One should have a detailed discussion with the cosmetic surgeon who will the best person to execute this surgery. He would assess the size, shape and symmetry of the breasts and photograph them for post-operative reference. He is also likely to suggest blood tests like hemogram, sugar, and urine tests prior to the surgery.
A mammogram may also be done to rule out any other problems in the breast. The patient will be asked to stop certain medicines like aspirin and smoking also should be curtailed.
Before the start of the operation, the surgeon marks out the position of the future nipple and areola with the patient in an erect posture.
After the anesthesiologist renders the patient asleep and the surgeon commences his surgery.
The operation - There are many different approaches or incisions used for breast reduction. The decision is made by the surgeon depending on the amount of reduction desired by the patient and the actual extent possible, as well as skin texture and elasticity of the patient. Two of the commonly used incisions are:
1) The keyhole incision
2) The anchor-shaped incision.
Once the incision is made, the skin is opened along this line. The underlying fat, glandular tissue and excess skin are cut away. The remaining skin is brought together and stitched or closed with help of fine tapes. In the process, the areola and nipple move to a new, higher position. In situations of breast ptosis, where the breasts are drooping, such that the nipples are facing downwards or are present below the crease of the breast, the entire nipple and areola may have to be cut away and then repositioned (this procedure is known as a free nipple graft). Stitches or thin surgical tape may be used to close the wound. A firm, supporting bra may have to be used or there may be dressings. One must follow the instructions of the doctor diligently.
