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The e-mémoires of the Académie Nationale de Chirurgie

Is it legitimate to propose surgery of the breast area before the end of puberty?

Véronique MARTINOT-DUQUENNOY | C. CALIBRE | P. GUERRESCHI

Seance of wednesday 07 june 2023 (Les malformations congénitales thoraco-mammaires)

DOI number : 10.26299/am4x-6754/emem.2023.21.05

Abstract

Breast surgery is usually recommended for women who have completed puberty. Indeed, during adolescence the breast is constantly changing, the patient's weight is often unstable, the risk of inflammatory scars (hypertrophic or keloid) is higher and disturbances of areolar sensitivity can affect the patient's quality of sexual life. In addition, the risk of infection is not negligible, especially during an acne outbreak. In case of early implant placement, iterative changes should be planned. Finally, the result obtained is not always stable but above all the lack of psychological maturity and the legal need to obtain the agreement of both parents are obstacles to early surgery. However, the authors argue for the possibility of surgical correction of the breast around puberty, in particular because of the very clear positive psychological impact. Other arguments are also detailed: to ensure a breast reconstruction in successive stages started early, to limit the repercussions of hypertrophy, to correct thoracic or skin anomalies. These indications are illustrated by numerous clinical cases demonstrating the need for customized surgery on a case-by-case basis.