Breast reduction|Decreasing breast reduction surgery

What are the possible complications?

The following are the potential problems that may occur after breast reduction:

Scarring:  Breast replacement surgery and troublesome scars

can be cosmetically improved by injecting cortisone into the scar to flatten it, using the vascular lasers to remove residual redness, the pigment removal lasers to treat hyper-pigmentation and the carbon dioxide laser to resurface uneven lumps and bumps. 

If the scar is dramatically white or the nipple has an abnormal appearance color can be implanted into the tissue using medical tattooing techniques in Breast reduction.

ematoma:  A hematoma is a collection of blood.  A sudden increase in swelling, pain and tightness in one or both breasts is an indication that there is a hematoma within the breast. 

The drainage tubes put in place after surgery remove small amounts of blood and serum but do not prevent hematomas: they must be surgically drained. 

It is important to realize that hematomas are a potential

complication of most types of surgery and are not a reflection of the quality of the surgery.  Rather, the early recognition and appropriate treatment of the hematoma is an indication of a surgeon’s skill in Breast replacement surgery.

• Prior to surgery, a photograph of the breasts is taken.  The planned incisions are drawn on the breasts while the patient is in a sitting position.  A general anesthetic is then administered.

• A keyhole incision is made around the nipple and down to the inframammary fold.  With most techniques the incision extends along the inframammary fold to leave an inverted “T” shaped scar pattern.  The nipple-aerolar complex and its underlying breast tissue with the accompanying blood supply and nerves are preserved in order to maintain sensation and circulation to the nipple.

A more recent technique developed by Dr.M.Lejour avoids the scar under the breast.  The incision extends from around the nipple-areolar complex down to the inframammary fold but not along the fold.  This procedure is best used for reduction of smaller breasts in Breast replacement surgery.

Excess breast tissue and skin within the incisions is then removed and in some cases fat is sucked out using a liposuction technique.  The nipple-areolar complex is raised to the planned height, and the incisions are closed.

Approximately 50% of women can still breast-feed when this technique is used.  For women with very large breasts, or for those who are older and have medical problems, the nipple and aerolar complex is often totally removed and reapplied using a grafting technique.  In this case, there is little or no residual sensation in the nipple and breast-feeding is not possible.

Drainage tubes are usually inserted into both breasts.  This enables any accumulated fluid or blood to drain into the dressing.  The drainage tubes are removed and the dressings changed 48 hours after surgery.  Normally, the incisions heal within two weeks, and no further dressings are necessary.  Women who smoke, however, tend to heal more slowly, particularly at the juncture of the inverted “T”.  This is due to the constriction of the small blood vessels within the skin caused by the nicotine, as well as a reduced blood supply caused by the incision and the tension exerted upon the breast skin at the point of closure.  Women are cautioned not to smoke for ideally 5 months but minimally 2 days prior to surgery and a week or 2 following surgery.

In most cases swelling and bruising from the surgery is resolved by the tenth to fourteenth day, at which time the sutures are removed.  If the sutures are absorbable, this is not necessary.  The patient is advised not to shop for a new bra for approximately 3 to 4 weeks following surgery to allow swelling to completely subside.  Occasionally, some leakage is noted along the incision from the previous drainage tube sites.  This subsides as the bruising and swelling disappear.

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