Mammary hypertrophy

Mammary hypertrophy defines a too important volume of the breasts compared to the morphology of the patient.
In addition to its unaesthetic aspect, this increase in volume and thus in weight deteriorates the elasticity of tissues and involves a depression of the breasts (mammary ptosis) almost always associated. Moreover, this ponderal overload resounds on vertebral statics and involves pains of the dorsal musculature.

The purpose of surgical operation (mammary reduction) is to decrease the volume of the breasts, to correct the ptosis, and of this fact at the same time the esthetic and functional problem.

The best indications of the processing of a mammary hypertrophy are:

• youthful mammary hypertrophy, appearing from the start at the end of puberty and creating from the start of the psychological problems of command.
  
  
• mammary hypertrophy at the woman at the end of her pregnancies, and it frequently joins it in this case a ptosis.
  
  
• the mammary hypertrophy of origin hormonal, appearing after the menopause, and associated with an important lubricating infiltration.

These interventions can be thus carried out as from 17 years, in the important forms, if not it is certainly advised to await the term of the pregnancies before considering it.

The first consultation is fundamental because it makes it possible to determine your motivations well and to lay down precise objectives.
The medical history and surgical is referred to (allergies and capture…). The gynaecological and obstetrical past is specified thus that a possible capture of birth control pill.
The clinical exam enables us to quantify mammary hypertrophy by measurements and the size of the bra in order to determine the procedure used. It also depends on a gesture on a mammary ptosis.
The quality of the skin is noted (existence of stretch marks, pigmentation and risks of hypertrophic scars), the type of gland is estimated (glandular, greasy or mixed bosom).
The consultation ends in the capture of photographs, useful for the technical analysis and the postoperative evaluation.

A consultation with an doctor-anesthetist is programmed before the intervention to practice a complete physical exam and to prescribe the complementary examinations necessary.
This consultation makes it possible to refer to the various types of anesthesia, to take all the safety measures necessary.
The doctor-anesthetist then specifies you all the measures to be taken before the intervention concerning the fuel supply, drinks, the tobacco and the medicamentous captures.
A mammography or an echography is carried out according to the antecedents, of the quality of gland and the age, and to detect a possible associated cyst which would be withdrawn in same time.

Which type of anesthesia will be practiced?
The general anesthesia is indicated. Usually practiced with the Private clinic Elysium , she answers criteria of maximum security.

Which is the duration of the intervention?
The intervention lasts then between one and two hours, correcting hypertrophy and the ptosis associated.

Will there be visible cicatrices?
This intervention leaves cicatrices of which the length depends on the importance of the hypertrophy and the degree of the ptosis. Generally, this cicatrice with the form of “T” reversed.
In other cases, its form is in “L” or “I”. The role of the surgeon plastics technician is of course to avoid any useless cicatrice. These cicatrices are the subject of careful care and a rigorous monitoring as well as possible to improve the specific cicatricial potential to each patient.

How is held the intervention?
The drawing is carried out before the intervention, on a patient upright, in whom the measurements are taken with precision.
The intervention, made under general anesthesia, makes it possible to reposition the areola as well as the whole of gland according to the preoperative identification.
Glandular volume is decreased according to each case and the withdrawn tissue is systematically analyzed in histology.
The gland to obtain a harmonious form and the cutaneous joining is carried out with wire .
A bandage in the form of bra, slightly compressive, is implemented.

Which type of bandage will be used?
It is a bandage modelling in the form of support gorges, slightly compressive which is used the first day.
According to the cases, according to the intervention and the skin type, the mode of later application will be advised.
Generally, it is a bra which maintains well the chest which is advised, and its port is useful at least the first two months which follow the intervention.

Which is the duration of the hospitalization?
From short duration, it does not exceed in general two days.

The continuations are not very painful in general, and of analgesics are prescribed in a systematic way.
The wire used, are in general and there exists an edema which regresses into 2 or 3 weeks.
Some care are with being advised, like avoiding significant efforts, or a too physical sport during a fifteen or so days.

Like any surgical operation, the correction of mammary hypertrophy can have some rare complications such as: infection, hematoma or an anesthetic complication.

In the cases of mammary hypertrophies with ptosis important, it can exist cicatricial problems (skin necrosis) on the level of the areola.

This risk must be as much as possible reduced by an adapted choice of the technique. Indeed, the importance of the ptosis can lead to an engineering change to ensure a better vascular safety of the areola.
It is also advisable to supervise the cicatricial development and to ensure the post-operative consultings as well as possible to reduce the risk of hypertrophic scar or .
There exist frequently disorders of the sensitivity to the level of the areola, related on the surgical gesture and the cicatrices.

These amendments of the sensitivity often improve at the end of a few months.

To preserve more the possible for a long time one bends harmonious, symmetrical and natural, it is appropriate to advise the port of a bra harms and day the beginning (two to three months) then, only the day.

The cicatrices are supervised and are the subject of intensive care and personalized. It is advisable in particular to avoid an exposure to sun of the cicatrices during one year.

The operative procedures adhere to the physiology and the function of the bosom. So a pregnancy and a breast feeding are possible. They are however, disadvised because the pregnancy amends the chest again and compromises the result obtained.

For this reason it is necessary to advise each time that is possible, this type of operation at the end of the desired pregnancies.

The processing of a mammary hypertrophy allows the reduction of volume, in the respect of the physiology of the function of the bosom.

So the bosom evolves/moves normally in time, in particular according to the hormonal amendments and of possible variations of weight.

The mammary reduction is durable, but it can appear in time a certain degree of ptosis according to the quality of tissues.

This intervention is particularly satisfactory when the need for the cicatrices was understood.

The result is still better, if these cicatrices are discrete, i.e. if the nature of tissues of the patient lends itself to it and if the care is respected strictly.

The operated bosom is a bosom which remains natural i.e. there remains sensitive to the hormonal fluctuations and that he allows a possible breast feeding.