The importance of asking the right questions before surgery

Breast surgeries covered by public system are : Breast reduction of more than 250 gr per breast Symetrisation in breasts having more than 150 g of difference Breast reconstruction after mastectomy or even traumatism (burns for exemple).

There is no particular age at which the indication of a lift face is limited. This surgery is supposed to correct certain manifestations in the face that may betray some aging. This may be due to advanced age, but may also be related to a characteristic hereditary trait. That’s why this surgery can sometimes be indicated in people younger than expected.

It depends on the technique used by the surgeon. In breast augmentation where the prosthesis has been placed directly behind the gland, in most cases the loss of the erogenous sensation of the nipple is to be expected because the pouch prepared between the thoracic muscles and the gland interrupts in most cases. sometimes the path of the three intercostal nerves (fourth fifth and sixth) which carry the erogenous sensation of the nipple. In the retro-breast mammary augmentation, unfortunately, most of these surgeries are done in such a way as to place the prosthesis only behind the pectoral muscle and thus to approach this space behind the muscle by the free edge of the pectoralis major muscle. The approach of this space will interrupt at least two of the three intercostal nerves responsible for the erogenous sensation of the nipple. In our way of doing breast augmentation, we do not lose the erogenous sensation of the nipple because we approach the retro muscle space in another way either through the oblique large muscle, going back up the dissection of the pouch upwards. placing the prosthesis behind the four muscles of the anterior hemithorax: the large oblique, the large serratus, the small oblique, and finally the great pectoral. In this way, the three intercostal nerves responsible for the erogenous sensation of the nipple are not injured and the nipple, in our addition surgeries will retain its erogenous sensation. See the diagram in the breast addition page.

Traditional techniques of breast lift and reduction are based on ways of doing things that prevent the continuation of the milk ducts that extend from the gland to the nipple. A very small number of these techniques would make it possible to maintain a partial and incomplete capacity to breastfeed. The peculiarity of mammoplasty by the posterior total pedicle of Moufarrege that I use emanates from the fact that all the remaining gland continues to drain directly into the nipple. On a retrospective study of a series of patients with more than 550 people operated by me, we find a success rate quite equivalent to that of the capacity to breastfeed in the general population. It is therefore certain that in our patients we do not lose the ability to breastfeed if we had it before surgery.

It is indeed known that in traditional techniques it is necessary to give up maintaining an erogenous sensation at the level of the nipple. In the technique of mammoplasty by the posterior total pedicle of Moufarrege that I use, the intercostal nerves responsible for the erogenous sensation are not interrupted and therefore the erogenous sensation of the nipple is preserved in my technique.

This question has been topical since we diagnosed a type of lymphoma called large cell lymphoma on breast prostheses of a particular type. It seems that this pathology can be found in an infinitely small number of cases on some prostheses. These prostheses involved are mainly silicone prostheses with textured wall. We have not yet seen in the literature cases of large cell lymphoma on other types of prostheses that is to say the smooth saline prostheses. Personally, I only use smooth saline prostheses and I judge the risk of lymphoma in these cases as virtually nonexistent until proven otherwise.

Not only that it is possible to pass these tests on a breast prosthesis but also the prosthesis often facilitates reading for the following reasons: the saline prosthesis is easily examined in these images, it is placed behind the muscle and projects forward the mammary gland that will be the object of these examinations.

It has been defined in a retrospective study of thousands of breast reductions that they decrease the incidence of breast cancer, all techniques combined, by 25% compared to the incidence in the general unoperated population. The mammary reduction with the posterior total pedicle of Moufarrege shows by an extensive retrospective study that this surgical technique decreases the incidence of cancer by 62.5% compared to the incidence in the general population without surgery.