Saggy Breasts! why they need Mammary Glandular reposition
Throughout my years of experience in performing chest reconstruction surgeries, I have consistently approached each patient with meticulous attention. Among these cases, one particular instance remains etched in my memory due to the patient's young age.
Today, I would like to present a case that stands out as one of the most challenging surgery I have undertaken, emphasizing the complexity and significance of the procedure in question.
The case in question presented a pronounced degree of ptosis evident upon visual examination.
The nipples were notably positioned lower, in proximity to the navel rather than the expected lower chest line.
Within the patient's original chest location, palpation revealed an absence of breast tissue, with only thin skin and rib bones discernible.
Given the marked reduction in elasticity within both the skin and breast tissue, it became apparent that a standard breast reduction and reconstruction procedure would be inadequate.
In cases where both skin and breast tissue exhibit significantly diminished elasticity, it is imperative to emphasize a comprehensive approach. This involves securely anchoring the overall breast tissue to its intended position to prevent the manifestation of sagging observed in the current presentation.
Consequently, I underscored two pivotal considerations to the patient concerning the surgical intervention.
1. Involving vertical incision breast reduction.
: Recognizing that the compromised skin elasticity may result in a slight residual appearance of skin along the lowe chest line.
>> This can be readily addressed through a simple corrective procedure.
2. To achieve a relatively normal breast shape in the intended position, glandular rearrangement is deemed essential.
: While the patient desires a minimally sized breast, it is crucial to priortize breast shape over volume. Consequently, glandular rearrangement becomes imperative, as the patient's primary concern lies in achieving an aesthetically pleasing breast contour rather than maximizing volume.
Performing breast reduction surgery utilizing the vertical incision method for a case presenting such pronounced ptosis is a relatively uncommon choice among surgical practitioners. My decision-making process extends beyond a simple assessment of ptosis severity; paramount is the meticulous evaluation of skin elasticity. In instances where skin laxity is notable, consideration for an inverted-T incision becomes a crucial factor.
In the case at hand, taking into account the patient's tender age, I judiciously opted for the vertical incision approach instead of an inverted-T incision as the initial choice. This decision was reached following a transparent discussion regarding concerns related to potential residual skin visibility along the lower chest line. The patient, having comprehended these nuances, elected to proceed with the vertical incision technique.
Enclosed herein are images captured within the surgical suite, offering a visual documentation of the patient's condition during the course of the procedure.
In the recumbent position, the patient's breasts exhibit substantial lateral descent. The task of repositioning these breasts to their anatomically intended location on the thoracic cage while ensuring a cosmetically refined outcome presented a notable clinical challenge.
Responding to the patient's specific preference for a substantial reduction in breast volume, the surgical approach prioritized a meticulous reduction in breast volume to align with the desired outcome.
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I performed a surgery that lasted approximately 4 to 4.5 hours. The patient, after 10 days, expressed concern, stating, "Doctor, it seems like my breasts haven't reduced as much as I thought..."
Given the persisting postoperative swelling and the fact that the patient had long dealt with significant breast sagging, feeling some uneasiness about the initial shape was anticipated. However, receiving such feedback after dedicating careful consideration to the surgery left me somewhat disheartened.
Fortunately, over the course of one, two, and eventually five months post-surgery, the natural settling of the breast shape brought about a high level of satisfaction for the patient, alleviating her initial worries.
Now, let me present the appearance of the breasts five months after the surgery.
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The preoperative breast shape is notably transformed into an aesthetically pleasing appearance, to the extent that its prior state is not readily recollected. For a more comprehensive understanding, I recommend direct comparison through before-and-after photographs rather than relying solely on detailed descriptions.
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I am committed to approaching my medical practice with diligence and humility, always striving to provide the utmost care.
Sincerely,
Dr. Jaewoo Kim
THE Plastic Surgery
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