Mammoplasty and breast size change

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غلامحسین غرابی دکتر زیبایی

Specialist in plastic and cosmetic surgery
Member of the American Society of Plastic Surgeons
Member of the Iranian Plastic Surgeons Association



Mammoplasty is a surgery that changes the structure, size and appearance of the breasts. This surgery has different types that are performed according to the conditions of people. But the general public knows this surgery with the term breast reduction.

While, in addition to shrinking, shaping, beautifying and other beauty operations, which is referred to as (breast lift), it is also included under this type of surgery. In the past, implants or breast prostheses were used to increase the size of the breasts, which were sometimes recognizable. But today, with many advances made in the field of medicine, there are better alternative methods to increase breast size. In fact, medicine and technology have advanced so much that it is now possible to completely reconstruct a natural breast without implants.

Mammoplasty is a term that refers to breast surgery. Contrary to what is thought, plastic surgery is not only for breast enlargement, because different types of operations are performed according to the needs of people. During this operation, the surgeon changes the line and shape of the nipples, the volume and areola of the mammary glands.

Why is mammoplasty surgery attractive to most women?

 There are reasons that make women perform this surgery, including:

  • removing body defects
  • increasing self-esteem
  • becoming more attractive
  • getting rid of large and heavy breasts

In this article, we explain the types of mammoplasty, how it is performed, before and after care, etc.

What is mammoplasty?

Breast reduction, also known as mammoplasty, is a procedure to remove excess breast fat and breast tissue, thereby changing the size of the breast to fit the body and correcting the problem of disproportion of body parts in people with large breasts.

Large and disproportionate breasts can cause physical and mental discomfort. People with macromastia (a condition in which the breasts are large in size) may experience physical problems due to the large size of the breasts, such as difficulty performing some daily activities. In addition to the physical ailments associated with macromastia, some patients may experience significant emotional distress or psychological problems due to the size of their breasts. Although breast reduction or complete removal of the breast (mastectomy) is usually done to treat problems and medical conditions such as breast cancer, but patients who have large breasts and feel uncomfortable about this issue, mammoplasty can be used as a cosmetic surgery and change the size of your breasts.

If you ask people who have had breast augmentation surgery for the reasons, most of them will mention social problems and the inappropriateness of the clothes and its size..

Types of mammoplasty

According to the patient’s condition, there are different types of this surgery. Contrary to popular belief, this type of surgery does not only include breast reduction and also treats other physical or mental problems that a person is dealing with.

Breast reduction is not only a good way to reduce the size of the breasts, but it is also recommended to raise the location of the breast in the chest area, eliminate the difference in the size of the breasts, and restore the location of the breasts after breastfeeding. . There are cases that prohibit breast plastic surgery, such as when a person has diseases such as fibrocystic, infections or breast cancer.

Changes in the size and shape of the breasts will be visible after a few weeks after the surgery. In addition to correcting the size of the breasts, their appearance is also improved. In general, mammoplasty surgery includes two general cases, which are mentioned below:

Breast reduction:

Mammoplasty is related to both physical problems (breast size) and psychological problems. It has been proven that large breasts psychologically affect people’s self-confidence and relationships more than small breasts, and these patients try to hide it as much as they can. In addition to mental problems, if the breast size is too large (lack of body fit), it affects the spine and causes back pain.

For this reason, breast reduction is a cosmetically preventive measure, as it prevents and corrects spine problems. In fact, the purpose of this type of surgery is to reduce the size of the breasts and their fibers to maintain their natural position.

Breast reduction is usually done for the following reasons:

when the breasts are too large due to hormonal factors, obesity or breastfeeding problems, and when the breasts sag due to aging or the effect of gravity.

Breast reconstruction:

Reconstruction mammoplasty is performed in cases where a person suffers from diseases such as breast cancer. In these cases where the breast and chest muscle need to be removed, breast reconstruction increases the patient’s self-esteem. This operation can be done through methods such as using anatomical breast prostheses, using one’s abdominal fat, or breast implants using body muscles.

Pre-operative care

Before your operation, you will undergo a full medical examination and history during a face-to-face consultation with Dr. Gholamhossein Ghorabi, you will be given the necessary explanations regarding the surgical technique and the recovery period, and the necessary tests will be requested. It is necessary to perform blood and urine tests to determine the blood type and hormone levels, as well as to determine the amount of blood cells.

It is also necessary to diagnose any underlying, microbial and viral diseases in the person’s body before performing the operation. After the tests, the person needs to undergo breast ultrasound. Mammography or breast ultrasound helps to diagnose breast cancer, detect cell masses and breast cysts and informs the doctor about the condition of the breasts. Two weeks before the operation date, the use of drugs containing salicylate, the use of hormonal contraceptives and anticoagulants should be stopped. Also, smoking before the operation should be reduced because it affects the healing process and blood supply to the tissue. After performing the tests and following the necessary health recommendations, the surgeon maybe performs a 3D modeling of the breast on the computer.

In this way, the person will notice how the breasts change and how they look after the operation. In these models, things like breast width, initial volume of mammary glands, breast shape, elasticity of the skin are examined according to the height and weight of the patient.

Stages of mammoplasty

After the person has passed all the tests and recommendations and is mentally ready, the surgery is performed. The person can decide what kind of anesthesia the surgeon will use.

In this surgery, general anesthesia is usually used, but if general anesthesia is not suitable for the person, local anesthesia is injected intravenously. Depending on the type of mammoplasty operation, the type of incisions made by the surgeon will be different.

Considering that the purpose of this surgery is to reduce the size of the breast, based on the chosen technique, the incision is made in the following places:

along the edge of the areola and extending it vertically to the transverse line under the breast, and if necessary, extending this incision in the line transverse under the breast and some of the fat tissue and glandular tissue of the breast are drained.

Breast size reduction is done in different ways:

After doing this operation in the mentioned way, breastfeeding may be difficult.

In cases where breast tissue has been removed due to cancer to reconstruct the breast, the doctor removes the skin and creates a small bag behind the muscle or breast tissue. Then he puts the implant in it.

In general, the surgery takes two and a half to four hours, depending on the technique.

Rehabilitation after surgery

The postoperative period is considered very important. The length of this period, the occurrence of risks and side effects for the person, depends on how to pass the recovery period and follow all medical recommendations.

Usually, the recovery period after mammoplasty lasts 2 months. Breast shape can change over the course of a year. The full implant takes 6 months to take root in the breast tissue. During the post-operative recovery period, the chest muscles and back muscles are regenerated. At this time, physical exercises and medical gymnastics can be done, but only with the doctor’s advice.

In the first days after the operation, the woman may experience severe pain. During this period, doctors can prescribe a analgesic for the patient. It is also sometimes necessary to take antibiotics to prevent any infection in the wound and suture area.

Remember: in the first 2 years after the operation, the sensitivity of the breasts and nipples will decrease. In addition, sensitivity may disappear completely or temporarily.

Care after mammoplasty

After plastic surgery, there are recommendations that must be followed by the person. Usually, the recovery period of mammoplasty surgery is not painful, but the recovery process depends a lot on the patient’s body and condition.

Recommendations after surgery include:

Sleeping on your back, using bra without a rim for one month, reducing body movements, Not doing heavy sports such as weight lifting or running, not consuming alcohol and smoking, not using swimming pools. For 15 days after the operation. Other points that a person must follow are described below. To facilitate recovery, the arms should be straight during the movements. It is necessary to use a bra without a rim or chest strap. In this way, the breast tissue remains in place while the tissue heals. It is necessary to hydrate the skin of the breast area well, because the use of a bra and tightening of the skin can cause excessive drying and the skin becomes stretched and wrinkled. In addition to sleeping on your back, it is recommended to raise the bed a little with a pillow or blanket to reduce the inflammation of the chest area. Physiotherapy treatment can help reduce inflammation and return to normal more quickly. Mammography and breast examination by the surgeon should be done continuously. It is very important to protect the wounds from sunlight, because it can cause pigmentation in the skin. It is estimated that sports activities should not be done for 2 months because some exercises are harmful for breast implants..

Possible postoperative complications

Like other surgeries, mammoplasty may have side effects. Scar formation, infection, breast asymmetry, loss of nipple sensitivity, immune reactions to the anesthetic, bleeding and hemorrhage, blood clots in the breast tissue, bruising and swelling of the breasts, accumulation of fluid and water. Interstitial tissue in the breasts, damage to structures and mammary glands, necrosis or loss of tissue and fat cells, loss of ability to breastfeed, etc. are among the complications that a person may face after the operation. .

Sometimes it may be necessary to reconstruct the breast tissue due to the reasons and complications mentioned above. Factors such as asymmetry in the breasts, hemorrhage, etc., can cause the breasts to disappear again.

To prevent complications such as infection, using antibiotics and washing the wound with antiseptics can be very useful. In fact, the side effects of the operation depend a lot on the type of post-operative care. Using the correct dressing, how to sleep, observing hygiene tips, etc. can reduce possible complications.

Dressing after mammoplasty

Like any other surgery, mammoplasty also requires a dressing. Proper dressing of wounds has always had a great impact on the healing process.

Research has shown that severe complications after breast surgery are reduced when an appropriate dressing that provides immobility, minimal dead space, compression, and shock protection is used consistently.

In a breast dressing, a sterile gauze is placed around the breast and the suture line. The bandage is done in such a way that keeps the chest tight. But with the passage of time and the contraction of the chest, the compression effect of the bandage is lost and it needs to be changed again. Therefore, loose bandage cannot be a good option for after mammoplasty.

The conventional traditional dressing, which consists of a gauze, a pad and a bandage, may cause necrosis due to excessive pressure when the dressing is tightly closed.

Also, this type of bandage causes the chest and surrounding areas to sweat because it covers the entire chest area. Using maternity bras as a bandage can be a good option to maintain the shape of the breasts after surgery.

Scars after mammoplasty

In breast reduction surgery, incisions are made on the skin. Scars are inevitable in any surgery, including breast reduction or mammoplasty.

But there are methods that can be used to reduce the size and scars and prevent scarring on the tissue and skin. The first step is to find an experienced plastic surgeon who specializes in mammoplasty.

The expertise and experience of the surgeon has a significant impact on the success of the surgery and the results after it. The way of cutting, stitching and dressing the wound can be effective in reducing scars. Using a bandage and a suitable bra is another way that helps reduce the scar after mammoplasty. Massaging the scar is another scar reduction technique. In this case, the patient massages the scar horizontally and vertically with his fingers. Massaging increases the secretion and production of collagen and increases the flexibility of the skin.

Doing ten minutes of massage every day has a great effect on reducing scars. Another way to prevent scars is to use silicone sheets or wound gels. Silicone sheets and wound gels are OTC solutions for scar repair. Silicone sheets are bandages that contain silicone and hydrate the wound area to help maintain skin elasticity.

The cost of mammoplasty surgery

Costs related to breast reduction, like other surgeries, undergo many changes. One of the important factors in determining the cost of surgery is the increase in the cost of surgery centers.

Another influencing factor in the cost of this operation is the surgeon. The more experienced and expert the doctor is, the higher the price of mammoplasty. Therefore, this operation is considered one of the sensitive operations and any mistake and lack of experience can lead to the loss of the nipple and areola. It is recommended to go to the best surgeon in this field to perform mammoplasty, although it is possible. will incur more costs.

Can mammoplasty be used to treat gynecomastia?

Gynecomastia is a condition in which the breast size increases in men. This happens in adults and almost 30% of men suffer from this condition. In this case, the male breast is abnormally enlarged compared to other parts of the body and forms a reserve of fat tissue.

This disease can be caused by reasons such as weight gain, liver diseases, and genetics. In this case, with mammoplasty surgery, excess fatty tissue in the breast can be drained and its size can be changed according to the person’s height, weight and other organs.

Additional information about mammoplasty

According to the information mentioned in this article, mammoplasty is performed to reduce the size of breasts that are large due to various factors (drug use, disease, hormone increase, genetic background, etc.).

Complications from this procedure depend on factors such as post-operative care and skilled and experienced surgeon. Because this procedure is considered a cosmetic procedure, it is not affected by any health insurance and its costs are freely calculated (except in special cases such as cancer patients).

Due to the high sensitivity of this procedure, choosing an experienced surgeon should be the first and most important priority for people applying for mammoplasty. Although this procedure is common in women, it is also used to treat gynecomastia in men.

Who is suitable for breast reduction?

Healthy people who have large breasts (macromastia) and this causes pain in the neck, shoulder and back are good candidates for breast surgery.

What is the right age for mammoplasty?

There is no age requirement to perform this procedure, but the following must be taken into consideration:

• The chest is so large that it interferes with social activities

• The person’s physical and intellectual development is complete

• The person has made a conscious decision and is fully aware of its possible consequences

• Having reasonable expectations of the result of the action

How to prepare for the operation

If you are sure of having perfect physical and mental health and you have regularly done the usual sports exercises, you are ready to perform the breast reduction surgery. Don’t forget to stop smoking.

Can I choose the size I want?

Discuss your goals with the surgeon before surgery. The cosmetic surgeon will try to fulfill your request, provided that your health is not at risk..

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