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Breast ptosis is the weighing of the breast gland causing a stretching of the surrounding skin and a global sagging of the breast. The breast lies in a too low position and is flattened in its upper part.
Breast ptosis can be present from the start, or appear after weight loss or preagnancy with breast feeding. It can be isolated (pure ptosis) or associated to mammar hypertrophy.
Conversely, there can be a ptosis with a small breast (hypoplasia or hypotrophic).

The aim of this operation is to elevate the nipple and areola to a more youthful position, tighten the gland and remove excess skin, in order to obtain lifted and harmoniously shaped breast

The operation shapes the breast by stretching the skin envelope and concentrating the glandular tissue. The gland is concentrated and put back in proper position, after removal of the skin excess, thus placing the nipple and areola back in a youthful position

The skin incisions are sutured and cause scars.

When the ptosis is very severe, the scars have an anchor shape, with a peri-areolar scar between the brown and white skin, a vertical scar from the areola down to the bottom fold of the breast (infra-mammary fold). The length of the horizontal scar is proportional to the severity of the sagging.

When the ptosis is milder, an isolated vertical scar method can be used, thus avoiding the horizontal scar in the bottom fold and leaving only the peri-areolar and vertical scars.

In some very mild breast ptosis, it is possible to use a concentric (or doughnut) mastopexy, which leaves only one scar around the areola.

Finally, in case of a too small breast volume (mammar hypoplasia), breast implants can be added, to restore a satisfying breast volume. In this case, it is usually possible to remove the excess skin around the areola and reduce the scar only to a peri-areolar scar

Mammoplasty may be performed from the end of adolescence, when growth has ended, throughout life.

A further pregnancy or breast-feeding are possible, but we advise to wait for a minimum of 6 months after surgery.

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• THE RESULT

It can be best appreciated one year after the procedure: the breasts are usually harmoniously shaped, symmetrical and have a natural shape. Besides the physical improvement, this operation usually has a positive effect on weight control, exercise, clothing and psychological health.
• POSSIBLE COMPLICATIONS

Mastopexy, even if performed for aesthetic reasons, is a genuine surgical procedure, with the consequent risks related to all medical acts, no matter how mild they might appear.

Post-operative care is usually simple after a Mastopexy. However, complications may occur: some are general, inherent to every surgical act, others are local and most commonly occur in very larges breasts.

Fortunately, genuine complications are rare after a properly performed mammoplasty. In fact, the vast majority of operations meet the patient’s satisfaction.




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BREAST REDUCTION, IS A SURGICAL PROCEDURE THAT REDUCES THE SIZE AND SHAPE OF THE BREASTS BY REMOVING EXCESS SKIN AND UNDERLYING BREAST TISSUE. IT ALSO REDUCES THE SIZE OF THE NIPPLE-AREOLAR COMPLEX, WHICH FREQUENTLY BECOMES ENLARGED AS A RESULT OF BREAST DEVELOPMENT. THE SURGERY CREATES BREASTS THAT ARE LIFTED, SMALLER AND SHAPELIER.
WITH LARGE BREASTS, A VARIETY OF MEDICAL CONDITIONS CAN RESULT:

  • “SHOULDER GROOVING” DUE TO EXCESSIVE WEIGHT ON BRA STRAPS
  • BACK AND NECK PAIN
  • DIFFICULTY FITTING INTO CLOTHES
  • SLUMPED SHOULDERS AND OTHER POSTURAL CHANGES
  • DIFFICULTY WITH PHYSICAL ACTIVITIES
  • IRRITATION TO THE SKIN IN THE CREASE UNDERNEATH THE BREASTS
  • FEELINGS OF SELF-CONSCIOUSNESS

WHO IS A CANDIDATE?

WOMEN WITH DISPROPORTIONATELY LARGE BREASTS ARE GOOD CANDIDATES FOR SURGERY. THIS IS DONE FOR BOTH COSMETIC IMPROVEMENT AND SYMPTOMATIC RELIEF. IN GENERAL, WOMEN WITH SIZE DD OR GREATER ARE THE MOST FREQUENT CANDIDATES. HOWEVER, EVEN SIZE C OR D CAN BE TOO LARGE FOR A PETITE WOMAN. WHILE WOMEN FROM ANY AGE CAN BENEFIT FROM THE PROCEDURE, IT IS USUALLY PERFORMED AFTER THE BREASTS ARE FULLY DEVELOPED

BEFORE ANESTHESIA IS GIVEN. THE DOCTOR NEEDS AN ARCHITECTURAL PLAN TO ENABLE HIM TO MAKE ADJUSTMENTS THAT WILL ACCOMMODATE THE CHANGES OF THE BODY AS IT MOVES FROM A PRONE POSITION TO AN UPRIGHT POSITION. WHATEVER TECHNIQUE IS USED, THE SKIN WILL NEED TO BE TIGHTENED AS THE NIPPLE-AREOLAR COMPLEX IS MOVED UP. EXCESS TISSUE WILL BE REMOVED AND REMAINING TISSUE WILL BE CONTOURED AND RESHAPED. LIPOSUCTION IS USED IN MANY CASES FOR REMOVAL OF EXCESS FAT THAT MAY BE ON THE SIDES OF THE CHEST.

THE SHORT-SCAR OR LOLLIPOP TECHNIQUE WAS DEVELOPED IN EUROPE AND NOW SHARES GREAT POPULARITY IN THE UNITED STATES. THIS PROCEDURE LIMITS THE INCISIONS AND RECONSTRUCTS THE INTERNAL BREAST TISSUE TO A MORE CONICAL SHAPE, GIVING THE BREASTS A YOUTHFUL APPEARANCE THAT IS LONG LASTING. THE INVERTED-T TECHNIQUE IS A TIME-TESTED GOLD STANDARD. THIS PROCEDURE CAN BE USED FOR ALL SIZE BREAST LIFTS AND REDUCTIONS. THE SKIN INCISION IS MADE LIKE THE LOLLIPOP INCISION, BUT AN ADDITIONAL HORIZONTAL INCISION IS MADE ALONG THE CREASE. THIS CAN TIGHTEN THE SKIN TO A GREAT EXTENT, BUT AT THE EXPENSE OF A SLIGHTLY LARGER INCISION. THE SHAPE OF THE BREASTS RELIES LARGELY ON THE SKIN-TIGHTENING COMPONENT.

THE FREE-NIPPLE GRAFT TECHNIQUE IS USED FOR VERY LARGE-BREASTED WOMEN, IN WHICH THE ANCHOR TYPE OF PROCEDURE IS NOT SAFE. THE FREE-NIPPLE TECHNIQUE EXCISES THE NIPPLE OFF OF THE UNDERLINING BLOOD SUPPLY. THE SKIN AND BREAST IS RECONSTRUCTED MUCH LIKE THE INVERTED-T TECHNIQUE, THE NIPPLE IS REPLACED AND SEWN INTACT AS A FULL-THICKNESS SKIN GRAFT. THIS TECHNIQUE WORKS EXTREMELY WELL IN LARGE-BREASTED WOMEN. THE SCARS ARE SIMILAR TO AN INVERTED-T. THE NIPPLE-AREOLAR AREA USUALLY LOSES SENSATION.

ONCE THE INCISIONS ARE MADE AND THE BREAST TISSUE IS REDUCED, THE SKIN IS METICULOUSLY CLOSED IN SEVERAL LAYERS. STERI-STRIPS™ ARE PLACED OVER THE SUTURED INCISION LINES, GAUZE PADS ARE PLACED OVER EACH BREAST AND A SOFT COMPRESSION BRA WITH FRONT HOOK CLOSURE IS PUT ON THE PATIENT.

ANESTHESIA

THE SURGERY IS DONE UNDER GENERAL ANESTHESIA.CLICK THE IMAGE TO VIEW MORE PICTURES

POST-SURGERY

AFTER SURGERY, THE PATIENT WILL BE KEPT IN THE RECOVERY ROOM FOR A FEW HOURS. THE PATIENT WILL BE ALLOWED TO GO HOME WITH THE HELP OF A FAMILY MEMBER OR FRIEND ONCE SHE IS FULLY AWAKE. .

IN 3 TO 5 DAYS THE DRESSINGS WILL BE REPLACED, AND IF DRAINS ARE USED, THEY WILL BE REMOVED. IN 24 HOURS AFTER THE DRAINS HAVE BEEN REMOVED, THE TINY INCISIONS WILL CLOSE, MAKING THEM WATERPROOF AND THEN IT IS SAFE FOR THE PATIENT TO SHOWER. UNTIL THE DRAINS ARE REMOVED THE PATIENT MAY ONLY TAKE SPONGE BATHS, AS THE INCISION SITES ARE VULNERABLE TO INFECTION AND THEREFORE MUST BE KEPT DRY. THE SURGERY BOOKLET HAS DETAILED INSTRUCTIONS FOR WOUND CARE.

AFTER THE FIRST WEEK, MOST OF THE SWELLING AND BRUISING WILL BE RESOLVED, BUT WOMEN SHOULD ALLOW THEMSELVES TWO FULL WEEKS FOR RECOVERY. THE PATIENT IS ABLE TO RETURN TO NORMAL ACTIVITIES AFTER THE BRUISING AND TENDERNESS HAVE RESOLVED.

ALL SURGERIES CARRY THE RISK OF INFECTION, BLEEDING AND ANESTHESIA COMPLICATIONS. REDUCTION MAMMOPLASTY WILL LEAVE SCARS FROM THE INCISION AROUND THE NIPPLE-AREOLAR COMPLEX CONTINUING TO THE BASE OF THE BREAST AND ALONG THE BREAST FOLD WHEN USING THE INVERTED-T TECHNIQUE. IT IS POSSIBLE THAT THERE MIGHT BE A REDUCTION IN SENSATION OF THE NIPPLE AND BREAST AREA. IT MAY TAKE UP TO 6 MONTHS FOR THE FEELING TO RETURN. BREASTFEEDING USUALLY REMAINS AN OPTION FOR WOMEN THAT HAVE HAD BREAST REDUCTIONS, BUT THERE MAY BE A SMALL MINORITY THAT WILL LOSE THE ABILITY TO NURSE. IN RARE INSTANCES, ONE BREAST MAY BE SLIGHTLY A DIFFERENT SIZE. THERE MAY BE SOME SLIGHT DIFFERENCES WITH THE NIPPLE-AREOLAR COMPLEX.

RESULTS

WOMEN ARE ABLE TO ENJOY IMMEDIATE RESULTS OF THEIR BREAST REDUCTION, BUT NEED TO PLAN ON AT LEAST A COUPLE OF MONTHS FOR THEIR BREASTS TO SETTLE INTO THEIR NEW POSITION AND SHAPE. RIGHT AWAY WOMEN WILL NOTICE THAT THEIR BALANCE IS BETTER. SHOPPING AND TRYING ON CLOTHES WILL BE A GREAT EXPERIENCE. IMPROVED POSTURE, AND REDUCTION IN BACK AND NECK PAIN WILL BE REALIZED AS THE BODY ENJOYS A LIGHTER GRAVITATIONAL PULL. EVEN THOUGH THERE ARE SCARS THAT RESULT FROM THIS SURGERY, BREAST REDUCTION PATIENTS ARE SOME OF THE HAPPIEST PLASTIC SURGERY PATIENTS STATING THAT THE CHANGES THAT THE SURGERY HAS MADE ARE LIFE CHANGING.


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Mammary hypoplasia is defined as a breast volume which is insufficiently developed in proportion to the patient’s morphology. It can be a pre-existing condition (small breasts from puberty) or appear later, after substantial weight-loss, a pregnancy followed by breast-feeding, or hormonal problems.
It can occur alone or be associated with ptosis, that is sagging of the breasts and skin stretching and a lowered areola.
The great majority of implants used in France and elsewhere in the world are pre-filled silicone gel implants.
These implants, are very close to the consistency of a normal breast.
The most important points concerning the new generation of implants, which ensure their safety, are the new improved envelopes and the gel itself.
The shells, which are now stronger, prevent any leakage of gel (which was a cause of capsule formation) and have much greater resistance over time.
• BEFORE THE PROCEDURE

A thorough preoperative examination with blood tests will be carried out as prescribed.
An anesthesiologist will see you in consultation at the latest 48 hours before the operation. In addition to the usual preoperative tests it can be helpful to use medical imagery, (mammography, echography).
No aspirin-based medication should be taken during the 10 days preceding the operation.
You will probably be asked not to eat or drink anything for six hours before the operation.

• HOSPITAL STAY AND TYPE OF ANESTHESIA

Type of anesthesia
This is usually classic general anesthesia, you will sleep throughout the operation. Rarely ‘twilight’ anesthesia is used (local anesthesia with intravenous sedation), this can be discussed with the surgeon and anesthesiologist.

• THE PROCEDURE

Each surgeon has adopted his or her own specific technique, which he or she adapts in order to obtain the best results in each case.
We can however give some basic points:
The incisions
jj There are several possible approaches
– Peri-areolar approach (around the areola) the incision is either below the circumference of the nipple or horizontal to the nipple (1&2).
– Axillary approach
The implant is inserted through a small incision situated in the armpit (3), or in
– The inframammary approach
The incision is in the inframammary fold (4).

These incisions correspond of course to the position of future scars which will thus be hidden in natural folds or lines.
Sacars: 1 or 2 in the areola, scar 3 in the armpit, scar 4 in the inframammary fold

The position of the implant
jj2
jj3
This can be in a pocket made in the breast tissue behind the mammary gland and in front of the pectoral muscle, or behind both the mammary gland and the pectoral muscle.
The choice of position will have been predetermined with your surgeon.
– Implant in front of the muscle,
– implant behind the muscle; gland

The choice of position will have been determined in consultation with the surgeon.
• AFTER THE OPERATION

There can be pain for the first few days after the procedure, particularly when the implant is large and/or placed behind the muscle. In this case pain medication of the strenth necessary to dull the pain, is prescribed for several days.
Even if there is no pain there will be a strong sensation of tightness.
• THE RESULT

This can be truly seen from two to three months after surgery, the time necessary for the breasts to become softer and for the implants to settle. The procedure will have improved not only the volume but the shape of the breasts.

All things considered, the risks must not be overestimated, but you must be conscious that an operation, even a minor one, always has some degree of unknown factors.
You can be assured that if you are operated on by a qualified Plastic Surgeon, he will have the experience and skill requires to avoid these complications, or to treat them successfully if necessary.