Auckland, New Zealand (Smile Makeover)
would never have though my teeth could look that good
Auckland, New Zealand (Breast Augmentation)
all spoke good English which was re-assuring and nothing was too much trouble
Hawkes Bay, New Zealand (Tummy Tuck) I'm very pleased already with the result I can see
Auckland, New Zealand (Breast Augmentation) So much better than I had imagined and the hospital was great
Hawkes Bay, New Zealand (Breast Lift, Tummy Tuck, Liposuction)
The hospital - well this was way beyond what I was expecting from the head nurse down to the orderly.
Surgery: Breast Reduction Time required: 2 -3 hours Anaesthesia: General Length of Stay (In Hospital): 2 nights in hospital standard room Follow up: 7-10 days after surgery
Procedure
There are many variations to the design of the incisions for breast reduction. The size and shape of your breasts, as well as the desired amount of reduction, are factors that will help your plastic surgeon determine the best technique for you.
The most common procedure involves an anchor-shaped incision that circles the areola, extends downward, and follows the natural curve of the crease beneath the breast. The surgeon removes excess glandular tissue, fat, and skin, and moves the nipple and areola into their new position.
He or she then brings the skin from both sides of the breast down and around the areola, shaping the new contour of the breast. Liposuction may be used to remove excess fat from the armpit area.
In most cases, the nipples remain attached to their blood vessels and nerves. However, if the breasts are very large or pendulous, the nipples and areolas may have to be completely detached before they are shifted to a higher level.
In such a case, you will need to have made the decision to sacrifice sensation and the possibility of breast-feeding in order to achieve your desired breast size.
Stitches are usually located around the areola, in a vertical line extending downward, and along the lower crease of the breast. In some cases, techniques can be used that eliminate the vertical part of the scar. And occasionally, when only fat needs to be removed, liposuction alone can be used to reduce breast size, leaving minimal scars.
Pre Operative
Your plastic surgeon will examine your breasts, taking measurements and perhaps photographs for your medical record. The size and shape of your breasts, the quality of your skin, and the placement of the nipples and areolas will be carefully evaluated.
You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries including breast biopsies, and medications that you currently take.
It is important for you to provide complete information. You should tell your plastic surgeon if you plan to lose a significant amount of weight, particularly if you have noticed that your breasts become smaller with weight loss.
Your surgeon may recommend that you stabilise your weight before having surgery.
Depending on your age, or if you have a history of breast cancer in your family, your plastic surgeon may recommend a baseline mammogram before surgery and another mammographic examination some months after surgery. This will help to detect any future changes in your breast tissue.
Following breast reduction, you will still be able to perform breast self-examination. Breast reduction surgery will not increase your risk of developing breast cancer.
Below are important points that you need to consider before undergoing any surgery:
Stop smoking well in advance of surgery.
Stop taking Aspirin, herbal or diet supplements and certain anti-inflammatory drugs at least 2 weeks as taking these substances can cause increased bleeding.
Do not eat nor drink anything at least 6 – 8 hours before surgery.
Use antibacterial soap and allow the soap lather to cover the skin of the surgical area for 10 minutes on the night before your surgery and in the morning of your surgery.
Post Operative Care
You may feel some pain for the first couple of days-especially when you move around or cough-and some discomfort for a week or more. Your surgeon will prescribe medication to lessen the pain.
After surgery, you'll be wrapped in an elastic bandage or a surgical bra over gauze dressings.
A small tube may be placed in each breast to drain off blood and fluids for the first day or two.
The bandages will be removed a day or two after surgery, though you'll continue wearing the surgical bra around the clock for several weeks, until the swelling and bruising subside.
Your stitches will be removed in one to three weeks.
If your breast skin is very dry following surgery, you can apply a moisturizer several times a day, but be sure to keep the suture area dry.
Your first menstruation following surgery may cause your breasts to swell and hurt.
You may also experience random, shooting pains for a few months.
You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This usually fades over the next six weeks or so.
Resumption of social activities may be possible in about two weeks.
You should limit your exercises to stretching, bending, and swimming until your energy level returns. You'll also need a good athletic bra for support.
A small amount of fluid draining from your surgical wound, or some crusting, is normal. If you have any unusual symptoms, such as bleeding or severe pain, don't hesitate to call your doctor.
Resumption of sexual activity should be avoided for a minimum of one week. After that, care must be taken to be extremely gentle with your breasts for at least the next six weeks.
Result
Patients who undergo breast reduction surgery frequently are seeking relief from physical symptoms caused by the excessive weight of large breasts.
Breast reduction usually can solve these problems as well as improve the size and shape of your breasts. Following breast reduction, your breasts will be more proportional to the rest of your body, and clothes will fit you better.
Potential Risks & Complications
The hospital’s team and our plastic surgeons take every precaution possible to prevent and minimise the risks of surgery. However, much of the responsibility for risk avoidance rests with the patient as well.
Risks of General Anaesthesia
The risks of general anaesthesia include human error, unsuspected inherited hypersensitivity to aesthetic drugs, accidental overdose of anaesthesia, any undetected airway disconnection or airway blockage. General anaesthesia, which increases the risk of vomiting and impairs protective airway reflexes, can cause aspiration of stomach contents.
Blood Loss
Intra-operative and post-operative blood loss is rare which will require immediate medical attention. Cease taking any anti¬coagulants which may include aspirin and aspirin-containing medications, vitamin E, garlic tablets and more. Be sure to disclose each and every medication you may be taking or have taken in the weeks before surgery.
Hematoma & Seroma
Any sudden change in contour, or colour should be reported immediately. A hematoma is a collection of clotting or clotted blood in a body cavity which can cause pain, scar tissue, infection and more. A seroma is a collection of the watery portion of the blood in a body cavity. It can also cause pain and scar tissue.
Infection
Infections usually show symptoms within the first few days. Report any redness, severe swelling, discharge, foul smell, severe pain which develops several days after your surgery and does not improve, intense heat of the area and fever over 100.5º F.
Wound Separation
The separation of the wound edges may be an issue in some cases. Keep the area very clean and contact your surgeon immediately.
Fat & Tissue Necrosis
Necrosis of the breast tissue, breast envelope and or incision line is very rare but there are increased risks in patients with diabetes, compromised wound healing abilities, history of smoking and circulatory problems.
Loss of Sensitivity or Numbness
Loss of sensitivity is common, although temporary. Nerve endings are severed during this surgery, so you must be patient until they regenerate and sensations begin to return. This can take several months, however permanent sensation loss in the areola (nipple) area or breasts, in general, can and may happen.
Scarring
This is perhaps the biggest issue in breast surgery. We try to leave as small as scar as possible however the extent of scarring will depend on the size of your breast, the amount of lift needed and your skin quality. Mastopexy does leave noticeable, permanent scars, although they'll be covered by your bra or bathing suit.
Asymmetry
There may be asymmetry. Although your surgeon will attempt to make your breasts as even in volume and height as possible, the body is not made of modeling clay. The body also heals differently from patient to patient.
Nipple Position, Different Size-Areolas
Because the breast is never symmetrical, you will always have one breast that is different from the other. At first this difference will be very noticeable since your breasts are swollen. Once the swelling subsides, then you won’t notice the difference as much but it will always be present (no one has symmetrical breast).
Hyper-pigmentation or Permanent Bruising
Permanent hyper-pigmentation (permanent dark spots) from the bruising are a risk. Hyper-pigmentation should subside in a matter of a few weeks but may stay for longer than expected. Simple applications or warm compresses after you're healed can assist in the dilation of the blood vessels and the resorption of the blood.
Pulmonary Thrombo-Emboli
A thrombo-embolus is a blood clot that can break free and travel to the lungs resulting in pulmonary thrombo-emboli. It can happen within three weeks of the surgery but will most likely show symptoms of shortness of breath and fatigue within the first 72 hours.
General Dissatisfaction
There are risks of the results not living up to what you expected. Scars will be a definite issue and you must take this into account beforehand. They will also appear worse before they get better so prepare yourself.
Patience and scar products can help. Having too much tissue removed may leave you with smaller breasts than you would like.
Be sure that you communicate your desired post-operative cup size to your surgeon. Regardless, balance maybe the last thing on your mind before surgery, as long as your back stops hurting and your bras stop digging into your shoulders. Think about the long term.
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