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aesthetic plastic surgery

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BREAST REDUCTION
If you are thinking about Breast Reduction surgery
The size of a woman's breasts may be determined by several factors such as inherited genes, body weight and hormonal influences. The problem of large breasts may cause difficulty at all ages and these are chiefly backache, neck pain, grooves in the shoulders from bra straps, rashes under the breasts and the feeling of self consciousness.

Large breast size can attract unwanted attention from the opposite sex. Women also find exercise difficult and clothing difficult to fit.

Breast Reduction - What can be done
Reduction mammoplasty is an operation which removes excess breast tissue, fat and skin from the breasts.
The breasts are reshaped and the nipples repositioned to form newer smaller breasts. This should result in more attractive breasts and reduce many of the problems mentioned previously.

There are several different surgical designs to reshape the breasts, all of which involve a scar around the nipple and coloured skin around it (the areola) and most will involve vertical scars which will join onto a horizontal scar in the fold of the breast in a T shape.

Each method will use different scars and will have advantages and disadvantages and your surgeon may select with your approval the best technique in your particular case.

Reduction mammoplasty may be used to correct asymmetry of the breasts where one breast is very much larger than the other and where it is considered the least normal of the two.

What to expect after Breast Reduction
Apart from the change in shape and reduction in size the most obvious consequences are the scars. These are designed to be invisible whilst wearing normal clothing and as far as possible are designed to lie under the average bra or bikini top. Over the months following surgery the scars will fade from being red, possibly thick and uncomfortable to becoming much paler and less obvious.

The scars will always be visible when clothing is not worn and will vary from one woman to another. In some they may be very thin, in others they may stretch and become quite red and possibly ugly. In the vast majority of women, however, the scars are an acceptable and small trade-off for the benefit of dealing with the problem of large breasts.

Few women are able to breast feed following breast reduction surgery as the nipples are separated from the milk ducts and at the time of pregnancy the milk supply will gradually dry up, sometimes with the assistance of hormone treatment. Pregnancy will not be affected by breast reduction but young women may wish to take the fact that they are unable to breast feed into account before having this operation.

The nipples are likely to be less sensitive following surgery because nerves are divided and numbness can extend over part of the breast as well.

Will the improvements last?
Unless your operation is done at an age when your breasts are still growing, they should not re-grow afterwards. They will, however, increase if you either put on weight or become pregnant and decrease in size if you lose weight. Even normal breasts have the tendency to droop with time and you can expect some changes in shape to occur after reduction mammoplasty.

What to expect before the Breast Reduction operation
You will be admitted the day before or on the day of surgery. While in hospital and before your operation you will be seen by both your surgeon and the anaesthetist. The staff on the ward will help you to settle in. You will be fitted with a pair of elastic stockings and have an injection which can help to reduce the risk of developing clots in your veins after surgery. The operation is carried out under general anaesthetic and when you wake at the end of the operation there will be some discomfort which will last for two or three days. You will be given pain killing injections or tablets.

Drainage tubes are not regularly used. If used they will be removed within a short period of time. You will need to remain in hospital for one or two days. All stitches used will be dissolvable.

At home you will be tired and require help at home for a period of time from two to six weeks depending on your age and fitness and home circumstances.

A well fitting sports bra will need to be worn following surgery but because of post-operative swelling the final size of your breasts may not be obvious for several weeks. There is likely to be some tenderness and lumpiness of the breasts for several weeks or months following surgery but there is no reason why you cannot sunbathe and go swimming once the scars have fully healed.

What are the limitations in Breast Reduction surgery?
It is important that you discuss thoroughly with your surgeon beforehand the size of breasts that you wish to achieve. If you wish for a large reduction you must remember that the shape and cosmetic quality of your breasts may be less than otherwise. It is also possible that there may be a degree of unevenness, although this is often less than existed before the surgery.

In women with very large breasts the benefits of a significant reduction may outweigh the potential imperfections of poor shape and loss in nipple function and sensitivity. In women with breasts which are only slightly larger than normal very careful thought must be given to the scarring, potential shape and size and outcome of the surgery may not be as cosmetically pleasing as a normal breast appearance.

What are the risks of Breast Reduction operation?
Any major operation with a general anaesthetic carries a small risk – these will have been discussed with you specifically before you operation by Mrs Karanlik.

How to prepare for the Breast Reduction operation?
It is probably a good idea to see your general practitioner prior to the surgery, particularly if you have other medical problems. Your surgeon is likely to recommend that you reduce weight if you are overweight and advise you on risks if you are on the contraceptive pill.

Smoking does affect the healing of the breast wounds and you should make attempts to reduce your consumption or give it up.

Breast Reduction - After your Surgery
After surgery, you'll find steri-strips over the scars with dressings over these. Finally the sports bra which you brought in with you will be over the top of this. The dressings will be removed 24 hours postoperatively but the steri-strips should be left in place until you are reviewed in out-patients 10 days later.

You may feel some discomfort for the first couple of days - especially when you move around or cough. This will last for a week or so. Your surgeon will prescribe medication to lessen the discomfort.

You'll probably find it most comfortable to continue wearing the sports bra around the clock for 2-3 weeks, until the swelling and bruising subside. Your stitches will not need to be removed as they will be dissolvable.

If your breast skin is very dry following surgery, you can apply a moistueriser several times a day, but be sure to keep away from the suture area. You may get the wounds wet after 48 hours. A shower is best or a bath splashing the water up over the scars. Be sure to dry the scar-line afterwards and do not soak the wounds.

Your first menstruation following surgery may cause your breasts to swell and hurt. You may also experience random, shooting pains for a few months. You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This usually fades over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.

Getting back to Normal
Although you will be up and about next day, your breasts may still ache occasionally for a couple of weeks. You should avoid lifting or pushing anything heavy for three or four weeks.

Your surgeon will give you detailed instructions for resuming your normal activities. Most women can return to work (if it's not too strenuous) and social activities in about two weeks. But you'll have much less stamina for several weeks, and should limit your exercises to stretching, bending, and swimming until your energy level returns. You'll also need the sports bra for support.

A small amount of fluid draining from your surgical wound, or some crusting, is normal. If you have any unusual symptoms, such as bleeding or severe pain, do not hesitate to call our office.

Your new look following Breast Reduction
Although much of the swelling and bruising will disappear in the first few weeks, it may be six months to a year before your breasts settle into their new shape. Even then, their shape may fluctuate in response to your hormonal shifts, weight changes and pregnancy.

Your surgeon will make every effort to make your scars as inconspicuous as possible. Still, it is important to remember that breast reduction scars are extensive and permanent. They often remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be placed so that you can wear even low-cut tops.

Of all plastic surgery procedures, breast reduction results are one of the quickest body-image changes. You will get rid of the physical discomfort of large breasts, your body will look better proportioned, and clothes will fit you better.