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The condition medically known as mammary hypertrophy or macromastia refers to the disproportionately large growth of the breasts. This growth can be uni- or bilateral, and it can occur in patients who have neither had sexual relations nor pregnancies or as a result of excessive weight gain or multiple pregnancies. In most cases the patient expresses aesthetic discomfort due to large breasts, which impair her ability to perform such daily activities as exercise or simply the ability to wear a tight or attractive garment. Nonetheless some cases patients show signs and symptoms of breast pain (more pronounced during monthly periods), back and neck pain, posture disorders, formation of creases and even pain in shoulders created by bra straps. Patients as young as 18 can have this operation performed without complications, even before having had children or pregnancies. The surgeon and the patient should agree upon which is the best procedure based on the patient's age, volume of the breast, and other specific characteristics.
All operations for breast reduction involve three fundamental steps: the elevation of the areola nipple complex, resectioning of the mammary gland, and tracing of the zone of skin to be removed. In cases of minor hypertrophy the scar may be only vertical, but in more severe cases the resulting scars will always be in the form of an inverted T. In most cases general anesthesia is used; following a carefully selected technique and approximately 2 hours of surgery, dressings and soft bandages are applied to the chest area. The patient remains one night in the clinic or hospital, generally drainage tubes are left in the breasts to permit the exit of residual blood for the first 48 hours, rest at home is indicated for the first week, with a gradual increase in activities up to two weeks, with a cushioned and comfortable bandage in place. The stitches are removed in 12 days and a special lycra garment is worn for 6 weeks. All patients are prescribed analgesics, anti-inflammatories and antibiotics. The remaining scars fade with time and after 8 months tend to be less visible.
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