SEBASTIEN GARSON M.D
This fact sheet was developed under the aegis of the French Society of Plastic Reconstructive and Aesthetic Surgery (SOF.CPRE) as an addition to your initial consultation, to try to answer all the questions you can ask yourself if you plan to use surgery baldness. The purpose of this document is to provide you with all the necessary and essential elements of information to help you make your decision with full knowledge of the facts. Also you is it advisable to read with the greatest attention.
• DEFINITION OBJECTIVES AND PRINCIPLES
Breast hypertrophy is defined by an excessive volume of the breasts, particularly in relation to the patient's morphology. This excess volume is generally associated with sagging breasts (breast ptosis) and sometimes with a certain degree of asymmetry.
Breast hypertrophy almost always implies a physical and functional repercussion (neck, shoulder and back pain, discomfort in the practice of sports, clothing difficulties). There is also frequently a notable psychological repercussion.
These sometimes major physical alterations, as well as the psychological suffering induced, give a therapeutic purpose to this restorative surgical act.
If they exist, the conditions of coverage by !'Assurance Maladie will be specified to you by your surgeon.
The aim of the surgery is to reduce the volume of the breasts, to correct ptosis and possible asymmetry, in order to obtain two harmo nious breasts in themselves and in relation to the patient's morphology (two reduced, ascended, symmetrical and remodeled breasts).
The procedure removes excess breast tissue. A volume in harmony with the patient's silhouette and in accordance with her wishes is preserved. This residual breast volume is lifted, concentrated and reshaped.
The skin envelope must then be adapted, which requires the removal of excess skin in order to ensure a good fit and shape to the new breasts. The edges of the skin cut in this way are then sutured: these sutures are at the origin of the scars.
Often these scars have the shape of an inverted T with three components: periareolar around the areola between the brown skin and the white skin, vertical, between the lower pole of the areola and the submammary fold, horizontal, hidden in the submammary fold.
The length of the horizontal scar is proportional to the extent of the hypertrophy and ptosis.
Sometimes, especially when the hypertrophy and ptosis are moderate, a so-called "vertical" method can be used to remove the transverse scar in the submammary fold and to reduce the scar ransom to its periareolar and vertical components. Breast plasty for hypertrophy can be performed from the end of growth and beyond, throughout life.
A subsequent pregnancy is of course possible. Breastfeeding is most often possible after breast surgery. However, this cannot be promised in all cases and the risk of not being able to breastfeed after certain breastplasties for hypertrophy must be mentioned.
The risk of cancer is not increased by this procedure. It would even be slightly reduced.
• BEFORE THE OPERATION
A routine pre-operative check-up is performed as prescribed.
The anaesthetist will be seen in consultation at the latest 48 hours before the operation.
In addition to the usual pre-operative examinations, it may be useful to check the breast imaging (mammography, ultrasound).
No medication containing aspirin must be taken for 10 days before the operation.
• TYPE OF ANESTHESIA AND CONDITIONS OF INTERVENTION
Type of anesthesia:
This is a classical general anaesthesia, during which
you're sound asleep.
A one- to two-day hospitalization is usually
Each surgeon adopts a technique that is specific to him and that he adapts to each case to obtain the best results. However, there are some common basic principles:
The removed tissue is always sent to a specialized laboratory for microscopic examination (histological examination).
At the end of the operation, a shaping bandage with elastic bands in the shape of a bra is made.
Depending on the surgeon and the extent of the hypertrophy, the operation can last from two to four hours.
AFTER THE INTERVENTION: THE OPERATING SUITES
The after-effects of the operation are generally not very painful, requiring only simple analgesics.
Swelling (oedema) and bruising of the breasts, as well as discomfort when raising the arms are frequently observed.
The first dressing is removed after 24 to 48 hours and replaced by a lighter dressing. The dressing will be reapplied regularly until healing is achieved.
Discharge takes place one to three days after the operation, and the patient is then seen again in a post-operative consultation.
A bra is then put in place to ensure good support.
It is advisable to wear this bra for about a month after the operation.
The stitches, if they are not absorbable, are removed between the eighth and twentieth day after surgery.
Convalescence and a work stoppage of 8 to 21 days should be considered.
It is advisable to wait one to two months before resuming sports activities.
• THE RESULT
It can only be judged from one year after the operation: the chest then usually has a harmonious and natural curvature, symmetrical or very close to symmetry. Beyond the local improvement, this operation generally has a favourable impact on weight balance, sports practice, clothing possibilities and psychological state.
It is simply necessary to have the patience to wait the necessary time to attenuate the scars and to observe during this period a good monitoring, at the rate of a consultation approximately every three months for one year.
The operated breast is a breast that remains natural and sensitive, especially to hormonal variations.
The goal of this surgery is to bring improvement and not to achieve perfection. If your wishes are realistic, you should be very satisfied with the result obtained.
• FAULTS OF THE RESULT
These are essentially scars, which are carefully monitored: they often take on a pinkish and swollen appearance during the second and third months after surgery; beyond that, they generally fade gradually to become, over time, hardly visible.
However, they may remain enlarged, white or, on the contrary, brown.
As far as scars are concerned, it is important to know that although they generally fade well over time, they cannot disappear completely. In this respect, one should not
don't forget that if it's the surgeon who does the sutures, the scar is the patient's.
Sometimes asymmetry of the breasts may persist, whether in terms of volume, height, size or orientation of the areolas.
In all cases, a secondary surgical correction can be made, but it is advisable to wait at least a year or two.
• POSSIBLE COMPLICATIONS
A breast plastic surgery for ptosis, although performed for essentially aesthetic reasons, is nonetheless a real surgical procedure, which implies the risks associated with any medical act, however minimal it may be.
The postoperative consequences are generally simple after a breast surgery. However, complications may occur, some of a general nature, inherent to any surgical procedure, others more specific to breast surgery.
A distinction must be made between complications related to anaesthesia and those related to the surgical procedure.
As far as anaesthesia is concerned, during the consultation, the anaesthetist will himself inform the patient of the anaesthetic risks. It is important to know that anaesthesia induces in the organism some reactions
sometimes unpredictable, and more or less easy to control: the fact of having recourse to a perfectly competent Anaesthetist, practising in a truly surgical context, means that the risks incurred have become statistically almost negligible.
Indeed, it is important to know that techniques, anaesthetic products and monitoring methods have made huge progress over the last twenty years, offering optimal safety, especially when the operation is performed outside the emergency room and in a healthy person.
As far as the surgical procedure is concerned: by choosing a qualified and competent Plastic Surgeon, trained for this type of intervention, you limit these risks as much as possible, without however completely eliminating them. Fortunately, real complications are rare following a breast plastic surgery for ptosis performed properly.
In practice, the vast majority of procedures are trouble-free and patients are fully satisfied with the results. However, despite their low frequency, you should still be aware of the possible complications:
The occurrence of an infection requires antibiotic treatment and sometimes surgical drainage.
A haematoma may require evacuation.
Necrosis of the skin, in fact rarely observed with modern techniques, may be responsible for delayed healing. Alterations in sensitivity, particularly of the nipple, may be observed, but normal sensitivity usually reappears within 6 to 18 months.
Above all, the evolution of the scars can be unfavourable with the occurrence of hypertrophic scars, even keloid scars, of unpredictable appearance and evolution, which can compromise the aesthetic aspect of the result and require specific local treatments that are often long..
In total there should not overstate the risks, but just be aware that surgery, even seemingly simple, still a small share of hazards. The use of a qualified Plastic Surgeon ensures that it has the training and knowledge required to avoid these complications, or effectively treat if jurisdiction.
These are the pieces of information that we wanted to bring you in addition to the consultation. We recommend that you keep this document, read it again after the consultation and reflect "a clear head." This reflection may raise new questions for which you wait for additional information. We are available to talk during the next consultation, or by phone, or even on the day of surgery when we meet in any way before anesthesia.
Phone : + 33344282959
7 impasse de la Passerelle 60300 SENLIS
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