19 June 2014
Breast hypertrophy (enlargement) can be an early problem for a woman or a gradual increase in size over the years, causing neck, shoulder and back pain, restriction in mobility and exercise and significant difficulty in getting well fitting clothes including brassieres.
Principles of surgery
Surgery involves reduction of skin and breast tissue (which is made up of glandular tissue and fat) and also the elevation of the nipple-areola complex.
The method of choice
While there are many methods to reduce the breast, the vertical mammoplasty, initially described by the French surgeon Dr. Daniel Marchack, later popularised by Prof Madeline Le Jour of the University of Brussels in Belgium and now fine tuned by Dr. Elisabeth Hall-Findlay of Banff in Canada, is a very sound technique. It gives an excellent reduction of breast size, good nipple-areola complex elevation, minimal scarring and excellent long-term results, with maintenance of shape and position.
The surgery is done under general anaesthesia, usually as an inpatient in hospital.
While surface healing takes place rapidly, internal healing, the regaining of strength and the restoration of shape takes up to 6 months.
However, the initial three weeks is a key period in the healing process, during which there are many restrictions on the activities permitted.
A specially designed compression garment is also used for the first three months.
Time off work, including at home and looking after young children for at least the first three weeks after surgery helps in the recovery from surgery.
Breast droop (Ptosis) is also well-corrected, with a very similar technique, the vertical masto-pexy.
There are a number of operations, for correction of ptosis, which use skin-tightening techniques.
While technically simpler and less time-consuming, the improvement is short lived, due to the restretching of the tightened skin.
The vertical masto-pexy, is quite similar to the verticalmammoplasty, but with a very small reduction of breast tissue, and with an excellent lift of the breasts and nipple-areola complex, and with long-lasting results.
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