Breast reduction

Breast reduction – Cannes & Nice | Dr. Victor Médard de Chardon

SURGERY FOR BREAST HYPERTROPHY: BREAST REDUCTION

Definition: Breast hypertrophy is defined by an excessive volume of the breasts, especially when compared to the patient’s morphology. This excess volume is generally associated with subsidence of the breasts (breast ptosis=drooping breasts) and sometimes a degree of asymmetry.
Breast hypertrophy almost always involves physical and functional repercussions (neck pain, achy shoulders and back, discomfort when doing sport, problems finding clothes to fit). Often sufferers also have important psychological problems. 

Aims: The aims of a breast reduction are to decrease the volume of the breasts, and correct ptosis and any asymmetry in order to achieve a harmonious result in respect of the patient’s morphology.

When to operate? Breast surgery for hypertrophy can be carried once the patient has stopped growing and then after at any time in life. 
After a pregnancy, it is advisable to wait at least 6 months before proceeding with breast reduction. 
In overweight patients, ideally it is best first to lose weight followed by a period of six months’ stability prior to considering breast reduction surgery.

PROCEDURE MODALITIES

Hospitalization: One night’s hospitalization
Anaesthesia: General anaesthesia
Duration: 2 to 3 hours

PRINCIPLES OF BREAST SURGERY FOR BREAST HYPERTROPHY

Breast reduction consists of the removal of excess breast tissue and skin. The surgeon conserves a volume that is in harmony with the patient’s silhouette and according to her desires. 
Often, scars are in the shape of an inverted T with three components: 
1. periareolar: around the areola between the brown and the white skin,
2. vertical: between the lower edge of the areola and the inframammary fold,
3. horizontal: concealed in the inframammary fold.

The length of the horizontal scar is proportional to the degree of hypertrophy and ptosis. 
Sometimes, especially with moderate hypertrophy and ptosis, the “vertical” method can be implemented, which enables dispenses with the transversal scar along the inframammary fold and reduces the scar to its periareolar and vertical components.

POST SURGERY

Oedema (swelling): 2 months
Ecchymosis (bruising): 7 to 15 days
A little pain, discomfort when raising the arms: 7 to 15 days
The vast majority of sutures are not visible as they are below the skin and are reabsorbable. Some sutures will require removing from each areola on the 15^th day.
The wearing of a brassiere: 6 weeks
Convalescence: 7 to 15 days
No driving: 7 days
No sport: 4 weeks
Visible shape after 3 months: immediately after the procedure, the upper breasts are deliberately very inflated and the lower breasts a little flat giving them a little natural look. They adopt their shape within 2 to 3 months. 
Definitive shape after 1 year
Scarring is deemed definitive after 1 year
Problems of sensitivity of the breasts are common and temporary. They improve after 6 months to 1 year.

STABILITY OF THE RESULT

The end results are lasting if there are no pregnancies after the procedure, and provided weight remains (relatively) stable. However, it is important to use an adapted technique to avoid the recurrence of ptosis (pseudo-ptosic-type aesthetic complication). This occurs within the year following the operation, with the falling of the lower part of the breast; the top of the breasts lose volume again; the areolas point upwards. The aesthetic aspect deteriorates initially and then stabilizes. Then another procedure must be performed if the patient wishes to return a pleasing aspect to their chest.
Following breast reduction, pregnancy is, of course, possible as is lactation, but we advise waiting at least 1 year after the procedure.

HEALTH INSURANCE COVERAGE

Breast reduction or mammoplasty for breast hypertrophy is a procedure that qualifies for health insurance coverage under certain conditions (when “prior to the operation, planned resection is at least 300 grams per breast operated on"). It is therefore the task of the surgeon to assess before the operation whether your breast reduction can be covered by the social security. Otherwise it will be considered an aesthetic surgery procedure.