Reduction mammoplasty is a plastic surgery procedure commonly used to relieve physical discomfort caused by breast enlargement. This procedure not only improves the patient's posture, but also significantly reduces shoulder and neck pain, spinal compression, cleavage eczema and other problems caused by excessive breast development. However, as a traumatic surgery, breast reduction surgery also has many risks and complications. In order to improve surgical safety and postoperative satisfaction, it is necessary to conduct a systematic analysis of preoperative evaluation, intraoperative management and postoperative care, identify potential risks and propose prevention strategies.
1. Common risks and types of complications
The risks of breast reduction surgery mainly include intraoperative bleeding, infection, flap necrosis, scar hyperplasia, nipple and areola sensory impairment, breast tissue necrosis, decreased lactation function, and psychological adaptation disorder.
1. Bleeding during and after surgery
Bleeding is one of the common risks of surgery. Intraoperative bleeding is mostly caused by incomplete vascular ligation or rough operation, while postoperative bleeding may be caused by hematoma formation or vascular recanalization. Heavy bleeding not only prolongs the recovery period but also increases the risk of infection.
2. Infection
Although infection at the surgical site is rare, once it occurs, it will significantly delay the wound healing process and even lead to skin grafting or reoperation. Common sources of infection include failure to clean the skin before surgery, non-standard aseptic operation during surgery, and improper postoperative wound care.
3. Skin flap necrosis and nipple and areola necrosis
After large-volume tissue resection, insufficient blood supply may cause flap necrosis, especially in smokers, diabetics, and individuals with poor blood supply. In addition, the nipple-areola area is very prone to necrosis if not handled properly because its blood supply depends on the local vascular arch.
4. Nipple sensory impairment and decreased lactation function
Breast reduction surgery often involves the mammary ducts and nerve tissue, which may cause sensory nerve damage during the operation. Postoperative symptoms include nipple numbness and dullness. Large-scale tissue resection and mammary duct damage may also affect future breastfeeding.
5. Scar problem
Scars are inevitable after surgery. Their shape, color and texture vary from individual to individual. Some patients may experience scar hyperplasia or keloids, which are more obvious in those with greater skin tension or a scar-prone physique.
6. Psychological and emotional reactions
Although most patients are satisfied with the surgical results, some people may experience loss, anxiety or body image disorder after the operation. If these psychological reactions are not handled properly, they may have an adverse effect on the recovery process.
2. Preoperative preventive measures
1. Comprehensive assessment of the patient's condition
A systematic medical history and physical examination are required before surgery, including breast imaging evaluation, breast size measurement, skin elasticity and blood supply assessment, etc., to determine whether the patient has high-risk factors such as diabetes, cardiovascular disease, abnormal coagulation function or smoking habits, and adjust the surgical plan accordingly.
2. Stop smoking and control chronic diseases
Smoking can cause microvascular constriction and increase the probability of flap necrosis. Therefore, it is recommended that patients completely stop smoking at least 4 weeks before and 4 weeks after surgery. At the same time, controlling blood sugar, blood pressure and weight can help reduce postoperative complications.
3. Fully communicate surgical expectations
In-depth discussions with patients about surgical goals, possible outcomes, and potential complications can enhance their psychological preparation and reduce the possibility of postoperative dissatisfaction and legal disputes.
3. Intraoperative Risk Control Strategies
1. Refined operation
The use of nipple transplantation technology that preserves the vascular arch or the use of a flap design with a good blood supply can effectively reduce the incidence of tissue necrosis. At the same time, rough traction should be avoided, and complete hemostasis should be ensured to reduce the risk of intraoperative bleeding and postoperative hematoma.
2. Strict aseptic technique
Strictly follow the aseptic principle during the operation, especially during skin incision, tissue stripping and suturing, strengthen antibacterial measures and reduce the infection rate.
3. Reasonable selection of incision and suturing method
The incision design should take into account both aesthetics and functionality. For example, inverted T-shaped, vertical and other incision methods should be individualized according to the breast volume and degree of sagging. Using absorbable sutures, reducing tension, and layered sutures during suturing can help reduce scar problems.
IV. Postoperative Care and Monitoring
1. Wound management and anti-infection treatment
After surgery, the incision needs to be checked daily and kept clean and dry. For people at high risk of infection, appropriate postoperative antibiotic preventive treatment can be given. If early signs of infection are found, they should be treated in a timely manner.
2. Use of support bra
It is recommended to use an elastic support bra after surgery, which helps to reduce tissue traction, promote blood circulation, and prevent skin sagging and hematoma formation.
3. Regular follow-up and psychological support
Regular follow-up should be conducted after surgery to evaluate breast morphology, sensory function, and scar recovery. For those who experience negative emotions or adjustment disorders, timely psychological intervention should be given, and professional psychological counseling should be recommended when necessary.
4. Avoid strenuous exercise and external impact
Avoid heavy lifting, strenuous upper limb activities, and prone lying within one month after surgery to reduce tension in the surgical area and the risk of tissue displacement, which helps stabilize the surgical effect.
V. Risk Management for Special Populations
1. Adolescent patients
For adolescents with breast enlargement, the relationship between incomplete breast development and the need for surgery should be weighed, and surgery should be delayed or conservative treatment should be adopted. If surgery is indeed necessary, an individualized surgical plan should be developed by an experienced doctor.
2. Obese patients
Obese patients have significantly increased risks of poor scar healing, bleeding, and infection after surgery. They should be assisted in weight management and improvement of metabolic indicators before surgery to improve surgical safety.
3. Patients with a history of multiple breast surgeries
For patients who have undergone breast augmentation, prosthesis removal, or other breast surgeries, due to changes in anatomical structure, the difficulty of surgery and the increased risk of complications, an intervention plan should be formulated based on imaging evaluation and surgical records before surgery.
Beauty Encyclopedia Tips: Risks and Complications of Breast Reduction Surgery
Although breast reduction surgery is a mature plastic surgery method, its safety and effectiveness depend on the comprehensive management of multiple factors. Standardized preoperative evaluation, rigorous intraoperative operation and scientific postoperative care can effectively reduce the occurrence of surgery-related complications. For patients, fully understanding the surgical process and potential risks, cooperating with doctors in health management and postoperative rehabilitation are the key to improving surgical satisfaction and quality of life. At the same time, the medical team should strengthen multidisciplinary collaboration and long-term follow-up mechanisms, continuously optimize surgical strategies, and ensure patients' physical and mental health and surgical safety.