Fat necrosis occurs when fat cells
lose blood flow. Fat cells are living cells and if there is no blood flow,
they may die and cause "fat necrosis". The liquefied fat cells can harden
overtime underneath the skin, causing firmness or contour irregularities. Surgical intervention might be needed to help alleviate some of the symptoms
caused by fat necrosis.
"Fat necrosis is more common in larger resections. A study by Strombeck
reported a 16% incidence of fat necrosis in obese patients having resections of
more than 1000 g. However, the incidence of fat necrosis has been reported as
low as 0.8% in 371 patients undergoing an average resection of 870 grams per
breast". This problem may prompt later investigation or biopsies to
differentiate these lumps from those associated with breast cancer.
Dog ears are small
folds of skin which occur at either end of the scar, caused by a natural folding
of the skin when the wound is closed. Dog Ears occur approximately five percent
of the time. Great care is taken during the surgery to avoid this
complication however; sometimes this cannot be avoided.
Small dog ears which
are seen in the early post-operative period will normally settle on their own
during the first six to nine months after surgery. If they do not settle after
this time, they can be simply cut out in a minor procedure under local
anesthetic.
Skin
or tissue necrosis following breast reduction is a very rare complication;
however there are increased risks with patients who fit a certain profile.
Patients with increased
risks of necrosis occurring:
As with any surgical
procedure, infection can occur during or after the breast reduction operation. Infections
can sometimes occur if wound separation happens. It is very
important to make sure you take all of your prescribed antibiotic medication.
Signs to call your surgeon immediately:
Fever – temperature of 101 degrees
or higher
Chills
Sweating
Excessive pain or redness
from the incision site
General malaise
Drainage from the
incision has a greenish tint
Bad odor coming from the
incision site
Draining too steadily
All the above symptoms
are signs of an early
infection,
and if caught early enough, then sometimes all the patient might need is an
increase in antibiotics. Infections can cause a delay in wound healing as well
as prolong the recovery time for breast reduction
surgery. Because of the risks that are associated with an infection
with this surgery, you need to be in the best of health at the time or the
procedure to give you the very best odds.
Possible loss of feeling in breasts can happen from breast reduction surgery.
Numbness in the nipples
and the surrounding breast tissue after breast reduction surgery is normal. This
will go away after a few weeks or so. In some rare cases this numbness can be
permanent. Plastic surgeons will tell their patients to give this at least a
year before diagnosing this as permanent sensation loss, as nerve fibers grow at
a very slow rate and can take months before the feeling comes back into the
breast area.
Shooting pain from the
nerves and tingling during breast lift recovery is also normal. This means the
nerves are trying to regenerate, so these sensations are a good sign that the
nerves are returning to normal function.
As you heal after breast reduction
surgery, the lower half of the breast tissue may stretch out below the level of
the nipple/areola complex. This causes the nipple/areola complex to point
upward and all the fullness of the breast is below this area causing asymmetry
to the breast creases. This condition is called Bottoming Out. If
this should happen after breast reduction, it may require additional surgery to
excise some of the extra skin along the lower incision lines.
Dark spots can cause permanent hyper-pigmentation from the bruising that occurs
from this surgery. Treatments are available if you should get this rare
complication, including Intense Pulse Laser treatments. Application of warm
compresses after you are healed helps with the dilation of blood vessels and the
re-absorption of blood.
Post operative blood loss is normally a rare complication with breast reduction
surgery; however, if you do get this you should seek medical help immediately. Blood transfusions may be necessary in severe cases.
Your plastic surgeon will
instruct you before the surgery to stop taking any anti-coagulants before your
surgery, and an include aspirin and aspirin containing medications, Vitamin E,
anti-inflammatories or
Warfarin etc.
A hematoma or a seroma can be a complication of breast reduction surgery. A
hematoma is a collection of blood in a body cavity in which pain, scar tissue,
swelling, edema, and also infection is possible.
A seroma is a collection of
the watery portion of the blood in a body cavity in which can also cause pain
and scar tissue to form.
This is a risk of most surgeries, including breast reduction. A pulmonary
embolism is a blood clot in the lung. A clot can break free from the surgical
site, and travel to the lungs. This condition can cause the patient great
distress and could lead into myocardial infraction or possibly a coma which
leads to the loss of oxygen rich blood to the brain.
Pulmonary Embolism
normally happens within the first 72 hours after surgery; however it has been
known to happen for up to three weeks after a surgical procedure. The important
factor to know with this complication is that it can occur without any warning
and normally happens suddenly.
Most patients will
have some change in nipple sensation following mammoplasty. This is usually
temporary but could take months to return.
Hypersensitive nipples can
occur after any breast surgery. To help with the discomfort patients should try
wearing some sort of gauze pad or Band-aid to help prevent the clothing from
rubbing the affected area.
Sometimes the incisions will pull apart. This
does not require additional surgery. It is treated with moist dressings.
However, if this occurs, recovery time is much longer.
Fortunately most "bad
reactions" to anesthesia are not life-threatening. However, all forms of anesthesia including the different forms of local, can
carry a risk of an allergic reaction. Anesthesia exposes the body to
controlled levels of toxic chemicals in order to make sure there is no pain felt
during a surgical procedure. The main goal of anesthesia is to either stop
pain temporarily or to induce a semi-conscious or unconscious state. Even
though anesthesia carries a risk, the benefits outweigh any potential
disadvantage.
The most important factor is making sure that
whoever administers the anesthesia are board certified in anesthesiology. By doing this, you reduce the risks of any complication that might arise during
surgery. All body functions and chemistry are monitored during your
surgery to ensure a safe procedure.
The most common reaction or danger of having
anesthesia is an allergic reaction to one of the medications used. This is
addressed immediately by the attending anesthesiologist by monitoring your vital
signs. If an allergic reaction occurs, your anesthesiologist is equipped
to handle this immediately. Severe allergic reactions during
anesthesia are fortunately rare.
It is very important to tell your
anesthesiologist every medication you take on a regular basis, so that he can
prevent any potential problem during surgery.
Some patients might not be
totally satisfied after breast reduction surgery with their size.
Sometimes the surgeon might not take off as much breast tissue as they had hoped
for. Make sure you tell your surgeon the size and look you are after
before your procedure.
Recurrence of ptosis
is a very common problem, after several years the breast may begin to
droop again. Although it will not be to the extent it was before surgery, what
you will notice is that you loose some of the superior pole fullness. Some of
the newer techniques however; do focus on maintaining more fullness superior by
glandular reshaping.
