Breast reduction surgery is getting popular day by day awareness about cosmetic surgery. Females with excessively large breasts which are out of proportion to their body make them psychologically depress and they develop social issues.
Patients become more concerned about their large size breasts because they are not able to wear dresses of their own choice and feel shy to go to parties with short dresses.
Dr Abdul Malik is doing this breast reduction surgery in Multan at Medicare Hospital Multan (0345-4492128).
Candidates for Breast Reduction Surgery
1- Females who are at a young age before marriage around 15-20 years age and their breast becomes very large due to hormonal problems ( gigantomastia)
2- Girls at puberty or after it develop some benign swelling and their breast size increases much
3- Women who are obese or overweight and their breast becomes huge in size
4- Females who develop very large breasts after multiple pregnancies due to hormonal changes which occur with feeding and pregnancy and their breast becomes large and also loose
Evaluation and Assessment
Patients visit the clinic and Dr Abdul Malik himself with his female assistant takes the detailed history including last breast feed, family completion or future conceiving, any lump or swelling in the breast, any history of diabetes, blood pressure, heart problem or medications. Then Dr Abdul Malik examines the patient.
During the examination, he assess
- the size of breasts,
- the shape of the breast,
- the asymmetry between two breasts,
- the asymmetry between the location of nipples,
- any chest or breast deformity,
- size of chest,
- sogginess of breast,
- any lump in the breast or any other associated problems.
Then Dr Abdul Malik guides the patient about the technique of surgery, their pros and cons, side effects of each procedure, outcome and recovery and complications. Then baseline blood tests are advised to the patient including chest X-ray and ECG for fitness for anaesthesia.
Types of incisions
1. Donut shape incision:
Mean incision or cut around nipple-areola complex – with this incision mild to moderate breast reduction is possible
2. Loly pop incision:
In this technique, cut is made around the areola and then cut comes down on the breast. With this technique moderate to large size breast reduction is possible.
3. Inverted T incision:
With this technique, a cut is made around the nipple then comes down on the breast and extends along the inframammary fold. With this large breast reduction is possible
Breast amputation with free nipple graft – in this technique when there is a very very large breast, the use of this technique is helpful in which almost 80-90 per cent breast is removed and the nipple is repositioned as free nipple graft
Vascular pedicle to preserve nipple blood supply
Blood supply to the nipple is v important and different vascular pedicles are used for this purpose
1- superior pedicle
3- superomedial pedicle
4- inferior pedicle with inverted T technique
5- central mound pedicle
The procedure is usually performed under general anaesthesia and before procedure marking is done in a standing position. Position of inframammary fold is marked, new nipple position is marked, distance from clavicle is marked, distance from upper breast border is marked, the vascular pedicle is marked and the skin incision is marked. Then anaesthesia is given and in a supine position, the patient is paint and drapped.
Then infiltration of the solution is done to decrease bleeding. An incision is given according to marking, de epithelisation of skin is done, then nipple is lifted up on vascular pedicle, then proposed breast tissue is removed. Haemostasis is secured, the nipple is placed and stitched at the new position. The same process is repeated on the opposite side, symmetry is checked, then breast tissue is stitched and skin is closed and dressing is done.
Post Operative Care and Recovery
The patient is shifted to the recovery room after the breast reduction surgery procedure and keep admitted to the hospital for one day. Antibiotics and pain killers are given to the patient. On the next day, the patient is advised to mobilise herself and is discharged from the hospital. For the next 3-5 days antibiotics and pain killers are continued. Swelling and bruising can occur which is usually settled in a one to two week time period. After one week patient can return to work usually. Massage is advised to achieve symmetry and good healing. After 2-3 months good results are achieved.
Benefits & Side Effects
If the procedure is performed by a properly trained plastic and cosmetic surgeon then the patient can get benefits in form of:
3- increase confidence
4- pains that may occur with large breasts are alleviated
5- can wear dresses of their own choice
6-reintegrate back /join the society
7- long-lasting results
Side effects are usually minimal in experienced hands but can occur which usually settle with time. These include:
7-altered nipple sensation
8-compromise of nipple blood supply
The cost of the procedure is variable depending on which technique of surgery is required by the patient. The Cost of Breast Reduction Surgery in Pakistan is usually in the range of 1,50,000 to 2,00,000 Pkr.