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Dr. Júlio Stédile, M.D.

Facial Plastic Surgery

Facial Plastic Surgery
&
Otorhinolaringology

Breast Reduction

Breast reduction is one of the most common cosmetic surgeries and its goal is to decrease the size and weight of the breast, providing it with a new shape. Breast flaccidity can also be corrected.Given that the there are several breast shapes and sizes, there are also variations in the technical details that must be used for each particular case in order to always achieve the best result.

  • General or peridural anesthesia.
  • Surgery time up to 5 hours.
  • Hospitalization time 1 day.
  • Periareolar scar, vertical at the center of the breast and transversal in the submammary groove.

PREOPERATIVE RECOMMENDATIONS:

  1. Inform the medical staff 2 days prior to the surgery, at most, about the occurrence of flu, discomfort or fever
  2. Discontinue any medication for weight loss that might be being taken for at least 14 days prior to the surgery, including diuretics
  3. Preoperative behavior is also crucial for a successful surgery. For at least 15 days prior to surgery, excessive use of medications or alcohol must be avoided; specifically for tobacco, abstention must last at least one month before the procedure. Diabetics and hypertensive individuals must have their conditions managed
  4. The doctor will request several essential exams, such as electrocardiography, total blood count, coagulogram, fasting glycemia, electrolytes, HIV, urine and mammography. Patients with chronic diseases need specific tests and clinical evaluation before the procedure
  5. The surgeon must be informed of the use of any medication, since some drugs may contribute to the risk of hemorrhage: acetylsalicylic acid (aspirin), nonsteroidal anti-inflammatory drugs, anticoagulant agents, vitamin E, vitamin C, ginkgo biloba, ginseng, garlic, alcoholic beverage, and some homeopathic medicines used on a continuous basis
  6. 6 – The patient must plan her professional and social activities so as not to become indispensable for other people for at least 21 days

SURGICAL TECHNIQUE

There are variations in the technique employed. Usually, there are two scars, one with the shape of an inverted “T”, on the lower portion of the breast, and the other located around the areole, which is usually disguised to a great degree due to the color transition between the areole and the normal skin.

POSTOPERATIVE RECOMMENDATIONS:

  1. The drain is usually removed on the 1st or 2nd day after surgery. Shapers and elastic dressings specially adapted to every type of breast will be used and replaced on a regular basis. The patient can take a full bath on the 2nd or 3rd day. Avoid keeping the operated region wet for 7 days
  2. Most of the stitches are internal. External stitches are removed between the 10th and 15th day
  3. Any strenuous activity must be avoided, especially sudden movements of the arms and lifting heavy objects, for 4-6 weeks
  4. Due to the postoperative inflammatory process, changes may occur in the color and texture of the breast skin, along with some hardening of the breast; which should be resolved in around 20 days. To provide relief from these changes, the surgeon may recommend massage procedures
  5. No medication that was not prescribed by the doctor should be taken
  6. Don’t expose the operated area to sunlight for two months
  7. Even if the patient is feeling physically well, she should not forget to refrain from making physical efforts for 60 days
  8. Wear a special bra for at least 30 days

COMPLICATIONS:

Hematoma, seroma, infection, asymmetries, hypertrophic and keloid scars and anesthetics-related problems may occur.

Scarring undergoes different periods:

a) Immediate period: lasts until the 30th day and the scar is barely visible. In some cases, a mild reaction to stitches or dressing may occur.

b) Intermediate period: lasts from the 30th day to the 12th month.

In this stage, there is a natural thickening of the scar and a change in its color, shifting from red to brown and becoming increasingly clearer. This is the least favorable period of the scarring process and is the one that causes most concern to patients. However, we recommend that patients not worry about it because in the later period scar vestiges will decrease.

c) Late period: lasts from the 12th to 24th month. In this period the scar will take on its definitive appearance, becoming clearer and losing consistency.

SCAR VISIBILITY

Some patients tend to hypertrophic or keloid scarring. This trend can be predicted during the medical visit to some degree due to the patient’s clinical history and family characteristics.
Light-skinned people are less likely to have this scar-related complication, while people with darker skin are more predisposed to keloid or hypertrophic scars. However, this is not an absolute rule.
For the correction of hypertrophic or keloid scars there are several clinical and surgical resources that allow unaesthetic scars to be improved.
Procedures for eventual corrections will be performed at the right time, according to the existing scar alteration, the size and consistency of the new breast.

THE BREAST UNDERGOES DIFFERENT EVOLUTIONAL PERIODS:
a) Immediate period: until the 30th day. In this period, the shape of the breast is not as was planned yet, although the appearance of the breast seems better.

b) Intermediate period: from the 30th day to the 8th month. In this period, the breast evolves towards its ultimate shape. The nipple may still be sensitive and some “swelling” may remain. The shape of the breast is still evolving.

c) Late period: from the 8th to the 24th month. In this stage, the breast finally takes on its ultimate appearance as regards its shape, consistency, size, sensitivity and scarring.

CHANGE IN THE RESULT IN CASE OF PREGNANCY.
Usually, there are no problems in case of pregnancy. However, when the breast is too large and is subjected to a major reduction, lactation may be impaired. In cases of small and medium reductions, lactation can be preserved.

RESULT EVALUATION
The evaluation of the final result of the breast reduction surgery can only be performed between the 12th and 24th month postoperatively after the tissue has undergone all scarring phases.
If you’re concerned with attaining the final result before the expected time, don’t let it become a source of suffering. Be patient, your body will eventually get rid of all immediate discomforts.

BE WISE WHEN YOU CHOOSE A SURGEON. Just like in all other professions (lawyers, teachers, politicians, masons, cabinetmakers, baby-sitters, plumbers, etc.), there’s also a significant difference in the quality of the medical work provided.

REMEMBER THAT DIFFERENT SURGEONS HAVE DIFFERENT MEDICAL BACKGROUNDS, FOLLOW DIFFERENT PROCEDURES, HAVE DIFFERENT ESTHETIC VIEWS AND OBTAIN SIGNIFICANTLY DIFFERENT SURGICAL RESULTS.

Address

Dr. Júlio Stédile M.D.
Av. Dr. Nilo Peçanha, 2825/1403 ZIP CODE 91330-001
Bairro Três Figueiras - Porto Alegre/Rio Grande do Sul - Brasil
Phone: +55 (51) 2111-1017 / +55 (51) 2111-1018

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