Restoring of the slackened breasts, or stretched any other way breasts sewing up, that is to say, restoring their original young-looking, erect feature, are the most frequently done intervention in our clinic. Basically the need to do these arises when the connecting-tissue is loosened and. although playing a smaller role, the regressing of the stock of glands. The chest muscle does nothing about it, and with gymnastics, as some people think, delaying or stopping the loosening of breasts is also impossible.
In the case of thinner-skinned, bigger breasts the systematically worn brassier might possibly slow the course of slackening.
The course of slackening more often happens after childbirth and breast-feeding because the skin, which is so important to keep the shape, stretches and becomes thinner. This is caused by mechanic and hormonal influences during the pregnancy and so stops after the suckling, when the glands regress exaggeratedly. It is very important to know that for the disadvantageous change of the breast’s form, not the suckling but the pregnancy is responsible. Therefore it is absolutely meaningless to give up breast feeding, which is so important for the newborn, mainly during the first months.
Sometimes the breasts might slacken without pregnancy, because of the passing time, or their own weight. Sometimes at very young age the connective tissues are weak, because of a constitutional defect, or there is asymmetry and therefore slacken the breasts. Also, a fast slimming cure might cause the breast’s slackening. It is important is to carry out a slimming cure before the breast plastic operation and not after.
The essence of this kind of operation is the lifting the stock of glands; taking off the superfluous skin, forming cone-shaped breasts and fixing them. In these kind of cases the mass of the breasts don’t change, if the breasts are disturbingly big, or there are significant differences between the two of them, there is a possibility to decrease the mass by taking off a part of the stock of glands. It occurs, not very often, that there aren’t mouldable amount of glands, and the skin has slackened. Only the sewing up cannot give a good result, therefore we replace it by building in a silicon implantatum. The breast is lessened and the sewing up, the implantation+correction, are done in one sitting. Sewing-up, the breast the increase or decrease of breasts results in similar scars on the chest. Altough in ideal cases the scar thin, might be pale, but remains permanently.
The circle of the nipples is generally decreased, so they become definitely round and well shaped.
There are three different kinds of operations, which leave slightly different scars:
Around the nipple-techniques:
At this type of operation a scar issues only around the nipple.
Disadvantage: It can be only seldom used with particular shaped breasts. Only at definitely tube shaped breasts- so called tubularis shaped- is the operation able to produce well formed breasts. Otherwise the area at the middle would be too flat. The scar around the nipples is wrinkled but later on it becomes smooth.
The circle around the nipple might increase later.
Short scar techniques:
Only around and below the nipples issues one vertical scar. Lately this technique is used more often.
Advantage: Shorter scar, relatively lasting shape, less after-slackening.
Disadvantage: In the case of vertical cicatrise, there might be more problems with healing, the scar is temporary very wrinkled and becomes smooth only after1-2 months. Also for the first couple of weeks, the shape of breast isn’t yet final.
Reversed T shaped or anchor shaped cutting.
Around and below the nipple a short vertical cut is made. This results often at the bending a longer horizontal scar.
Its advantage is: that this technique is well used for bigger breasts the healing generally produces no problems and leaves thin scars.
Disadvantage: leaves a relatively longer scar-line
Although in the case of smaller breasts, the operation can be done with local anaesthesia, but we, in the sake of the patient, apply general anaesthesia because it is more comfortable for her and safer. Before the operation a general health check, laboratory test /blood and urine / ECG have to be done, and in our clinic they are available. A mammography check might be needed above the age of 35 years.
On average the duration of operation is 1,5 – 3 hours. Over the operated area we put a bandage, which consists of impregnated sheets, sterilized gauze, strong adhesive, nonallergiesing strips that secures the new shape, and a tailor made brassiere. In case of more reduction we put in a thin man-made tube, a drain that leads out mucus. With this any possible complication might be avoidable. The drain is taken out the day after the operation.
The ladies spend one night in our clinic, and can go home in the next morning. It is better to travel by car, but obviously you may not drive. Driving is allowed only after 3-4 days. It is important for the patient to have home-rest and stay in bed for 7-10 days. The patient needs the utmost forbearance. She has to decrease every physical activity, including the wide movement of arms. After the 7th-10th day, sitting in the office, or easier physical work etc. might be done. During the first two weeks the patient has to see us, two times weekly, for checking the wound, and changing the bandage. At the 12th-14th day the seams are taken out.
Ache: A blunt, tensing ache might occur during the first 3-4 days. This isn’t too strong and decreases gradually. Simpler painkillers, such as Demalgon, and Algopyrin will help effectively. In the 4th-5th day itching arising at the scars mean that the healing is going on.
Washing: Water isn’t allowed to get to the wound for four days. From the 5th days a shower is possible, but no bath. During showering the clean or soapy water will not cause inflammation. After a short shower the breasts can be dried by a soft, newly ironed towel, but not by rubbing of the operated surfaces. After finishing the shower sterilized gauze-sheets have to be put on the wound and they have to be tightened by a brassiere.
Two weeks after the operation the patient might go back to her normal style of life, to her job and if she lives abroad, may go home. It is still advisable to avoid for a couple of months intensive sports, mainly those which need wide moves of arms / Tennis, swimming/ and the stronger shaking of the body. /dancing, gymnastics, aerobics, etc./ Also more care needs to be taken during the sexual life. We don’t propose sunbathing, or using the solarium for 4-5 weeks and after this period, for half year a light-reflecting, sunbathing cream is needed. The wearing a brassier is also important for up to 2-3 months time, but only in the daytime.
The duration of the operation might be disadvantageously influenced by different kinds of effects. The following situations should be avoided: frequent body-weight variation, speed weight loss and heavy smoking. For bigger breasts it is advantageous to wear, if only temporarily, a brassier. By this additional slackening might be avoidable and so is the chance of a further repeated operation. The ableness for childbirth, or breast-feeding after the operation is influenced only in 5%. After repeated childbirth, or childbirths the breasts might slacken, so a correcting operation might be needed.
Just as after every operation, and equally with breast sewing up, there might occur complications. Their results are possibly longer healing, more after-care and rarely a newly made operation. In 2-3% of cases there might occur after-bleeding, inflammation and more rarely, in 1 % necrosis of tissue, this might be limited to the fat cells or to the skin. Very seldom it happens that the total or partial necrosis of nipples can occur: this could be cured by another operation. Pathological cicatrices come only in few cases and are greatly influenced by the individual inclinations. For treating the thicker scars we have lots of conservative methods, but if these cannot help we can create an acceptable solution by a smaller correcting operation.
Troubles with sensation might occur in 4-5% of cases. In these cases around the nipples and on the neighbouring skin surface occurs unsensibilities or changing sensation but these generally are last only temporarily, for a couple of weeks, and after they cease. Rarely, the time of regeneration lengthens possibly for one year long.