Research Paper on Breast Reduction Surgery: From Racial Acceptance to Macromastia Treatment

Introduction

According to Purohit (2008), reduction mammoplasty is a surgical procedure that entails volumetric reduction of the breast to improve is shape. Since his procedure involves reshaping the entire breast, the nipple-areola complex has to be repositioned. The key aim of performing breast surgery was to make a person more racially acceptable to the general society, however, the practice has transformed to be a treatment for macromastia. Women with large breasts, experience disabling symptoms like pain in the back, neck, and shoulder, inframammary maceration, breathing difficulties when performing exercises and psychological burdens due to unaesthetic appearance (Zhang et al., 2016). Due to these and other challenges, reduction mammoplasty is carried on women to relieve them of the burden of such symptoms and future unforeseen complications.

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Reasons for Reduction Mammoplasty

The target of reduction mammoplasty is to achieve breasts that are elevated, round in shape, symmetrical and with good projection. According to Makboul, Abdelhamid, and Al-Attar (2016), breast surgery is a perfect solution for both functional and aesthetic challenges linked to large breasts in women. The major challenge with the surgery technique is to redrap the skin envelope and maintain a viable nipple-areola complex (NAC).

Surgery Techniques

Although reduction mammoplasty has widely being used in treatment of macromastia, it is has evolved to be a treatment technique for large ptotic breast cancer The use of cosmetics has proved difficult in the treatment of hypertrophied breast and his has led to the development of more effective techniques such as reduction mammoplasty. There are, however, different breast reduction technique based on the need for a variety of NAC pedicles. Hence, the transposition of the NAC to a higher position is the reason for the various reduction mammoplasty (Makboul, Abdelhamid & Al-Attar, 2016). In this regard, surgical techniques performed include free nipple grafting, liposuction, handling the skin such short-scar techniques, and pedicle techniques such as inferior pedicle, medial pedicle. According to Fox who as performed more than 3000 reduction mammoplasty, the best technique is superior pedicle (Fox, 2005). When performing the surgery, the primary requirements are to move the NAC, to an appropriate youthful position and ensure that the patient attains comfortability with light breasts. Conversely, secondary requirements are to ensure that the woman can lactate, remain fertile, and have an erectile and functional nipple papilla. The surgeon starts by making inframammary line marks, on the breast while the lady lies in an erect position (Fox, 2005). After inducing anesthesia, the surgeon dissects straight via the tissue until the pectoralis fascia is identified. Finally, the surgeon resects the breast gland.

Risk Factors

Despite is significance and associated benefits, reduction mammoplasty, is linked to a number of risk factors that hinder is a successful and effective practice. Such risks include postoperative complications, like infection, reoperations, loss of the nipple, seroma, difficulties with wound healing, fat necrosis, and scars (Zhang et al., 2016). In certain cases, body mass index has also been reported to be a risk factor following breast surgery. The research study found that infection is highly linked to a BMI of greater than or equal to 30 kg/m2 (Zhang et al., 2016). Moreover, surgery performed o people above the age of 50 years did not show any significant increase in the complication incidence following reduction mammoplasty. This led to the conclusion that age is not a major risk factor after breast reduction surgery (Zhang et al., 2016). Besides, radiation, therapy, was linked to the rise in the rates of postoperative infection.

Conclusion

In conclusion, reduction mammoplasty is done on women to relieve the burden of symptoms associated with large breasts. It has also evolved to be a treatment for breast cancer and has hence become widely known worldwide. Associated risk factors of breast surgery include increased body mass index, infections, and scars among others.

References

Fox, J. (2005). Superior pedicle reduction mammaplasty. Aesthetic Surgery Journal, 25(4), 406-412. DOI: 10.1016/j.asj.2005.05.010

Makboul, M., Abdelhamid, M. S., & Al-Attar, G. S. (2016). Longterm followsup and patient satisfaction after reduction mammoplasty: Superomedial versus inferior pedicle. Indian Journal of Plastic Surgery, 49(2), 214-219. https://doi.org/10.4103/0970-0358.191299

Mohsen, S. (2018). Therapeutic reduction mammoplasty techniques in the management of breast cancer in large-breasted females - a comparative study between inferior and superior pedicle reduction mammoplasty. Egyptian Journal of Surgery, 37(2), 139-146. https://doi.org/10.4103/ejs.ejs_89_17

Purohit S. (2008). Reduction mammoplasty. Indian journal of plastic surgery: official publication of the Association of Plastic Surgeons of India, 41(Suppl), S64-S79.

Zhang, M.-X., Chen, C.-Y., Fang, Q.-Q., Xu, J.-H., Wang, X.-F., Shi, B.-H., ... Tan, W.-Q. (2016). Risk Factors for Complications after Reduction Mammoplasty: A Meta-Analysis. PLoS ONE, 11(12), 1-13. https://doi.org/10.1371/journal.pone.0167746