Other breast surgeries

Breast reduction techniques are the basis of oncoplastic surgery. Although I don’t carry out purely plastic surgery, I have gained extensive experience in reduction surgery over the last 25 years. I operate reduction surgeries for pathological breast hypertrophies (resecting at least 300 g per breast), as well as opposite breast symmetrization surgeries as part of breast reconstructions.

Over the years, I have developed a personal breast reduction technique using superior pedicle. It is based on the principles of Lejour’s technique (breast reduction by pure vertical scar) regarding the design and the use of liposuction, as well as the reduction principles of Lalardrie. It is extremely reliable, with a very low complication rate and perfectly adapted to oncoplastic. This is a rigorous, reproducible technique, which I can methodically teach to surgeons who come for an oncoplastic training. It is suitable for all kinds of breasts whatever their consistency (fat or glandular) or their volume.

From Left to Right : 
Large glandular breasts
After reduction of 780g

From Left to Right :
Narrow breasts mixed consistency 
After reduction of 820g

From Left to Right :
Large breasts fat consistency
After reduction of 790g

This surgery is not painful at all. It includes a hospital stay of 2 to 4 days depending on the case, with a prescription for daily nursing care after returning home. Showers are permitted after the drains are removed (5th to 8th post-operative day according to the case). The few non-absorbable sutures are removed during the check-up consultation, two weeks after the operation. The postoperative swelling subsides within one to two months. The scar is usually most apparent after 2 months and wears off between 6 months and one year. The final shape is obtained at this time.

From Left to Right :
Pre-operative

Result after 2 months
Result after a year

From Left to Right :
Pre-operative
Result after 3 months
Result after a year

There is a risk of hypertrophic scarring in about 5% of cases. The scar can then take longer and sometimes several years to evolve and disappear. The patient will remain satisfied as long as she was notified of this risk and since the surgery brought her an important functional comfort.

From Left to Right :
Substantial Hypertrophy
Hypertrophic scars after a year

From Left to Right :
Moderate hypertrophy with ptosis of the breast
Hypertrophic scars after a year

This healing process can be suspected more often for young patients, patients with poor wound healing and more particularly for patients of black skin.

1-Gigantomastia resecting more than 2kg of breast tissue

From Left to Right :
Pre-operative aspect
After reduction of 2510g

From Left to Right :
Pre-operative aspect
After reduction of 2kg

2-Substantial reductions between 1 and 2 kg of breast tissue

From Left to Right :
Pre-operative aspect
After reduction of 1730g

From Left to Right :
Pre-operative aspect
After reduction of 1210g

3-Moderate reductions between 600g and 1 kg of breast tissue

From Left to Right :
Pre-operative aspect
Pre-operative aspect

After reduction of 800g

From Left to Right :
Pre-operative aspect

After reduction of 740g

For congenital asymmetries with hypertrophy and for reductions in opposite breast reconstruction, the technical principles are the same as for the reductions. We reduce the 2 sides in different amounts depending on the importance of asymmetry.

From Left to Right :
Pre-operative aspect moderate Asymmetry
After reduction of 1030g

From Left to Right :
Pre-operative aspect significant Asymmetry
After reduction of 370g on the right breast et 790g on the left breast total of 1160g

From Left to Right :
Pre-operative aspect significant asymmetry
After reduction of 700g on the right breast et 1260g on the left breast total of 1960g

Asymmetries after conservative treatment are quite common and inconvenient for the patients. Since it is difficult to reduce the irradiated breast due to the risk of wound healing problems, a unilateral reduction of the non-irradiated breast can achieve symmetry and help the patient.

From Left to Right : Asymmetry after conservative treatment on the right breast – After reduction of 350g on the left breast

In case of hypotrophy on one breast, symmetry can be reached using a prosthesis

From Left to Right :
Pre-operative aspect congenital Asymmetry
Correction with prosthesis

or more and more by using lipofilling, with a more natural result.

From Left to Right :
Pre-operative aspect congenital Asymmetry
Correction with Lipofilling and no prosthesis

I also developed a personal technique to treat gynecomastia. Depending on the situation, I can perfom:

1 – a simple resection of glandular excess with a lower periareolar incision

From Left to Right :
Glandular Gynecomastia
Post-operative result

From Left to Right :
Glandular Gynecomastia and tuberous breasts
Post-operative result

2 - a simple resection of fat excess with liposuction

From Left to Right :
Gynecomastia, fat consistency
Post-operative result

3 – a resection of fat and glandular excess associating liposuction and glandular resection

From Left to Right :
Mixed Gynecomastia no skin excess
Post-operative result

From Left to Right :
Mixed Gynecomastia no skin excess

Post-operative result

4 - a resection of fat, glandular and skin excess using Round Block technique

From Left to Right :
Mixed Gynecomastia with skin excess
Peri-areolar incision with Round Block
Post-operative result

From Left to Right :
Pre-operative, from the side
Result, from the side

From Left to Right :
Mixed Gynecomastia with skin excess
Post-operative result after Round Block

From Left to Right :
Pre-operative, from the side

Post-operative result after Round Block