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Disproportionately large breasts can occur during puberty and later during pregnancy. In both these circumstances, the large droopy breasts cause much discomfort because of the heaviness and the embarrassing appearance. It can also lead to back pain and difficulty in getting a proper bra. All these are common reasons for affected women to seek a breast reduction.
Breast reduction surgery has evolved over the last few decades to become a safe surgery with fabulous results. Conventional techniques of breast reduction are open methods where the excess tissue is excised and the breast parenchyma is lifted and stitched in normal position. This entails having visible scars on the breast. For an unmarried woman having scars may be unacceptable.
Key hole breast reduction is ideal for young women with large breasts. The fat component in the large breast is removed by the key hole technique using tiny access points. This will reduce the size of the breast and the associated heaviness. If the skin tone on the breasts is good, there will not be any additional drooping from the procedure.
Anatomy
A breast is composed of a skin envelope, containing a "parenchyma" composed of varying proportions of fatty tissue and breast / fibrous tissue. As you will read below, some breast reduction techniques focus mainly on altering the skin envelope, and use this to shape the underlying content. More recent techniques have shifted this focus to concentrate on shaping the breast content (parenchyma) and allowing the skin envelope to re-drape. This "philosophy" of moving away from skin tightening and towards effecting change through manipulation of deeper tissues is also found in modern facelift techniques.
The procedure
Pre operative planning for the surgery is meticulously done with the patient sitting up. The placement of the nipple, amount of skin and breast tissue to be removed are pre marked. The procedure is performed under general anesthesia. The surgery takes about 3-4 hours to complete depending on the amount of breast reduction and the technique used.
The technique used will depend on the volume of the breast to be reduced and the amount of skin sagging to be corrected. Liposuction may be employed as an adjunct in some cases, when there are easily accessible significant fat stores. The vertical short scar technique is the preferred method in our centre. Very large breast reductions may require inferior pedicle reduction which will leave an anchor shaped scar.We prefer to perform breast reduction as a hospital based surgery.
Keyhole Breast Reduction Surgery Advantages
Advantages : - It is easy to perform, easy to teach and easy to learn. It involves the application of a "fixed" skin pattern design which results in an "anchor" type of scar on the breast (around the areola, a vertical scar to the breast fold, and a long scar underneath the breast, in the fold, from side to side). It can be used for small reductions, lifts, as well as very large reductions, and the results are generally good.
Keyhole Breast Reduction Surgery Disadvantages
Disadvantages : - The major disadvantage is the extent of the scarring, the quality of which can be good or bad, depending on the patient's skin type, and wound healing ability. In addition, the breasts are occasionally slightly under projected, and tend to "bottom out" with time - this may well be due to the fact that the breast content is not specifically addressed in this surgery, but rather, the shape of the content is determined by the skin pattern design which removes excess skin in both the vertical and horizontal planes.
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