Mammoplasty
Cosmetic Surgery - Plastic Surgery - Aesthetic Medicine - Reconstructive Surgery
Mammoplasty is the surgical reshaping or reconstruction of the breast.
The breast is a cone-shaped structure in which are housed the mammary
gland and fat. The skin covers the whole breast and the conical
structure is completed at its end by the nipple-areola complex which is
pigmented, elastic and contractile. The mammary gland and fat determine
the volume of the breast. The shape of the breast is determined by the
positioning of this volume and its relationship to the skin.
The main aim of mammoplasty is to get nice, smooth, shapely breasts
and to reposition after reducing the volume, adjusting the skin and
making the scars as short as possible. This correction is, of course,
adapted to the morphology and silhouette of the woman and her wish to
reconstruct both breasts so that they are harmonious, balanced or as
close as possible to symmetry with an appearance that is as natural as
possible.
Mammoplasty surgery in aesthetic plastic surgery deals with:
-breast hypertrophy: this is characterized by breasts that are too
large with an oversized breast cone and low nipple-areola complex,
pointing downwards. In breast hypertrophy, excess breast volume is also
associated with sagging breasts (ptosis) and occasionally a problem of
pre-existing asymmetry. Surgery for hypertrophy of the breast is also
called reduction mammoplasty.
-breast ptosis: the breast is set too low; frequently the upper part
is "displaced" with collapse of the mammary gland and skin
distension. Breast ptosis is either already present or occurs after
significant weight loss. When it is isolated, this is pure ptosis. But
it is often associated with breast hypertrophy. Surgery for breast
ptosis is also called mammoplasty for ptosis.
-breast hyperplasia (or breast hypotrophy) is characterized by an
insufficient volume of breast in relation to the morphology of the
patient. It is already present or occurs as a secondary effect of
pregnancy or weight loss. The SGA is isolated or associated with
ptosis. Correction by mammoplasty or breast augmentation involves the
placement of breast implants behind the breast gland.
Mammoplasty surgery in reconstructive plastic surgery deals with
breast reconstruction after mastectomy (removal of the mammary gland, a
zone of skin and the areola). Unfortunately, mastectomy is necessary
in some forms of breast cancer. The qualified plastic surgeon will
restore breast shape and volume and then reconstruct the nipple and
areola and, if necessary will carry out a symmetrisation of the
opposite breast. Breast reconstruction is supported by health
insurance. There are three categories of mammoplasty breast
reconstruction:
-breast reconstruction with breast implants placed under the pectoral
muscle, in cases where the quality of the skin and underlying muscle
allows this. This is the easiest type of breast reconstruction.
-breast reconstruction by rectus abdomini flap, a technique used when
the tummy has excess skin and fat enough to be moved to the chest to
reconstruct the breast without the need for mammary implants.
-breast reconstruction by latissimus dorsi flap, the skin and the
stretched thin muscle of the back (latissimus dorsi) are collected at
the back to be transferred to the breast. The missing breast volume is
supplemented by a breast implant behind muscle. Plastic surgeons use
this technique of reconstruction when the residual skin of the chest is
insufficient or weakened by radiotherapy and could not by itself
protect the breast implant.
Other rarer flaps are used, like the gluteus maximus or the contra lateral breast.
Mammoplasty techniques for reconstruction are varied to suit different
situations (thin skin, damaged skin, changes in volumes of the breast
to be reconstructed, etc.). Reconstruction is a personal choice and the
qualified plastic surgeon will select the best solution in
consultation with his patient.
After these techniques have been used and to improve the quality of
the breast reconstruction, the plastic surgeon may resort to the
technique of lipo-filling, that is to say autologous fat grafting, in a
second operation..
Mammoplasty is a delicate surgical operation, requiring a lot of
rigour and with all the risks associated with any medical procedure
(anaesthesia and surgery) even when carried out under the most
favourable conditions, that is to say by a qualified plastic surgeon.
Plastic surgeons have developed these mammoplasty procedures and
because of their training they are, naturally, breast reconstructive
surgeons. Without overstating the risk, a proportion of risks exist,
and turning to a qualified plastic surgeon can prevent complications or
treat them effectively.