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    Supernumerary breasts

    Excess breast tissue can be traced back to an incomplete regression of the milk line in the unborn child in the womb. Hormonal influences during menstruation, pregnancy or lactation can change the size of the additional (accessory) breasts and cause pain. As this is normal breast tissue, all forms of breast diseases can also occur in the surplus breast tissue. Surplus breast tissue occurs mostly on both sides and is often found near the armpit and pectoral muscle. The excess breast tissue leads to a protrusion, cyclic pain and occasionally to painful movement restrictions of the arm. The discomfort can be remedied using a scar-saving technique. In the case of very large excess breasts, the removal of the skin mantle should be considered, which can be accompanied by a scar of a few centimetres. Since pregnancy leads to an enlargement of the excess breast tissue and a reduction of the skin tension, it is recommended to remove the breast tissue before pregnancy.

    How are extra breasts removed?

    Before each operation, the patient is meticulously checked several times to ensure the greatest possible patient safety. The operation is not started until all requirements have been met according to the checklist.

    Before the operation, the breasts are marked in a standing position. If the operation is performed in twilight sleep, you will be given medication that will relieve your anxiety and reduce your sensitivity to pain. If you do not sleep deeply anyway, you may feel something happening on the surface of your body.

    In the area of the armpit along the natural skin folds, the tissue is first sucked out using the tumescent technique through a skin incision of about one centimetre. The marked areas are injected in order to operate more gently and to prevent the formation of bruises and contour irregularities. The injection and liposuction are performed with fine microcannulas, which are inserted into the subcutaneous fat tissue of the marked areas via the smallest skin incisions of about two to three millimetres. After the tissue has been infiltrated and loosened, the excess fatty tissue is removed by negative pressure using an aspiration cannula. The cannulas are inserted through several openings and guided in a fan shape to achieve a uniform suction image. The mammary gland is then removed through an incision of about one centimetre in the armpit area. In moderate accessory breasts, the skin recedes after six to twelve months. If the breasts are larger and the skin tension is reduced, the excess skin is additionally removed. Depending on the findings, drainage tubes are inserted into the wound, which can be removed again after a short period. The wound is closed with fine threads, which dissolve themselves after about three weeks. Finally, a light pressure bandage is applied.

    The outpatient procedure lasts 60 minutes. Immediately after the operation you will be continuously monitored in a so-called recovery room. You can drink something after the complete awakening and, if you tolerate this well, also eat something. Before you leave the practice, appointments for check-ups will be made and the behavioural measures will be discussed with you in detail. You will receive a comprehensive written report and a telephone number where you can reach the surgeon 24 hours a day in an emergency.

    Before, after and even during the operation you can watch movies or your favourite series with virtual reality glasses. This is not only entertaining, the distraction also demonstrably leads to less sensitivity to pain.

    How can you prepare for the removal of supernumerary breasts?

    • All your questions about possible complications and alternative treatments should be answered before the operation.
    • On the day of surgery, shower with a disinfectant soap (e.g. HiBiScrub® Plus, Octenisan® Wash Lotion, Prontoderm® Shower Gel).
    • Keep nicotine and alcohol consumption to a minimum.
    • If necessary, stop taking hormone-containing medication (the pill) temporarily.
    • Blood-thinning medication (e.g. ASS, Thomapyrin®) must be discontinued at least ten days before the operation after consultation with your treating physician.
    • Vitamin preparations (A, E) and dietary supplements (omega-3 fatty acids, St. John’s wort preparations, etc.) must be discontinued at least four weeks before the operation.
    • Surgery limits the ability to travel by air. Therefore, do not plan any professional or private air travel during the four weeks following the operation.
    • Before performing aesthetic surgery, you should take out follow-up insurance.

    What do you have to consider after the removal of excess mammary glands?

    • This is followed by regular checks of your well-being and the results of the operation.
    • An elevation of the upper body of about 30 degrees (also during sleep) over five days is beneficial for the reduction of swelling and wound healing.
    • An elevation of the upper body of about 30 degrees (also during sleep) over five days is beneficial for the reduction of swelling and wound healing.
    • From the third postoperative week onwards, several daily massages for a few minutes in a circle and lengthwise and crosswise to the course of the scar with oily creams (e.g. Bepanthen® ointment or Linola® fat) help to inconspicuous scars.
    • Bending down, lifting heavy loads, swimming, sauna, sexual intercourse and sports activities should be avoided for four weeks, possibly longer if swelling still exists.

    Author’s statement

    Author: Stéphane Stahl, MD, PhD. There are no financial relationships with the pharmaceutical or medical device industries that could have influenced the above text. Any reproduction, even partial, is permitted for personal use only. All texts used on this website are protected by copyright.

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