoms can include pain, firmness, redness, and/or bruising. Fat necrosis usually goes away without treatment but can form permanent scar tissue that may show up as an abnormality on a mammogram.
b. Lipoma: is a non-cancerous lump of fatty tissue that is soft to the touch, usually movable, and is generally painless.
Intraductal papilloma are wart-like growths in the ducts of the breast. These lumps are usually felt just under the nipple and can cause a bloody discharge from the nipple. Women close to menopause may have only one growth, while younger women are more likely to have multiple growths in one or both breasts.
Breast hamartoma is an uncommon breast tumor that accounts for approximately 4.8% of all benign breast masses. they are larger and softer than common adenofibromas and, are well-defined.
Phyllodes Tumor are typically large, fast-growing masses that form from the periductal stromal cells of the breast. They may be cancerous and noncancerous depends upon histological grade. Treatment for Phyllodes is wide local excision.
2. Nipple Discharge
Release of fluid from the nipple. There are different types of discharges like
- Cloudy white color — most common, can be galactorrhe
- Cear or light white — pregnancy
- Red—contains blood — most often due to breast infection or intraductal papillomas, but can be breast cancer
- Whitish — yellow, yellow or green — pus due to infection
3. Breast Pain
Breast Pain it accounts for 50-70% of womens. also known as mastalgia, mammalgia and mastodynia, is common and may include a dull ache, heaviness, tightness, a burning sensation in the breast tissue, or breast tenderness. Two types of breast pains are there- cyclical and noncyclical.If the pain is linked to the menstrual cycle, it is known as cyclical mastalgia (cyclical breast pain).
Gynaecomastia is an increase in the size of male breast tissue. Associated in young boys and also in older individuals. Sometimes associated with lumps. Treatment is surgical removal.
5. Granulomatous Mastitis
Granulomatous mastitis can be divided into idiopathic granulomatous mastitis or occurring as a rare secondary complication of a great variety of other conditions such as tuberculosis and other infections, sarcoidosis and granulomatosis with polyangiitis, and results as a complication of diabetes.
6. Accessory Breast
Accessory Breast :is a condition in which abnormal accessory breast tissue is seen in addition to the presence of normal breast tissue. This normal variant can present as a mass anywhere along the course of the embryologic mammary streak (axilla to the inguinal region). Treatment is removal of accessory breast cosmetically.
7. Breast Atrophy
Breast atrophy means spontaneous atrophy or shrinkage of the breasts. Breast atrophy commonly occurs in women during menaupouse when estrogen levels decrease. It can also be caused in antiestrogen treatment for breast cancer, in polycystic ovary syndrome (PCOS), and in malnutrition such as that associated with eating disorders like anorexia nervosa or with chronic conditions. Treatment- medicines, proper nutrion, weight gain and surgery- implants (breast augmentation).
8. Breast Hypertrophy
Breast hypertrophy enlarged breasts is a condition in which the breasts become excessively huge. It can be macromastia or gigantomastia. Breast hypertrophy is a benign progressive disorder affects both or only one breast. Treatment is surgery- Reduction Mammoplasty.