Problems and Problem Solving

Abstract

If the only problems with the circumareolar reduction/mastopexy/repair surgeries were the occasional stitch granuloma, as illustrated in Figure 12.1, there would be no question that the procedure is vastly superior to standard surgeries. As readers know, patients gain and lose weight, the breast stretches or contracts, fibrocystic disease interferes with prostheses, and scars often behave erratically. The same psychological problems are seen. Patients whose breasts are reduced often have a change of heart and ask for further enlargement. Those who have implants removed are sometimes no longer content with the breast size that is achieved by utilizing all of their remaining breast tissue. These problems are independent of the surgical procedure and are not always avoided by extensive preoperative counseling. The problem of capsular contracture has become less of a concern with the advent of textured prostheses and improvement in control of bacterial overgrowth.