Breast Reduction

III. (a) Circumareolar breast reductions with minimal scarring.

With the new advances in plastic surgery women now can enjoy the look and feel of being feminine, sensual and sexy again. I am referring to the fact that in the past women feared undergoing breast reductions or lift surgery because of the extensive scarring. We can now offer newer techniques that in the appropriate patient can minimize the extent of scaring. Many of these techniques are only performed by a handful of surgeons across the country.

These newer procedures involve a different philosophy. In traditional reductions/lifts, the skin was manipulated in a variety of ways to give the breast its final look. The skin was used as a vector or as a way to reshape the breast. The drawback with this philosophy was twofold:

1. We had to place the long T shaped scars in order to attain a nice breast shape.

2. We were depending on the skin to maintain the results of our breast shape, but we realized that with time the skin would stretch again creating a droopiness or sagginess to the breast. The results although nice could fall short after a years period.

The new philosophy came from the Brazilians and Europeans whereby it was felt that the gland or the breast itself should be reshaped, and the skin is only used as a cover for the breast. With this new mindset, it now allowed us to reduce the breast size, reshape the breast directly and limit our scars since the skin was no longer being used to shape the breast. This is how the limited scar breast lift/ reduction technique was born.

The technique does have its major limitations:

• Not every patient is a candidate for the limited scar reductions; this will depend greatly on the size of your breast and the quality of your skin.
• If you have a great amount of stretch marks or loose skin, then that means that the skin has lost its elastic properties and will not mold well to the new breast shape. In these cases, you may require a vertical scar, an L- Shaped scar or a Full T-Shaped scar.
• Also if if your breasts are just too big and the amount of reduction is too great, then you may also require a vertical or T- shaped scar. Exactly what is too big will be up to each individuals' surgeons experience, training, and aesthetic judgment. The circumareolar reductions are mainly for patients that have good skin quality and small to medium breast.
• You will have some wrinkling around the areola this will last for three months, and very rarely do we have to perform a simple scar revision.

A newer technique that can be used in all sizes of breast, in almost every patient, and it appears to maintain a longer lasting result is one that was described by a Brazilian surgeon named Dr. Ruth Graf, and pioneered in the United States by Dr. Thomas Biggs. In this procedure after the breast is reduced, part of the breast gland is tunneled underneath the pectoralis muscle, this will maintain superior breast fullness since the muscle will not allow the breast gland to descend. The results have been excellent to date, giving the breast an appearance almost as if you had implants. The length of the scar will depend on how big and how droopy your breasts are. There are only a handful of surgeons performing this technique, but to date we have had excellent results. Dr Mendieta has modified this technique even further by also incorporating a technique described by Dr. Dennis Hammond to further increase the superior pole fullness.

During my fellowship in France and Brazil I learned the technique and have been able to help many women restore their self-confidence and self esteem.

To find out if you are a candidate for the Circumareolar Breast Reduction procedure contact our South Florida practice or fill out our online consultation form.