Breast uplift
(Mastopexy)
The „sew up” of the breasts means
the restoration of dulled, hanging breasts to
their original tightness and repositioning. Causes
of the problem:
- slackness of the connective tissues of skin
(this is the primary reason)
- the slackness of the gland mass and its regression
(in a less degree)
Many think that the breast muscles
are also responsible for the breast dullness,
and they try to delay or stop it by doing gymnastics.
However, this is wrong, because the breast muscle
has nothing to do with this process.
Facts which influence the atony
of the breasts:
- pregnancy - breast feeding: Most frequently
the atony occurs in such situations, since the
skin expands during the pregnancy because of
mechanical and hormonal effects, becomes thin
and after breast feeding the adenoids tissue
degenerates too much. It is important to know
that rather the pregnancy, than the breast feeding
is responsible for this, so it is meaningless
to decline breast feeding, which is very important
for the new born baby.
- by ageing the breasts can be sagged
- too big breasts
- the structural weakness of the connective
tissues of the skin
- developmental deformity of the asymmetrical
sagging breasts
- rapid and drastic weight loss
The essence of operation:
removal of the extended surplus skin,
lifting the gland mass, making it conical - shaped
and fixing it. The mass of the breast does not
change, however if the breasts are disturbingly
big or there is great difference between the two
breasts, it is possible to reduce the size by
removing a part of the gland mass. It occasionally
occurs that the skin is slack, but barely has
any formable, shaped gland mass. Since the 'sew
up' itself would not give good results, the gland
mass is supplemented with silicon implants, and
the breast lift is done the same way. This means
that the implantation and correction is carried
out together. The breast lifting itself either
lessening or increasing, ends up with similar
scars on the breast skin. Generally the nipple
area will be diminished and it will be rounder
and have a sharper contour at the rims.
Fundamentally there are
three operational types available and these are
producing some different scars.
- TRADITIONAL reversed T shape or
anchor incision
Around and under the nipple, short vertical
and in the submammarial folds often longer horizontal
scars are formed.
Advantage: also applicable with larger
breasts, mainly the wound healing is problem
free, only thin scars.
Disadvantage: relatively longer scar
lines remain.
- SHORT SCAR technique
Only a vertical scar develops around and under
the nipple.
Advantage: Less scars, relatively hard-wearing
form, less post sagging.
Disadvantage: with the vertical scars,
more frequent problems appear when the wound
recovers. Temporarily the vertical scar is very
wrinkled, after one or two months smoothening
out. For several weeks the breast shape is not
final.
- PERIAREOLARIS technique around the
nipple
Scars only develop around the nipple area (areola).
Advantage: the solution producing the
least scars.
Disadvantage: only rare, in the case
of the so called 'tubularis' pipe form can be
a good result achieved, otherwise the middle
part of the breast would be very pressed down.
The scar around the nipple area is over wrinkled,
however will later smoothen out. The areola
can expand disadvantageously later on.
Mostly, the operation is carried
out in general anaesthesia, since it is more convenient
and safer for the patient, than the local anaesthesia.
The operation is preceded by necessary routine
laboratory tests (blood-, urine, ECG), which can
be completed in our clinic too. Over the age of
40, the patient also has to go for a mammography
analysis.
The duration of operation is
in average 1,5 to 3 hours. At the end of the operation
a bandage and a tight bra is put on the operated
areas. In case of a significant breast reduction
a thin plastic tube is lead out from the wound
to drain the wound fluid away. This drain tube
is generally removed the day after the operation.
Resting: The patients
are generally required to spend a night in our
clinic and the next morning they can go home.
It is practical to travel by car but the patient
isn’t yet allowed to drive by herself. The patient
is allowed to drive 3-4 days after the operation
at the earliest. On the 7th - 10th day after the
operation, lighter physical, or intellectual,
office, sitting work can be done. In the first
two weeks the patient approximately has to come
twice for a control and changing the bandage.
The stitches are removed on the 12 - 14th day.
Pain: blunt, stretching
type of pain (not unbearable and gradually decreasing
in strength) in the first 3 - 4 days. Simple painkillers
like Algopyrin, Demalgon might be of help. The
sign of the wound healing is a slight itching
feeling on the area of the scars after the 4th
-5th day.
Cleaning: water mustn't
reach the wound for four days. From the 5th day
on the patient can take a shower (not bathing).
This time the over flowing clear water, even shampoo,
can not cause an inflammation on the operated
area. After a short showering the breasts should
be blotted with freshly ironed towels, but carefully
not to rub the operated areas, than sterile gauze
pads should be placed over the wounds and fixed
with a bra.
Two weeks after the operation
the normal lifestyle can return: Work can be started,
foreigners can return home. However, for several
months intensive sports like, tennis, swimming,
gymnastic, dancing, aerobic are not suggested.
Sunbathing and solarium are not suggested for
4 - 5 weeks, than for half a year the use of a
sun protective cream is necessary. It is important
to wear a special bra for further 2 - 3 months,
but only within daytime.
The success of the operation
could disadvantageously be influenced by different
factors like, frequent, drastic weight change
or smoking. In 95% of the cases the operation
does not affect the breast feeding ability. However,
after repeated pregnancies the breast can be dulled
again, so a repeated corrective operation might
be necessary.
Post operative complications:
- secondaryost bleeding, inflammation (2-3%)
- necroses of tissues (less than 1%)
- partial or full necroses of the nipples (very
rare, with another plastic surgery operation
can be corrected)
- chronic scar development (few percent, individual
susceptibility factor influences to great extent,
at worst a scar corrective operation is necessary.
- sensation disturbances (temporary, occurring
in the adjacent skin or areola, 4 - 5%)
The chances of these complications are somewhat
higher in case of a reducing operation of big
breast.
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