Frequently asked questions
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Reduction Mammoplasty

1. What are the scars of breast reduction?

There are numerous techniques described for breast reduction and breast lift, each with its advantages, disadvantages and indications. Thus, the shape and extent of the scar will depend on the technique used and the patient's breast type, which will be defined during the medical appointment. From these variables, one can have periareolar scar mammoplasty, vertical scar, inverted T (horizontal and vertical) or L-shaped scar.

2. How to know if I will develop very visible scars, forming keloids?

The aim to develop hypertrophic or keloid scars is greatly influenced by genetic factors. In general, fair-skinned people are less prone to this healing complication, whereas dark-skinned or oriental people are more prone to keloid or hypertrophic scarring. This tendency can be predicted to some extent during the first appointments when the surgeon asks a series of questions about the patient's previous clinical life, as well as the analysis of family characteristics, which often aid in the prognosis of scars. This trend, however, is not an absolute rule, as background analysis facilitates prognosis, but does not define it. This genetic tendency will influence the scar, regardless of its extension or shape.

3. Is there correction for these unsightly breast scars?

Nowadays, plastic surgery has several features that allow not only to improve such scars (keloids and hypertrophic scars) but also to prevent their appearance. Corticoid-based ointments and injections at the scar site and small compressive silicone plaques constitute the main treatment that will be instituted by your surgeon at the appropriate time. It is important not to confuse keloids or hypertrophic scars with the normal course of a scar, which maintains a reddish appearance for the first 2 months and gradually improves over time. In addition, doubts about your scar should be answered by the plastic surgeon and not by third parties.

4. Is postoperative mammoplasty painful?

In the early days it is normal to feel a slight pain, which gives away perfectly with the use of common painkillers and anti-inflammatory drugs. During this period, the patient's rest helps a lot in pain control and therefore it is important to follow medical guidelines regarding arm movement, physical activities and other efforts to avoid severe pain.

5. What type of anesthesia is used?

In great majority of cases epidural anesthesia, in some cases general anesthesia. The anesthesia indications, advantages and disadvantages will be specified by the anesthesiologist during an appointment before the surgery.

6. How long does the surgery last?

Depends on each patient, however the average mammoplasty is between three and four hours.

7. How long will I be hospitalized?

Usually for 24 hours.

8. Are drains used in breast prosthesis surgery?

Usually a small drain stays inside the breasts for an average period of 24 hours, being removed before hospital discharge. The drain is important to prevent the accumulation of blood and secretions inside your breast, reducing the incidence of complications in surgery and assisting in the regression of postoperative edema.

9. When can I perform physical activities?

Generally, you will be able to perform lighter walks after 3 weeks of surgery. Running and cycling, just one month after surgery and weight training, 2 months later. These periods are average, so it is important to ask your surgeon if you are qualified to perform any kind of physical activity before doing so.

10. How long will I have to wear the surgical bra (mesh)? And when can I sunbathe again?

It is recommended that the surgical bra is worn for at least 1 month after surgery, as it will decrease breast swelling and protect scars, which is not the case with conventional rimmed bras. In the 2nd month it is allowed to alternate periods using the surgical bra and rimless bras, as well as short periods without using the bra, following the surgeon's assessment.

As for the sun, the ideal is that the patient protects herself for at least 3 months. During this period, the mammary scar preserves local redness, which is fully expected and regresses spontaneously as it matures. If the patient exposes himself to the sun without adequate sun protection, the scar may appear darker (hyperchromic) and will not have a pleasant aesthetic result. Even after the 3rd month, the ideal is for the patient to apply sunscreen factor 50 to the scar region whenever sunbathing, because even hidden by the swimsuit there is the action of sun rays on the breast scar, which does not occur with the application of the sunscreen.

11. I have sagging, sagging breasts, but I'm happy with the size. Can I perform mammoplasty without reducing breast size?

Usually yes. In this case, the surgery is called mastopexy (breast lift). Technically, this mammoplasty can be performed only with the removal of the skin, without the removal of the breast tissue that is performed in the reduction mammoplasty. The extent and shape of the scars depend on the degree of fall (ptosis) of the breasts, and may be periareolar, inverted T-shaped, L-shaped or only vertical. It is important to remember that the removal of the skin provides a small reduction of the breasts, however it is necessary to provide proper breast repositioning.

12. What will breast size and consistency look like after surgery?

The breasts may be reduced in reduction mammoplasty or maintained in mastopexy. In addition, consistency and shape will naturally be improved after surgery, with correction of breast ptosis (fall) or hypertrophy, if any. Thus, in cases of volume reduction or correction of breast ptosis, it is possible to opt for several volumes that the original breast allows, without compromising it in the future. As with breast augmentation surgeries, the proportions between the volume of the new breast, the size of the chest and the height of the patient should be balanced, providing aesthetic harmony. It is also important to remember that the new breasts go through the following evolutionary periods:

a) Immediate Period: goes until the 30th postoperative day. In this period, although the breasts show remarkable improvement in appearance, the shape is still short of the planned result, after all, until it reaches the definitive shape, appearing "small defects" apparent early (inevitable in all cases), which tend to disappear over time. Remember that no breast is perfect after surgery, the result is gradual and improves over the months.

b) Mediate Period: goes from the 30th day to the 6th postoperative month. In this period, the breast begins to present an evolution that tends to the definitive form.

During this time, insensitivity or hypersensitivity may occur in the nipple region, in addition to a greater or lesser degree of "swelling" of the breasts; Moreover, its shape, although very close to the definitive one, still tends to improve. The scars, once reddish and hardened, begin to acquire a lighter color and consistency closer to the definitive. Despite some euphoria of most patients already in this period, the result will be even better in the coming months after surgery.

c) Late Period: goes from 6th to 12th month. It is the period when the breast reaches its final appearance (scar, shape, consistency, volume, sensitivity) and that minor imperfections that existed in previous periods are naturally corrected, as well as the regression of edema and aesthetic improvement of the scar. The degree of elasticity of the breast skin and the volume achieved are of great importance in maintaining the end result and it is worth remembering that the balance between both varies from case to case.

13. How long after mammoplasty will I reach the definitive result?

As mentioned above, the immediate result is very good, however only between the 6th and 12th month the breasts reach definite shape, consistency, sensitivity and volume.

14. If I get pregnant, will the result remain or be impaired?

Maintaining the outcome depends on a number of factors. Certainly, one of the main ones is the weight gain obtained during pregnancy. Exaggerated weight gain during pregnancy (over 15 kg) causes distension of the breast skin and after weight loss this skin may or may not return to its previous appearance. Lactation (breastfeeding) also assists in this breast distension. If the mammary skin does not return to its original aspect, breast ptosis (fall) may occur to a greater or lesser extent, depending on the distension to which the skin has been subjected. The surgeon's guidance in a future pregnancy should be to perform appropriate nutritional follow-up that allows you to gain just enough weight during pregnancy (an average of 7 to 10kg) and to follow routine breast skin care using specific moisturizers and creams to prevent stretch marks and maintain normal skin consistency. With regard to lactation, there is usually no impairment, and can be affected only in cases of large breast reductions (gigantomastias).

15. When will the mammoplasty stitches be removed?

In general, there will only be stitches around the areola, because the rest of the scar will have internal points and surgical glue (Dermabond). These points will be removed in surgeon’s office between the 7th and 10th day, without major inconvenience.

16. Do I have to wear dressings?

Yes, modeling dressings are used to protect scars and accelerate regression of breast edema. These dressings are changed periodically in the office during the period determined by the plastic surgeon.

17. When will I be able to take bath normally?

Usually 48 hours after surgery. After this period, the ideal is to avoid moistening the scars in the first week, always keeping them well dry to accelerate healing and prevent surgical infections.

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