Procedures

The wonder breast reduction technique is the most logical solution to reduce the breasts while at the same time it provides aesthetically beautiful breasts. I approach the breast reduction procedure very differently. The enlarged breasts need to be managed like a breast reconstruction. If you look at an enlarged breast, you will notice that many times the skin has been stretched due to the weight of the breasts. The nipples are unnaturally low. There is lost of upper pole fullness and subsequent saggy tissue in the inferior aspect of the breasts. The whole breast internal structures and ligaments that support the breasts have been affected allowing the tissue to descend and most of the breast tissue tends to lie on the lowest part of the breasts. For these particular reasons, the breasts need to be supported from the inside and the ligaments must be reconstructed again to provide long-term results and maintain the upper pole fullness while at the same time prevent excessive soft tissue relaxation.

With this technique, I also take into consideration the elasticity of the skin to better reshape the breasts and match the amount of breast tissue resections with an exact skin envelope. The reshaping of the breasts as well as the suspension rely on the pectoralis major muscle. This muscle is used to suspend the breasts in various forms, thus allowing the reshaping to counteract the forces of soft tissue relaxation and providing long lasting results.

Another unique aspect of this technique is that it limits the scar by avoiding the horizontal scar that runs toward the midline. The resulting scar is a vertical one with a short horizontal limb to the side.

The most impressive aspect of this technique is that it provides support of the soft tissue at the top and the look of an actual breast implant without an implant.

The wise pattern breast reduction technique is the most commonly performed breast reduction technique in the USA. This technique is very reliable and useful to safely reduce the breasts. With this technique, most commonly the nipple areola complex is transferred using the breast tissue that is in the lowest portion of the breasts. You can anticipate a scar around the areola vertically down and also horizontally. In other words, it is the famous inverted T pattern. You can reduce the breasts to accomplish a variety of shapes and sizes. As a matter of fact, you can successfully reduce breasts that have sagginess up to 25 to 30 cm of ptosis. This technique is very reliable, but it has its shortcomings. I rarely use this technique for various reasons. The breast tissue tends to relax early after surgery because this technique relies on the breast skin envelope to maintain the shape and long-term fullness of the breasts. The problem with relying on the skin is that the skin already has been damaged by the previous weight of the breasts and also the elasticity has been compromised. This means that the skin will slowly stretch with time allowing the fullness of the breasts to diminish and thus creating a flat breast on top with the bottom out of the breast tissue. The breasts often have a “boxy” look months after the surgery. In addition, the horizontal scar of the inverted T pattern many times extends to the midline, which can reduce the ability to wear clothes that show some cleavage.

Vertical breast reduction techniques were designed with the purpose of limiting the breast scars while at the same time reducing the breasts. These techniques will result in a scar that goes around the areola and vertically down. Besides, not every patient is a candidate for this procedure. The saggier your breasts, the more challenging it becomes to reduce the breast envelope while at the same time match the reduce breast tissue with the resulting excess skin to be removed. This is a major problem in a patient whose nipple areola complex has sagged more that 12 cm.

The best candidates to have this limited breast reduction technique are those with a breast ptosis less than 12 cm. and those with good skin envelopes as well as minor skin elasticity.

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