DOCSLIB.ORG

Modifications in Vertical Scar Breast Reduction

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Modifications in Vertical Scar Breast Reduction British Journal of Plastic Surgery (2001), 54, 341–347 © 2001 The British Association of Plastic Surgeons doi:10.1054/bjps.2001.3573 Modifications in vertical scar breast reduction G. M. Beer, W. Morgenthaler, I. Spicher and V. E. Meyer Institute of Hand, Plastic and Reconstructive Surgery, University Hospital Zürich, Zürich, Switzerland SUMMARY. The use of vertical-scar breast reduction techniques is only slowly increasing, even though they have been advocated by Lassus and Lejour and are requested by patients. Possible reasons why surgeons are reluctant to use these techniques are that they are said to be more difficult to learn, they require considerable experience and intuition, and their applicability is confined to small breasts. Several surgeons have developed modifications, combining vertical-scar breast reduction techniques with details of the familiar inverted-T-scar technique. We present a procedure involving two further modifications of the vertical-scar breast reduction technique: first, a standardised, geometrical preoperative drawing from our superior-pedicle T technique, with the aim of establishing a reproducible method of reduction requiring no particular intuitive touch, and, second, the addition of a periareolar skin resection, to give the breast the desired round shape. Between September 1998 and December 1999 we used this technique in a prospective series of 52 patients. The median resection weight was 450 g. The maximal postoperative follow-up was 15 months. There were no acute postoperative complications necessitating reoperation. The late complication rate was within the expected range for such procedures (seven patients, 13.5%) and included vertical-scar widening, areolar distortion, residual wrinkles due to incomplete shrinkage of the undermined skin in the inferior pole and asymmetry of the breast. This procedure enables us to offer patients with moderate to marked hypertrophy a reproducible versatile vertical breast reduction technique. The technique is easy to teach and easy to learn, especially for those who are familiar with the superior pedicle inverted-T-scar tech- nique. © 2001 The British Association of Plastic Surgeons Keywords: vertical-scar breast reduction, modifications, standardisation. Breast reduction has been a controversial theme in plastic shape the breast by drawing together the skin of the surgery over the decades, as evidenced by the multitude amputated lateral and medial breast pillars with repeated of surgical techniques available. In the past, the surgeon rows of skin-framing stitches going upward and down- and the patient have had to choose either a beautiful ward, tightening the skin until the breast reaches the shape and long scars or short scars with a less beautiful desired form. When finally suturing the vertical incision shape. The inverted-T-scar breast reduction, still the most he did not try to gather the skin to shorten the scar. frequently used technique the world over, is a prime Lejour, in contrast, developed a procedure that shapes the example of a technique that gives a good shape but leaves breast with glandular sutures and then drapes the skin long scars.1,2 At the other end of the scale, the vertical over the underlying gland.9–13 She widely undermines the technique leaves short scars but is said to create less skin in the inferior pole, making it thin enough to shrink. beautifully shaped breasts. This dilemma for patients Whereas Lassus closes the skin with a considerable ended when Lassus and Lejour refined and popularised a amount of tension, Lejour does not, in order to minimise version of vertical-scar breast reduction that combined a the dangers of skin necrosis and stretching of the scar. beautiful shape with short scars. Despite the short scars, these vertical-scar breast reduc- Interestingly, this technique has a long history, starting tion techniques enjoy only a limited popularity. Reasons with Dartigues,3 who, in 1925, described a vertical-scar for this include the fact that the techniques are said to be procedure for mastopexy. The technique was revisited by more difficult to learn, that they require considerable Arie4 in 1957 but did not gain wide acceptance because experience and intuition, and that they are applicable the vertical scar crossed the inframammary line and only to small breasts.14,15 extended far into the upper abdomen. It was Lassus who The Lassus and Lejour techniques have been modified revived vertical-scar breast reduction by developing a several times to try to make them as easy to learn, plan procedure with an upper pedicle for the areola, a central and execute as the inverted-T-scar methods. The majority wedge resection, no parenchymal anchor stitches and no of authors have tried to adapt the vertical-scar technique undermining of the breast tissue.5–8 When, in very large to their familiar T-scar technique by modifying the design breasts, the inferior portion of the scar showed below the of the pedicle or the modes of resection or reshaping, inframammary fold, he added a short horizontal scar. thus making the change from the old method to the new Later on, Lassus modified his technique and returned to method less drastic. the use of a vertical scar that always ended above the The modification we present here is derived from the original inframammary fold. The main feature of his basic principles of the inverted-T-scar breast reduction operative technique is that it relies solely on the skin to procedure of Pitanguy1 and Höhler,2 a very reliable 341 342 British Journal of Plastic Surgery method in which all details of the preoperative marking and resection can be planned by measuring. Patients and methods A prospective series of 52 patients aged between 17 and 57 years (mean: 33 years) were operated on between September 1998 and December 1999. Out of these, 45 patients had a bilateral breast reduction, five patients had a balancing unilateral breast reduction with contralateral breast reconstruction and two patients had a unilateral breast reduction with a contralateral mastopexy to correct breast asymmetry. The resection weight ranged from 10 g (the two unilat- eral mastopexies) to 1270 g (mean: 340<204 g; median: 450 g). All operations were performed by two surgeons. The postoperative follow-up included clinical examina- tion and photographic documentation of the patients after 1 week and after 1, 3, 6 and 12 months. The postoperative follow-up ranged from 3 to 15 months. All patients, irrespective of their age, were offered a Figure 1—Preoperative drawing. The usual three vertical marker lines: 16 base-line mammography 3 months after the operation. the mid-sternal and the two mid-clavicular lines. The postoperative results were analysed using a stan- dardised protocol, measuring the sternal notch to nipple distance, the length of the vertical scar, the breast projec- tion and the diameter and configuration of the areola. Additionally, our visual impression was recorded, since ‘perfect numbers’ in breast measurement do not necessarily correspond to beautiful breasts. Preoperative markings The patient is marked preoperatively in an upright position. As in the conventional inverted-T-scar breast reduction, three vertical lines, the mid-sternal line and both the mid- clavicular lines, are determined (Fig. 1). The inframam- mary fold is located, marked and transposed to the anterior skin on the mid-clavicular line of the breast. The new position of the areola (A) is marked 2 cm below this point. Thus, the distance from the sternal notch to A varies between 20 and 23 cm, depending on the stature and height of the patient. Point A becomes the apex of the classical triangle (Fig. 2) with an angle of between 80Њ and 120Њ. The angle is estimated by gently pinching the breast between two fingers at the lower border of the are- ola until the fingers touch each other. The angle depends Figure 2—Preoperative drawing. Point A lies at least 2 cm below the on the size of the breast, the amount of superfluous skin representation of the inframammary fold on the mid-clavicular line. The and the desired shape of the reduced breast. The larger the lines AB and AC are each 9 cm long and meet at an angle of between angle, the more conical the breast will become and the 80Њ and 120Њ. more tension will result on the vertical scar. The sides AB and AC measure 9 cm each. At the ends measured with precision, thus ensuring the reproducibil- of these sides (B and C) lines are drawn horizontally to ity of the method. meet the marking of the inframammary fold, as in the inverted-T-scar technique (Fig. 3). Additionally, lines are continued downwards from B and C in a V-fashion to Operative technique meet at the mid-clavicular line 2–4 cm above the infra- The patient is placed in a semi-sitting position with her mammary fold (D) (Fig. 4). The bigger the breast, the arms at her sides. The superior pedicle is de-epithelialised larger the distance from point D to the inframammary and cut in the usual manner, beginning at point A and fold should be. Thus, in contrast to the ‘classical Lassus including the areola. The rest of the rhomboid ABCD is and Lejour’ vertical-scar breast reduction markings, all incised and the central tissue lying beneath this area is parts of the drawing follow precise geometrical anatomi- resected en bloc. The skin beyond B, C and D down to the cal criteria. The lines and markings may be calculated and inframammary fold and laterally to the medial and lateral Modifications in vertical scar breast reduction 343 extremities of the breast is undermined in such a way that shape of the parenchymal breast is perfect, the superior only a thin layer of subcutaneous tissue remains adherent pedicle is buried and the whole length of the overlying to the skin.
Load more

Recommended publications
  • Breast Reduction with Dermoglandular Flaps Tessier’S “Total Dermo-Mastopexy” and the “Yin-Yang Technique”
    BREAST SURGERY Breast Reduction With Dermoglandular Flaps Tessier’s “Total Dermo-Mastopexy” and the “Yin-Yang Technique” Francesco Gargano, MD, PhD,* Paul Tessier, MD,† and S. Anthony Wolfe, MD‡ skin and the gland and less “isolation” of the areola from the skin Abstract: The use of dermoglandular flaps in reduction mastopexy was and its vascular and nerve network. Because of this, there was advocated by Paul Tessier, who never published his method, but had actually greater security for the nipple and the skin flaps; but, the most rapid almost finished the following article before his death in June 2008. Dr. method seemed also to be a reason for its choice. Tessier is acknowledged as the “father” of craniofacial surgery, but he had The Ragnell procedure, and particularly the Biesenberger interest in aesthetic surgery, and was quite proud of the technique he procedure, has been criticized because of a lack of vascular security had developed using dermoglandular flaps in reduction mammoplasty. He associated with an extended dissection between the skin and the had literally hundreds of techniques and methods that he had developed but gland. During 1947 or 1948, I observed Mcindoe brilliantly per- which never found their way into print, both because of his enormous forming a Biesenberger procedure, and noted a good shape of the surgical schedule, and perhaps his self-imposed standards for anything that breast at the end of the operation. Thus, I began using the Biesen- he published, which were almost impossibly high. The technique proposed berger procedure in this pure form, but was never satisfied with my by Dr.
    [Show full text]
  • Breast Reduction Questionnaire
    BREAST REDUCTION QUESTIONNAIRE Name Age Do you have any of the following: (Please check) ___Breast pain ....................................................... 611.1 ___Shoulder pain.................................................... 723.9 ___Neck pain.......................................................... 723.1 ___Upper back pain................................................ 724.1 ___Lower back pain................................................ 724.2 ___Rash beneath your breasts................................ 695.89 ___Finger or hand numbness.................................. 354.2 ___Bra strap indentation.......................................... ___Breast asymmetry.............................................. 611.8 ___Nipple discharge................................................. ___Difficulty examining your breast.......................... ___Fibrocystic breasts............................................. 610.0 ___Breast masses................................................... 611.72 ___Poor posture....................................................... Do you have difficulty finding properly fitting clothing as a result of your large breasts? Yes____ No____ Do you have to limit your physical activities as a result of your large breast size? Yes ____ No ____ Have you seen a physician, surgeon or chiropractor for treatment of back pain of problems related to your large breasts? Yes ____ No ____ Are you self-conscious about the size of your breast? Yes ____ No ____ How tall are you? How much do you weigh? Largest bra
    [Show full text]
  • ASAPS Traveling Professors
    ASAPS Traveling Professors Alfonzo Barrera, MD – Houston, TX Term: July 2013 – June 2015 Advances in Hair Transplantation for the Treatment of Male Pattern Baldness Hair Transplantation Enhancing Aesthetics in the Reconstruction of the Face and Scalp Correction of Alopecias Secondary to Facial Rejuvenation Surgery Incorporating Hair Transplantation into your Aesthetic Surgery Practice Safe and Predictable Facelift, 28 year Experience Facelift and Hair Transplantation as a Single Procedure The use of I.V. Sedation and TIVA (Total Intravenous Anesthesia ) in Aesthetic Surgery Laurie A. Casas, MD – Glenview, IL Term: July 2012 – June 2014 Primary Breast augmentation and augmentation Mastopexy-preoperative and intraoperative strategies to maximize patient satisfaction and long term results Superior Pedicle augmentation Mastopexy without and implant Which scar which Pedicle in breast reduction surgery Revision breast augmentation: managing the inframmary fold Difficult breast augmentations: preoperative planning, intraoperative technique and postoperative management Managing Breast asymmetry-patient centric decisions-preoperative planning-intraoperative decisions and postoperative care Cosmetic Medicine: how to successfully integrate it into your plastic surgery practice Longitudinal care of the plastic surgery patient with full scope of non surgical and surgical aesthetic plastic surgery REVISED 5/13/2012 Successfully integrating a satellite medispa into your aesthetic plastic surgery practice Long term results of using Sculptra for panfacial
    [Show full text]
  • Feasibility of Mapping Breast Cancer with Supine Breast MRI in Patients Scheduled for Oncoplastic Surgery
    European Radiology (2019) 29:1435–1443 https://doi.org/10.1007/s00330-018-5681-y MAGNETIC RESONANCE Feasibility of mapping breast cancer with supine breast MRI in patients scheduled for oncoplastic surgery S. Joukainen1 & A. Masarwah2 & M. Könönen2 & M. Husso2 & A. Sutela2 & V. Kärjä3 & R. Vanninen2,4,5 & M. Sudah2 Received: 2 May 2018 /Revised: 9 July 2018 /Accepted: 24 July 2018 /Published online: 17 August 2018 # European Society of Radiology 2018 Abstract Objectives To prospectively determine the feasibility of preoperative supine breast MRI in breast cancer patients scheduled for oncoplastic breast-conserving surgery. Methods In addition to a diagnostic prone breast MRI, a supplementary supine MRI was performed with the patient in the surgical position including skin markers. Tumours’ locations were ink-marked on the skin according to findings obtained from supine MRI. Changes in tumours’ largest diameter and locations between prone and supine MRI were measured and compared to histology. Nipple-to-tumour and tumour-to-chest wall distances were also measured. Tumours and suspicious areas were surgi- cally removed according to skin ink-markings. The differences between MRI measurements with reference to histopathology were evaluated with the paired-sample t test. Results Fourteen consecutive patients, 15 breasts and 27 lesions were analysed. Compared to histology, prone MRI overestimated tumour size by 47.1% (p = 0.01) and supine MRI by 14.5% (p = 0.259). In supine MRI, lesions’ mean diameters and areas were smaller compared to prone MRI (– 20.9%, p = 0.009 and – 38.3%, p = 0.016, respectively). This difference in diameter was more pronounced in non-mass lesions (– 31.2%, p =0.031)comparedtomasslesions(– 9.2%, p =0.009).
    [Show full text]
  • Reduction Mammoplasty Policy Number: PG0054 ADVANTAGE | ELITE | HMO Last Review: 02/13/2018
    Reduction Mammoplasty Policy Number: PG0054 ADVANTAGE | ELITE | HMO Last Review: 02/13/2018 INDIVIDUAL MARKETPLACE | PROMEDICA MEDICARE PLAN | PPO GUIDELINES This policy does not certify benefits or authorization of benefits, which is designated by each individual policyholder contract. Paramount applies coding edits to all medical claims through coding logic software to evaluate the accuracy and adherence to accepted national standards. This guideline is solely for explaining correct procedure reporting and does not imply coverage and reimbursement. SCOPE X Professional _ Facility DESCRIPTION Reduction mammoplasty or breast reduction surgery reduces the volume and weight of the breasts by removing excess fat, glandular tissue, and skin. The goals of the surgery are to relieve symptoms caused by heavy breasts, to create a natural, balanced appearance with normal location of the nipple and areola, to maintain the capacity for lactation and allow for future breast exams/mammograms with minimal scarring or decreased sensation. Surgeons use different techniques, but the most common one involves an anchor-shaped incision that goes around the areola, down the breast toward the crease between the breast and abdomen, and then horizontally in the crease under the breast. The surgeon removes excess breast tissue, fat and skin to reduce the breast size. POLICY Reduction mammoplasty (19318) requires prior authorization for all product lines. COVERAGE CRITERIA HMO, PPO, Individual Marketplace, Elite/ProMedica Medicare Plan, Advantage Coverage for reduction mammoplasty is dependent on benefit plan language, may be subject to the provisions of a cosmetic and/or reconstructive surgery benefit and may be governed by state and/or federal mandates. Under many benefit plans, reduction mammoplasty is not covered when performed solely for the purpose of altering appearance or self-esteem or to treat psychological symptomatology or psychosocial complaints related to one’s appearance.
    [Show full text]
  • Breast Reduction Surgery (Policy OCA 3.44), Effective 08/01/21
    bmchp.org | 888-566-0008 wellsense.org | 877-957-1300 Medical Policy Breast Reduction Surgery Policy Number: OCA 3.44 Version Number: 22 Version Effective Date: 08/01/21 + Product Applicability All Plan Products Well Sense Health Plan Boston Medical Center HealthNet Plan Well Sense Health Plan MassHealth ACO MassHealth MCO Qualified Health Plans/ConnectorCare/Employer Choice Direct Senior Care Options ◊ Notes: + Disclaimer and audit information is located at the end of this document. ◊ The guidelines included in this Plan policy are applicable to members enrolled in Senior Care Options only if there are no criteria established for the specified service in a Centers for Medicare & Medicaid Services (CMS) national coverage determination (NCD) or local coverage determination (LCD) on the date of the prior authorization request. Review the member’s product-specific benefit documents at www.SeniorsGetMore.org to determine coverage guidelines for Senior Care Options. Policy Summary Breast reduction surgery (reduction mammoplasty) is considered medically necessary for symptomatic macromastia when Plan criteria are met for a female member (or a member born with female reproductive organs and/or with typical female karyotype with two [2] X chromosomes). The Plan complies with coverage guidelines for all applicable state-mandated benefits and federally-mandated benefits that are medically necessary for the member’s condition. Plan prior authorization is required for reduction mammoplasty. If applicable medical criteria are NOT met, the surgery is considered cosmetic. Breast Reduction Surgery + Plan refers to Boston Medical Center Health Plan, Inc. and its affiliates and subsidiaries offering health coverage plans to enrolled members. The Plan operates in Massachusetts under the trade name Boston Medical Center HealthNet Plan and in other states under the trade name Well Sense Health Plan.
    [Show full text]
  • Breast Reduction Mastopexy
    NICHOLAS T. HADDOCK, M.D. Breast Reduction / Breast Lift (Mastopexy) Patient Care Instructions General Information A breast reduction or breast lift (Mastopexy) involves repositioning the nipple to a higher position, making the areola or colored part of the nipple smaller, and re-shaping the breast with a removal of a varying amount of skin and breast tissue. When a reduction is performed a significant amount of breast tissue is removed with the primary goal to relieve back and neck pain. Things to handle prior to your surgery Arrange for someone to drive you home from the hospital and stay with you for 2 to 3 days. Necessary medications will be called into your pharmacy. These should be picked up prior to surgery. Protein supplementation can be started one to two weeks before surgery and should include over 20 grams of additional protein daily. Have electrolyte containing fluids such as Gatorade or electrolyte water on hand. Have stool softeners/laxatives on hand, such as Colace, Biscodyl, Milk of Magnesia. These can be purchased at your local pharmacy. Review the attached list of medications not to take during the perioperative period. If you have any further questions that were not addressed during your consultation then please call Dr. Haddock’s nurse, Tina Ethridge at (214) 645-2353. If you are unsure if you can stop medications then please call the prescribing provider to confirm if this is medically safe. For your convenience, we have included a Suggested Shopping List in the addendum to these instructions (page 6). Pre-Operative Guidelines Smoking should be stopped a minimum of 4 weeks prior to surgery.
    [Show full text]
  • Systematic Review of Outcomes and Complications in Nonimplant-Based Mastopexy Surgery
    Journal of Plastic, Reconstructive & Aesthetic Surgery (2019) 72, 243–272 Review Systematic review of outcomes and complications in nonimplant-based mastopexy surgery a, d , ∗ b a Pietro G. di Summa , Carlo M. Oranges , William Watfa , c b d Gianluca Sapino , Nicola Keller , Sherylin K. Tay , d b a Ben K. Chew , Dirk J. Schaefer , Wassim Raffoul a Department of Plastic, Reconstructive and Aesthetic Surgery, Lausanne University Hospital, Lausanne, Switzerland b Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland c Department of Plastic and Reconstructive Surgery, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy d Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, Glasgow, Scotland, UK Received 21 April 2018; accepted 28 October 2018 KEYWORDS Summary Background: Mastopexy is one of the most performed cosmetic surgery procedures Mastopexy; in the U.S. Numerous studies on mastopexy techniques have been published in the past decades, Risks; including case reports, retrospective reviews, and prospective studies. However, to date, no Breast lift; study has investigated the overall complications or satisfaction rates associated with the wide Hammock lift; spectrum of techniques. Glandular Objectives: This review aims to assess the outcomes of the various mastopexy techniques, rearrangement; without the use of implants, thus focusing on associated complications, and to provide a sim- Bottoming out; plified classification system. Ptosis Methods: This systematic review was performed in accordance with the PRISMA guidelines. PubMed database was queried in search of clinical studies describing nonprosthetic mastopexy techniques, which reported the technique, indication, and outcomes. Results: Thirty-four studies, published from 1980 through 2016, were included and repre- sented 1888 treated patients.
    [Show full text]
  • Breast Surgeries 9026
    Coverage of any medical intervention discussed in a Dean Health Plan medical policy is subject to the limitations and exclusions outlined in the member's benefit certificate or policy and to applicable state and/or federal laws. Breast Surgeries MP9026 Covered Service: Yes Prior Authorization Required: Yes Additional For prophylactic mastectomy see MP9449 Prophylactic Information: Mastectomy. For procedures related to breast reconstruction see MP9476 Breast Reconstruction Surgery Medicare Policy: Prior authorization is dependent on the member’s Medicare coverage. Prior authorization is not required for Medicare Cost (Dean Care Gold) and Medicare Supplement (Select) when this service is provided by participating providers. Prior authorization is required if a member has Medicare primary and Dean Health Plan secondary coverage. This policy is not applicable to our Medicare Replacement products. BadgerCare Plus Dean Health Plan covers when BadgerCare Plus also covers the Policy: benefit. Dean Health Plan Medical Policy: 1.0 Augmentation Mammaplasty (Mammoplasty) 1.1 Breast augmentation is considered not medically necessary and therefore is not covered except for indications outlined in MP9476. 2.0 Breast Reductions (Reduction Mammoplasty) 2.1 Breast reduction surgery for women aged 18 and older or for whom growth is complete (e.g. breast size stable over one year) requires prior authorization through the Health Services Division when ALL of the following criteria are met: 2.1.1 Significant and persistent complaints documented in the medical
    [Show full text]
  • Medical Policy Breast Surgeries
    Medical Policy Breast Surgeries Subject: Breast Surgeries Authorization: Prior authorization is required for breast surgery procedures requested for members enrolled in HPHC commercial (HMO, POS, or PPO) products. Prior authorization is not required for mastectomy procedures including prophylactic mastectomy. This policy utilizes InterQual® criteria and/or tools, which Harvard Pilgrim may have customized. You may request authorization and complete the automated authorization questionnaire via HPHConnect at www.harvardpilgrim.org/providerportal. In some cases, clinical documentation and/or color photographs may be required to complete a medical necessity review. Please submit required documentation as follows: • Clinical notes/written documentation —via HPHConnect Clinical Upload or secure fax (800-232-0816) • Photographs— HPHConnect Clinical Upload function, email ([email protected]), or mail (Utilization Management, 1600 Crown Colony Dr., Quincy, MA 02169). Please note that photographs should not be faxed as faxed photos cannot be utilized in making a medical necessity determination. Providers may view and print the medical necessity criteria and questionnaire via HPHConnect for providers (Select Resources and the InterQual® link) or contact the commercial Provider Service Center at 800-708-4414. (To register for HPHConnect, follow the instructions here.) Members may access these materials by logging into their online account (visit www.harvardpilgrim.org, click on Member Login, then Plan Details, Prior Authorization
    [Show full text]
  • Breast Reduction Post-Op
    ! POST-OPERATIVE INSTRUCTIONS FOLLOWING BREAST REDUCTION SURGERY Patient Name Date Surgery Date For you to have the best possible results after surgery it’s important to follow these instructions. Use this as a checklist of your progress as you heal. Included are normal post-surgical experiences and key health considerations that may be a cause for concern. TYPICAL POST-OPERATIVE SYMPTOMS Typical symptoms of breast surgery; and signs to watch for following breast reduction surgery include the following: Tightness in the chest region and stiffness; Tingling, burning or intermittent shooting pain: These are normal experiences as the skin, tissues and sensory nerves heal. Pain medication will help you cope with any discomfort. If you have drains, you may experience additional localized discomfort. Consistent sharp pain should be reported to our office immediately. Hypersensitivity of nipples, or lack of sensitivity: This is normal and will gradually resolve over time. You may also experience a small amount of fluid or milk seeping through the nipples. If this becomes painful or excessive, notify our office immediately. Shiny skin or any itchy feeling: Swelling can cause the breast’s skin to appear shiny. As the healing process advances, you may also find a mild to severe itchy feeling of the breasts. An antihistamine like Benadryl can help to alleviate severe, constant itchiness. If the skin becomes red and hot to the touch, contact our office immediately. Asymmetry, the breasts look different, or heal differently: Breasts may look or feel quite different from one another in the days following surgery. This is normal; no two breasts are perfectly symmetrical in nature or following surgery.
    [Show full text]
  • Pre and Post Operative Instructions for Mastopexy/Breast Reduction
    Michael Bateman, MD 303.388.1945 www.michaelbatemanmd.com PRE AND POST OPERATIVE INSTRUCTIONS FOR MASTOPEXY/BREAST REDUCTION BEFORE SURGERY § Please read all of the information in your pre-op packet three times: immediately after your appointment, the day before surgery and again after surgery to ensure that you will remember the details. § By planning ahead, you can have a more relaxed recovery phase. Fill your prescriptions, stock your home with comfort foods and arrange a comfortable place to sleep. Do not be alone the night of surgery; plan to have someone stay with you. Remember that you will need a ride to the first and second post-op appointments as well. § NO SMOKING one month before and after surgery. Smoking impedes healing. § Start taking Arnica Forte the night before surgery. § All patients 35 years and older are required to have a mammogram within one year prior to surgery. THE DAY OF SURGERY § Make sure you do not eat, drink, smoke or chew anything except essential medications (as approved by your doctor) 8 hours prior to surgery. You may take a small sip of water with your Dramamine the morning of surgery. § Know where to go, when to be there, and please DO NOT FORGET 1. Your pre-op packet 2. Your garment § Wear comfortable clothing, preferably something you do not have to pull over your head. THE FIRST WEEK § The car ride home can cause nausea, so taking a Dramamine prior to discharge can help prevent a problem. A scopolamine patch (looks like a spot bandage) may be place on your inner arm or behind you ear in pre- op.
    [Show full text]