|
Patients Articles
Too Much Breast?
I
was conversing with a friend the other day about the
importance that our culture places on the form and size of a
woman’s breast. And we commented on the latest thing to get
that volume that today is perceived as aesthetically pleasing.
The opposite, that is to say, the excessively big breast is
something more problematic. It is not unusual that our
patients come to our office at an early age, sometimes
accompanied by their parents who complain about their
daughter’s supposed obsession.
In fact, nobody goes for aesthetic correction because of a
problem of more or less just a few centimeters, but for the
insecurity that size or form cause (with all its consequences)
in the permanent development of a young woman’s life.
When the breast has grown more than one suffers to accept,
some important relationship problems are created: clothes,
sports, the bathroom, walking down the street... everything is
difficult. And no one other than one who suffers the problem
knows how it negatively affects the quality of life. This is
the main reason for which adolescents, as early as age
fourteen, request the correction. And with the passing of
years oversized breasts can cause further, often more serious
problems, such as pressure on the lower part of the back that
can end up being unbearable.
Bras (brassieres) do not by themselves solve the problem, but
frequently cause greater difficulties, including depression
marks from the suspenders, compressions for not very
appropriate forms... It is not difficult to find serious back
problems in older women. This circumstance, can become a
chronic pathology, for a lifetime, because this situation was
tolerated.
Then, when is a breast so excessive as to think about its
reduction? Subjectively excessive: when the patient can’t
psychologically tolerate its form and volume. This is the
aesthetic indication. And objectively: when, although they
don't affect the patient personally, their size and
circumstances make fear a future pathology. It is the clinical
indication. Most of the times both circumstances usually
overlap.
Treatment? The surgery.
But what does the intervention consist of?
Several technical modalities exist, the purpose of all of them
is the same: to reduce the breasts’ weight and volume, while
achieving an aesthetic form at the same time. The intervention
is done with general anesthesia. The intervention is
previously planned based on the pictures. The design is made
with the patient awake and in vertical position adapting the
lines to the real measures of the patient.
We said that there are several tendencies regarding the
surgical techniques, however, there is no procedure that
avoids creating a scar. The connecting of flesh is a process
of biological repair that depends on the genetic informants
peculiar of each individual. There is no reliable laboratory
test that tells us how the scar will be. We know nonspecific
facts that we use: the direction of the skin’s lines of force,
specific instrumental, non-traumatic manipulations, highly
inert sutures. In spite of all these techniques, the final
result of a skin union is always an imperfectly controlled
mystery.
In the reduction of the breasts we always fight to get scar
marks smaller, but hide-and-seek and small, has not arrived at
satisfactory results but we should always think of a tribute:
THE NON AESTHETIC OVERWEIGHT FOR THE HIDDEN MARKS.
Within the accepted procedures the final scarring is found
according to a person’s image:
Those of typical anchor shape scars are found in people of the
Caucasoid countries
Those of an L or typical inverted T scars are found in people
of the Latin countries.
In periareolar incision:
·
Combination of the same ones according to each
particular case and the surgeon's knowledge.
·
The postoperative stage is very dynamic: The
slight cases can be developed in an ambulatory way. The bigger
cases should remain hospitalized for at least 24 hours. After
that time, the patient can develop her moderate normal
activity.
·
A bra with an appropriate design of scarring
control is indispensable. The nuisances are minimal and the
outcome is very satisfactory.
·
In short it is a very rewarding surgery for the
patient and for the surgeon.
Daniel Peñafiel S. M.D.
|
