It is one of the most common ones among the plastic surgeries because they are recommended not only to improve breast shape, but also to complement prophylactic treatment of certain breast diseases (special cases) and to prevent problems caused by very large breasts.

The most frequently asked questions about this surgery are:

DOES A BREASTS REDUCTION SURGERY LEAVE SCARS?
This surgery allows us to hide the scars, which is very convenient in the first months. The scars will inevitably go through several phases until they reach the final one of maturation, so that we have:

– IMMEDIATE PERIOD: Goes until the 30th day. It is little visible and, in some cases, it shows a mild reaction to the stitches or dressing.

– INTERMEDIATE PERIOD: From the 30th day until the 12th month. During this period, there will be a natural thickening of the scar, as well as a change in its color, from “red” to “brown” that will gradually fade. This period is the one that brings the greatest concern to patients, as it is the least favorable for scar evolution. As we cannot hasten the natural healing process, we recommend patients not to worry, as the scar remains will be reduced in the late period.

– LATE PERIOD: From the 12th to the 18th month. In this period, the scar begins to become lighter and less consistent, thus reaching its final aspect. Any assessment of the definitive outcome of the breasts surgery should be made after this period.

WHERE ARE THE SCARS LOCATED?
Depending on the applied technique, there can be variations regarding scars. Typically there are inverted-T-shaped scars at the bottom of the breast. The ones located around the areolas are well disguised by the color transition between the areola and the normal skin. Other types of scars are possible, such as in “I”, “L / J”-shapes or periareolar. From the first days after the surgery, you can wear a very “generous” neckline, because the scars are hidden. As time goes by (see previous item), the scars will become disguised.

I HEARD THAT THE SCARS IN SOME PATIENTS ARE VERY VISIBLE. WHY DOES THIS HAPPEN?
Some patients tend to develop hypertrophic or keloid scars. Your doctor can assess this tendency during the initial consultation by making a series of questions about your clinical history, as well as through the analysis of family characteristics, which help us greatly about the prognosis of scars. Generally, fair-skinned people are less prone to have hypertrophic scars. Previous scars resulting from surgeries or even accidents will help in the prognosis.

IS THERE A CORRECTION TO HYPERTROPHIC SCARS?
Several clinical and surgical resources allow the improvement of non-aesthetical scars, at the appropriate time. However, they cannot be confused with the “intermediate period” of normal healing (from the 30th day to the 12th month). Any doubt about this evolution should be clarified with us and not with other people who “are also anxious about the final result.”

WHAT WILL BE THE SIZE AND CONSISTENCY OF MY NEW BREASTS?

Breasts may have their volume decreased and the consistency and shape improved by surgery. Therefore, we can choose among many reduction volumes and lifting positions, within the possibilities the original breasts allow us to plan, without future complications. Just like in the breast augmentation surgery, there must be a harmony between the volume of the new breasts and the patient’s chest size. We seek to improve the look in relation to the flaccidity and the shape of the original breasts. The “new breasts” go through several stages of evolution in their form:

– IMMEDIATE PERIOD: Up to the 30th day. In this period, although the breasts present a greatly improved appearance, their shapes and volumes are still below the desired outcome, as still there are some initially apparent “small defects” (inevitable in all cases) before attaining the final shape. Remember this observation: the final outcome will only take place after the late period.

– INTERMEDIATE PERIOD: It is from the 30th day to the 8th month. In this period the breasts begin to show an evolution towards the definitive form, which will happen after the 8th month. In this period, an increase or decrease of breasts sensitivity may occur, as well as some lesser or greater degree of “swelling” of the breasts. Besides, they will be below the level of the final breasts. Despite the euphoria of most patients in this period, we usually say the results will be even better in the third (late) period.

– LATE PERIOD: From the 8th to the 18th month. It is the period when the breasts reach their final look (scar, shape, consistency, volume, sensitivity etc.). In this period, we usually compare through pictures each operated patient with her preoperative look. The degree of elasticity of the breasts skin and the obtained volume have great significance on the final result. The balance between them varies from case to case.

HOW LONG WILL IT TAKE TO ACHIEVE THE DEFINITIVE RESULT?
Even though the immediate and mediate results greatly satisfy the patients, only between the 8th and 18th months your breasts will have their final form (please see previous item).

WHAT TYPE OF SWIMSUIT CAN I USE AFTER THE SURGERY?

Any kind of swimsuit of 1 or 2 items in the intermediate or late period, provided that the upper item is not very tight. For sure, after the maturation of scars, the suits may be more “generous”, as you wish. However, in large breast reductions, the horizontal scar is a little more extensive, thus requiring a swimsuit that best disguises its presence.

WILL THE RESULT LAST IN CASE OF A NEW PREGNANCY?

Your gynecologist will tell you about the convenience of a new pregnancy. As for the result, it can be preserved, as long as that expert controls your weight gain during the pregnancy. Generally the new pregnancy does not affect the results, but, in reductions of very big breasts, lactation may be impaired. Lactation can be preserved in case of small and medium reductions. Some patients may experience a reduction in the support of breast skin.

IS THE POSTOPERATIVE PAINFUL?
Generally not, as long as you obey the doctor’s instructions, especially regarding to the movement of the arms in the first days.

IS THERE ANY DANGER IN THIS OPERATION?
Rarely does an augmentation cosmetic surgery present serious complications, as each patient is adequately prepared. Additionally, we make a careful study on the convenience of the association of this surgery simultaneously with others. It is not any more or less dangerous than traveling by airplane or automobile or crossing the street.

WHAT TYPE OF ANESTHESIA IS USED?
General, local, epidural or associated anesthesia, at the surgeon’s criteria.

HOW LONG IS THE SURGERY?
Depending on each type of breast, from 2.5 to 4 hours or a little bit more, in some cases. However, the duration of the surgery should not be confused with the patient’s hospitalization period in the Surgical Center, because this stay involves the period of preparation for anesthesia and postoperative recovery. Your doctor will inform you about the total time.

HOW LONG IS THE HOSPITAL STAY?
From half to a full day.

ARE SURGICAL DRESSINGS USED?
Yes, elastic and modeling dressing, especially adapted to each type of breasts. They are exchanged periodically.

WHEN ARE THE STITCHES REMOVED?
They are removed approximately after the 8th to 12th day, without major inconveniences.

WHEN CAN I TAKE BATH A FULL BATH?
Usually, after 2 to 3 days. Some cases may require cares on the operated area, like avoiding moisturizing of this area for 8 days is recommended.

HOW IS THE POSTOPERATIVE EVOLUTION?
You should not forget that, until your breasts reach the desired result, they will go through several stages (see items “1” and “5”). If you happen to be concerned about “achieving the desired final result ahead of schedule,” do not turn it into suffering: be patient because your body will take care of spontaneously removing all the immediate inconveniences that inevitably will draw the attention of some friend who will not refrain from saying “is this really going to disappear?” For sure you need to inform your surgeon of any concern you may have and he or she will give you all the necessary explanations so that you can have peace of mind.

WHEN CAN I RETURN TO MY GYM?
It depends on the type of exercises. Those involving the lower limbs may be restarted after 10 to 15 days, but always avoiding “high impact”. Exercises involving the chest usually have to wait from 30 to 45 days.

RECOMMENDATIONS ON BREAST REDUCTION SURGERY

PREOPERATIVE RECOMMENDATIONS:

• Inform until the eve of the operation any case of flu, malaise or anticipation of the menstrual period.
• Be hospitalized at the indicated hospital, according to the schedule.
• Avoid alcohol and heavy meals on the eve of surgery.
• Avoid any and all slimming drug that you may be using for a period of 10 days before surgery. This also includes diuretics.
• Schedule your social, domestic, professional or academic activities so as not to become indispensable to others for a period of approximately 3 to 5 days.

POSTOPERATIVE RECOMMENDATIONS:

• Avoid making efforts in the first 8 days
• Do not move your arms excessively. Obey the instructions that will be given at the time of hospital discharge in relation to the movement of the upper limb.
• Avoid wetting the dressing until you are authorized to do so.
• Do not expose yourself to sun or cold, until you are authorized to do so.
• Carefully follow the doctor’s prescription.
• Have a normal diet (except in specific cases that are prescribed otherwise), from the second day, mainly based on proteins (meat, milk and eggs) and vitamins (fruits)
• Return to the clinic for subsequent dressing and postoperative control, in the stipulated days and time.
• You will probably be feeling so well to the point of forgetting that you have recently been operated. Be careful! This euphoria may lead you to an untimely effort, which will cause certain disorders.
• Do not worry about the forms in intermediate phases. Clarify any doubts with your surgeon.