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Breast Reduction is the only real functional cosmetic surgery, with the aesthetic aspect more a seconday issue. Large breasts, are not only a cause of social hesitation, they can cause severe allergy and infection in the infra mammary line, as well as deep marks on the shoulder due to bra strap marks and shoulder pain due to the heavy breasts. The clothing pattern suffers, and the lady is not able to wear tighter clothes. Breast reduction surgery is the only way to correct large breasts. The problem is the scars. Conventionally there is a large scar on the lower aspect of the breast which many women find objectionable. However newer techniques of short scars is now available (more details on A comparison of the surgical techniques Conventionally the T scar technique, also known as the Anchor scar technique or the wise pattern technique is used. The advantage of this technique is the immediate results in terms of the breast shape. There is no need to wait for long periods to get an idea of the breast shape. It is faster to do, easier to teach and has predictable results. It is easier to do more skin resection with this technique, and hence there is a greater flexibility in breast shaping, the volume desired etc, with a T scar technique. The scars tend to settle a lot over time. The downside of the procedure is the long scar under both the breasts. But my teacher in Brazil used to tell me, that for women, breast shape is more important than the scars.
When we talk of the short scar procedures, popularised by Dr Ruth Graf, in Brazil, who I have trained under, this is an excellent procedure for someone who is scar conscious. The shape is good, however it may take upwards of 3 months to get a final pleasing shape of the breast. Literature quotes a percentage of upto 30% who may require a revision to correct the bunching that occurs over the stitch line. The skin that is removed in the short scar technique is more from the upper quadrant of the breast, and thus there is a chance of spreading of the peri-areolar scar, which may need to be revised.
Thus a lot of the decision making depends on consultation with the patient. Now a scarless technique by way of VASER is also available. more details are available on #bl1" #bl1
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