doctor often uses a measuring
tape and special patterns to help determine the proper location. In the traditional
breast reduction method (see illustrations) a keyhole-like incision is plotted
above the nipple: the round part of the keyhole will be the new location of
the nipple. A line is then drawn along the crease below the breast, and connected
with the vertical sides of the keyhole.
In the operation, the tissue in the lower part of the breast is removed and
the nipple is shifted up to its new position at the top of the keyhole. The
two vertical sides are then sewn together and the incision in the crease below
the breast is sewn up. A drainage tube is sometimes inserted to remove blood
that may seep from the cut surfaces. The method of sewing up the incisions
varies, but usually the deeper stitches are made with thread that is buried
and thus dissolved by the body and the skin is sewn together with invisible
stitches using nylon thread. As a precautionary measure, the glandular tissue
that was removed is usually sent for microscopic examination to assure there
are no cell changes in it.
After the incisions have been closed, they are bandaged. The method used depends
on the preferences of the surgeon u my own preference is surgical tape nearest
the incision, covered by a light gauze compress and a sports bra.
Complications and risks
In addition to
the risks of bleeding, infection etc. described in the first part of the book,
complications that may occur with this type of surgery are related to the
amount of tissue removed. If the breasts were merely lifted, usually the only
thing cut away was skin, and in these cases the risk of complications during
healing is extremely small. The risk of complications during healing is greater
with reduction of a really big bust, especially on older or heavier women
n and particularly if they are smokers. The worst of these is impaired blood
circulation, with possible necrosis of the nipple. If a lot of glandular tissue
was removed the sensitivity of the nipple and the surrounding skin may be
reduced. Many patients report somewhat reduced sensitivity in the nipple after
a breast reduction, but they are seldom bothered by it.
If a lot of glandular
tissue was removed, there is a risk that the ability to nurse will be affected.
But with modern methods, the milk ducts are left intact and still attached
to the remaining glandular tissue, so the patient may still be able to breast-feed
a baby. If the breasts were lifted and not reduced, there should be no effect
at all on the ability to nurse a child.
The breasts may be somewhat asymmetrical after the operation. A minimal deviation in size or appearance must be regarded as normal, but there should be no major deviations. Most women have slightly asymmetrical breasts before their surgery. The planning, measuring and marking before the operation is an important step in achieving the most symmetrical, natural-looking result possible.
The appearance of the scar will vary from patient to patient, but if the incisions
were sewn together properly and the strain on the scar is removed by taping
it for at least the first three months, the scar will usually fade and melt
into the surrounding skin sooner or later (see p. 68). However, the scars
will always remain, around the nipples and below them as well.
