Mammoplasty

What are the Types of Mammaplasty?

Types of mammaplasty are three. The three types are: breast augmentation (Augmentation Mammaplasty), breast lifting, and breast reduction (Reduction Mammaplasty) aesthetics. It is also possible to shape or equalize the breasts.

What is Augmentation Mammaplasty?

Augmentation mammaplasty is a breast enlargement surgery. The operation is performed as an open surgery. Before starting the surgery, anesthesia is applied to the patient. The incision for the surgery is usually made at the point where the breast joins the chest wall, around the areola, or under the armpit. A pocket is created either behind the breast tissue or under the chest wall muscles. Prostheses are placed into these pockets.

What is Reduction Mammaplasty?

Reduction mammaplasty is the process of reducing, lifting, and reshaping the breasts. There are three techniques for this surgery. They are:

• The technique where the incision is made only around the areola (Benelli technique): Only the area around the areola is cut.
• The technique that leaves a T-shaped scar: This is the most commonly used breast reduction technique worldwide and in Turkey. It is considered a classical method, but one of its major disadvantages is that it leaves a lot of scarring.
• Vertical mammaplasty (breast reduction with the vertical technique): In this technique, an incision is made around the areola and vertically from the areola to the inframammary fold. The incision along the inframammary fold may not be made, or a very small incision is made to remove skin. This technique is used in breast shaping as there is no long incision along the inframammary fold.

Mammaplasty After Breast Cancer

The purpose of oncoplastic breast surgery is to provide a good appearance while performing surgical treatment for a patient with breast cancer. This helps the patient feel better. The oncoplasty method chosen depends on the location of the tumor.

Crescent (Hilal) Mastopexy Excision:

This is suitable for central superior resection (removal of a diseased part of an organ) of a cancer that does not involve the nipple or areola. It is recommended for patients with a large areola and small tumor.

Batwing Excision:

This method is used for large excisions of upper central abnormalities that are within a few centimeters of the nipple. Unlike the crescent-shaped incision, in addition to the two circles, there are triangular sections on both ends.

Hemibatwing Excision:

Excision (cutting and removing) is performed only on one side in a triangular shape. The skin, breast gland, and pectoral fascia are delineated, and ptosis is slightly corrected. This method is not preferred for lesions located medially to the breast due to the visible scar it may leave.

Donut Mastopexy Excision (Round Block technique):

A second circular incision is made around the areola and in its immediate area. The circular skin between the two incisions is removed partially or completely. By releasing the skin, almost every part of the breast can be accessed. After the necessary excision, the breast sections are closed with 2-0 absorbable sutures. A continuous suture is applied to the subcutaneous skin incision, narrowing it, and the two incision parts are sutured together to create a new areolar boundary. The advantage of this technique is that it prevents scars in different parts of the breast.

B-Flap Excision (Grisotti Mastopexy technique):

In cases where the nipple-areola complex requires resection due to the proximity of the tumor, this is an ideal approach for women with sufficient breast volume and moderate breast ptosis.

Central Quadrantectomy:

In this method, a circumareolar incision is made to include 50% of the areola. It is particularly suitable for women with large breast sizes. In this method, the nipple-areola is left relatively thick to ensure sufficient blood supply. The area, which may have been marked with a clip, is resected up to the pectoral muscle. Several suture points, including the ones for the wound closure, are used to bring the tissues together.