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Breast reduction Tunisia

Definitions

The mammary reduction is an intervention indicated in the cases of hypertrophy with ptose mammary.

The patients often complain of " big breasts which fall ".

The breast is established from a woman to the other one and according to the episodes of the genital life of three components: the fat, the glandular tissue and the connective tissue (photo 1, 2 and 3).

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    Photo 1
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    Photo 2
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    Photo 3

The weight gain during the puberty is an obvious risk factor of the mammary hypertrophy at the girl.

The mammary hypertrophy, by its greasy component, is of course, frequent for the obese woman's.

THE MAMMARY HYPERTROPHY IS QUALIFIED OF :

  • Moderate when the volume of the breast is estimated between 400-600 cm3.
  • Rather important: 600-800cm3.
  • Important: 800-1000 cm3.
  • Very important beyond 1000 cm3.
  • Gigantomastie: volume of the breast estimated at more than 1500 cm3.

The ptôse of the breast, when it is an almost inevitable physiological phenomenon. We describe besides two types of ptôse :
Glandular Ptose : by involution of the gland (photo 4)
Cutaneous Ptose : by ageing of the skin (photo 5)

Breast reduction tunisia

CLINICAL EXAMINATION / THE DEMANDS OF THE PATIENTS

ON THE FUNCTIONAL DRAWING

The volume and the weight of breasts are, obviously, source of continuous unease to type of pains and cervical aches, (photo 6) indeed breasts are described as " heavy to carry" and source of a real physical handicap in the fulfillment of the movements of the daily life. On the other hand ,the macerations, very frequent, in folds under mammary, are very badly lived.

For all these reasons, the mammary reduction is an intervention in great demand even if scars will be present on the operated breast.

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    Photo 6

ON THE ESTHETIC PLAN

Photo 7

Although the demand of mammary reduction is most of the time of functional order, highly-rated unsightly of the hypertrophy returns frequently in the speech of a patient who consults for a mammary hypertrophy :

" I do not know any more where to hide them! ", " I always have the impression that we do not look at me in eyes but that we look at my breasts! " ( Photo7 )

The clinical examination absolutely has to eliminate a contraindication in the plastic surgery of the breast, a radiological and ultrasound balance assessment is systematically asked to make sure of the integrity of the breast.

A consultation of anesthesia is planned for the good progress of the intervention which will take place under general anesthesia.

THE intervention

PRINCIPLE

The volume of the mammary gland consists in reducing and in going back up areolas, this at the price of a scar which will be as the case may be, vertical line (photo 8) or having the shape of the letter T inverted photo 9).

This intervention lasts as this case may be between 2 and 3 hours.

OPERATING TIMES, BASIC PRINCIPLES

  • It will be drawn by the surgeon on a patient up. It is the very important time which will guide and will facilitate the operating act. This drawing will be a function of the technique planned for the mammary reduction ( photo10 ).
  • The aréolaire désépidermisation
  • Dissection of a scrap carries mamelon
  • Resection cutaneo-glandulaire
  • Raise the areola and the closure
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    Photo 10

The final scar is a function of the technique used to reduce the breast. Several techniques exist, to the surgeon to choose the one who is the most suited to the breast in question. Techniques used for important hypertrophies are generally in pedicule upper or more supero-internal, the final scar draws the letter T inverted (photo 11). The "vertical" technique, is classically indicated for the small and average hypertrophies, it is besides more and more used for the big hypertrophies (photos 12, 13, 14)

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    Photo 11
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    Photo 12
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    Photo 13
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    Photo 14

POSTOPERATIVE

This surgery requires 24 at 48 hours of hospitalization, the used threads are absorbable, a drain of redon is put to evacuate a possible bruise, it will be removed at the end of 24 or 48 hours, it will be necessary to plan the port of a hanging bra 1 month, It will be necessary to plan a work stoppage) of one to approximately two weeks.

See also