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Breast reduction may give women with large pendulous breasts relief from a variety of problems, from back and neck pain and irritated skin to skeletal deformities and breathing difficulties. These patients often complain of painful grooves in their shoulders produced by their breasts. In these cases the ideal procedure is a reduction mammaplasty in which the surgeon will not only reduce the size of the breast, but will sculpt it to give the best possible shape. In some patients the problem is mostly stretched skin with looseness of the whole breast in which the problem is confined to the shape and form of the breast. In these cases a breast lift is the ideal procedure and the surgeon will create a better shaped breast without necessary reducing the size of the breast. In fact sometimes these procedure is performed in conjunction with breast augmentation, depending on the size of the breast. Of all plastic surgery procedures, breast reductions and breast lifts result in the quickest body-images changes. Having a cosmetic breast procedure can greatly improve the way a woman sees herself, resulting in an enhanced self-esteem. THE PROCEDURE Depending on the size of the breast there are several variations of techniques employed. The most common technique employed is the classic Pitanguy technique which is used for larger and/or very flaccid breasts. In these cases incisions are placed circling the areola, extending downward, and following the natural curve of the crease beneath the breasts. The areola is reduced in diameter if needed and excess glandular tissue, fat and skin are removed. Subsequently the areola is placed in the new higher position even with the inframmamary crease or a little higher. The remaining tissues are reshaped around the areola to achieve the desired contour. For cases in which there is no, or little excess mammary tissue, a variation of the Pitanguy technique may be employed. In this case the incisions are placed surrounding the areola extending downward onto the natural crease of the breast without an horizontal extension. A pedicle or tissue base is created from the lower pole of the breast and it is transferred to the upper pole, so the breast adopts an harmonic conical shape. Then the incisions are sutured and a dressing is applied. One of the most important questions in regard to the technique employed is your goals and expectations of the surgery. Items like size and shape of the breast will be fully discussed prior to your surgery. POST OPERATORY Breast reduction and breast lifts surgeries are usually done as an outpatient procedure, but a one night stay may be recommended in individual cases. These procedures are usually carried out under general anesthesia, especially if associated with other procedures. In certain cases of breast lift local anesthesia and sedation may be utilized. You may feel some discomfort during the first couple of days, but will easily be controlled by the use of analgesics. For the first few days following breast surgery, you will wear surgical dressings and a special post-surgical bra is worn for several weeks. You should avoid lifting your arms or pushing anything heavy for the first three to four weeks. With the support of your surgical bra, you should be able to increase your activity level at a steady pace. You will be allowed to return to your
desk job work in four to five days if you were submitted into a
breast lift or after seven to ten days if a breast reduction was
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