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Patients who undergo breast reduction surgery frequently are
seeking relief from physical symptoms caused by the excessive
weight of large breasts. Breast reduction usually can solve
these problems as well as improve the size and shape of your
breasts. Following breast reduction, your breasts will be more
proportional to the rest of your body, and clothes will fit
you better.
Am
I a good candidate for breast reduction?
| You may be a good candidate for breast reduction
if you have one or more of the following conditions: |
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breasts that are too large in proportion
to your body frame |
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heavy, pendulous breasts with nipples and
areolas that point downward |
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one breast is much larger than the other |
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back, neck or shoulder pain caused by the
weight of your breasts |
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skin irritation beneath your breasts |
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indentations in your shoulders from tight
bra straps |
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restriction of physical activity due to
the size and weight of your breasts bra straps |
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dissatisfaction or self-consciousness about
the largeness of your breasts |
Breast reduction can be performed at any age, but plastic surgeons
usually recommend waiting until breast development has stopped.
Childbirth and breast-feeding may have significant and unpredictable
effects on the size and shape of your breasts. Nevertheless,
many women decide to undergo breast reduction before having
children and feel that they can address any subsequent changes
later. If you plan to breast-feed in the future, you should
discuss this with your plastic surgeon.
During the consultation, you will be asked about your desired
breast size as well as anything else about your breasts that
you would like to see improved. This will help your plastic
surgeon to understand your expectations and determine whether
they realistically can be achieved.
How
will my plastic surgeon evaluate me for breast reduction surgery?
Your plastic surgeon will examine your breasts, taking measurements
and perhaps photographs for your medical record. The size and
shape of your breasts, the quality of your skin, and the placement
of the nipples and areolas will be carefully evaluated.
You should come to the consultation prepared to discuss your
medical history. This will include information about any medical
conditions, drug allergies, medical treatments you have received,
previous surgeries including breast biopsies, and medications
that you currently take. It is important for you to provide
complete information.
You should tell your plastic surgeon if you plan to lose a significant
amount of weight, particularly if you have noticed that your
breasts become smaller with weight loss. Your surgeon may recommend
that you stabilize your weight before having surgery.
Will
my insurance help cover the cost of surgery?
Insurance coverage is sometimes available for breast reduction
surgery. Many factors determine your eligibility, including
the specific terms of your insurance policy and the amount of
breast tissue to be removed. A letter of predetermination may
be required by your insurance company prior to surgery. Your
plastic surgeon or a staff member in your surgeon's office will
discuss these matters with you.
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| One common breast reduction technique
removes excess breast tissue, fat and skin through the
incisions shown. The nipple and areola remain attached
to the underlying tissue but are shifted to a higher position.
The size of the areola is often reduced at the same time. |
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| Skin that formerly was located above
the nipple is brought down and together to reshape the
breast. |
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Where
are the incisions placed?
Individual factors and personal preferences will determine the
specific technique selected to reduce the size of your breasts.
The most common method of reducing the breasts involves three
incisions. One incision is made around the areola. Another runs
vertically from the bottom edge of the areola to the crease
underneath the breast. The third incision follows the natural
curve of the breast crease. After the surgeon has removed excess
breast tissue, fat and skin, the nipple and areola are shifted
to a higher position. The areola, which in large breasts usually
has been stretched, also is reduced in size. Skin that was formerly
located above the nipple is brought down and together to reshape
the breast. Liposuction may be used to improve the contour under
the arm.
Usually, the nipples and areolas remain attached to underlying
mounds of tissue, and this allows for the preservation of sensation.
The ability to breast-feed may also be preserved by this method,
although this cannot be guaranteed.
What
are some variations to the common breast reduction technique?
There are many variations to the design of the incisions for
breast reduction. The size and shape of your breasts, as well
as the desired amount of reduction, are factors that will help
your plastic surgeon determine the best technique for you.
In some instances, it may be possible to avoid the vertical
incision that runs from the bottom edge of the areola to the
breast crease or the horizontal incision underneath the breast.
Rarely, if your breasts are extremely large, the nipples and
areolas may need to be completely detached before they are shifted
to a higher level. In such a case, you will need to have made
the decision to sacrifice sensation and the possibility of breast-feeding
in order to achieve your desired breast size.
I
understand that every surgical procedure has risks, but how
will I learn more so that I can make an informed decision?
Fortunately, significant complications from breast reduction
are infrequent. Every year, many thousands of women undergo
successful breast reduction surgery, experience no major problems
and are pleased with the results. Anyone considering surgery,
however, should be aware of both the benefits and the risks.
The subject of risks and potential complications of surgery
is best discussed on a personal basis between you and your plastic
surgeon, or with a staff member in your surgeon's office.
Some of the potential complications that may be discussed with
you include bleeding, infection and reactions to anesthesia.
Rarely, a patient may require a blood transfusion during the
operation. This usually can be anticipated in advance, and your
plastic surgeon may, under certain circumstances, advise you
to donate your own blood in preparation for surgery.
Following reduction, sometimes the breasts may not be perfectly
symmetrical or the nipple height may vary slightly. If desired,
minor adjustments can be made at a later time. Permanent loss
of sensation in the nipples or breasts may occur rarely. Revisionary
surgery is sometimes helpful in certain instances where incisions
may have healed poorly. In the unlikely event of injury to or
loss of the nipple and areola, they usually can be satisfactorily
reconstructed using skin grafts.
You can help to lessen certain risks by following the advice
and instructions of your plastic surgeon, both before and after
surgery.
How
should I prepare for surgery?
Depending on your age, or if you have a history of breast cancer
in your family, your plastic surgeon may recommend a baseline
mammogram before surgery and another mammographic examination
some months after surgery. This will help to detect any future
changes in your breast tissue. Following breast reduction, you
will still be able to perform breast self-examination. Breast
reduction surgery will not increase your risk of developing
breast cancer.
If you are a smoker, you will be asked to stop smoking well
in advance of surgery. Aspirin and certain anti-inflammatory
drugs can cause increased bleeding, so you should avoid taking
these medications for a period of time before surgery. Your
surgeon will provide you with additional preoperative instructions.
Breast reduction surgery may be performed on an inpatient or
outpatient basis. If you are to stay in the hospital or surgical
facility, it will most likely be for only one night. Whether
you are released the day of surgery or the following day, you
will need someone to drive you home and to stay with you for
the next day or two.
Your Surgical
Experience
The goal of your plastic surgeon and the entire staff is to
make your surgical experience as easy and comfortable for you
as possible.
What
will the day of surgery be like?
Your breast reduction surgery may be performed in a hospital,
free-standing ambulatory facility or office-based surgical suite.
Usually, a general anesthetic is administered, so that you will
be asleep throughout the procedure. When surgery is completed,
you will be taken into a recovery area where you will continue
to be closely monitored. In many instances, small drain tubes
will have been placed in your breasts to help avoid the accumulation
of fluids. Gauze dressings will be placed on your breasts and
covered with an elastic bandage or surgical bra.
How
will I look and feel initially?
The day after surgery, you will be encouraged to get out of
bed for short periods of time. After several days, you will
be able to move about more comfortably. Straining, bending and
lifting must be avoided, however, since these activities might
cause increased swelling or even bleeding. You may be instructed
to sleep on your back to avoid pressure on your breasts.
Any surgical drains will be removed a day or two after surgery,
at which time your dressings may also be changed or removed.
You will be instructed to wear a support bra for a few weeks,
until the swelling and discoloration of your breasts diminishes.
Generally, stitches will be removed in stages over a period
of approximately three weeks, beginning about one week after
surgery.
You may notice that you feel less sensation in the nipple and
areola areas. This usually is temporary. It may, however, take
weeks, months or even more than a year before sensation returns
to normal. Your breasts may also require some time to assume
a more natural shape. Incisions will initially be red or pink
in color. They will remain this way for many months following
surgery.
When
can I resume my normal activities?
After breast reduction surgery, it is often possible to return
to work within just a couple of weeks, depending on your job.
In many instances, you can resume most of your normal activities,
including some form of mild exercise, after several weeks. You
may continue to experience some mild, periodic discomfort during
this time, but such feelings are normal. Severe pain should
be reported to your doctor.
Any sexual activity should be avoided for a minimum of one week,
and your plastic surgeon may advise you to wait longer. After
that, care must be taken to be extremely gentle with your breasts
for at least the next six weeks.
How
long will the results last?
Unless you gain or lose a significant amount of weight or become
pregnant, your breast size should remain fairly constant. However,
gravity and the effects of aging will eventually alter the size
and shape of virtually every woman's breasts. If, after a period
of years, you become dissatisfied with the appearance of your
breasts, you may choose to undergo a breast "lifting"
procedure to restore their more youthful contour.
Results of Breast Reduction
Breast reduction surgery will make your breasts smaller and
firmer. Without the excessive weight of large breasts, you may
find greater enjoyment in playing sports and engaging in physical
activity.
The incisions from your breast reduction surgery will heal and
fade over time. It is important to realize, however, that the
incision lines will be permanently visible, more so in some
individuals than others. Fortunately, the incisions for breast
reduction are in locations easily concealed by clothing, even
low-cut necklines.
Breast reduction often makes a dramatic change in your appearance.
For this reason, it may take some time to adjust to your new
body image. Most women, however, eventually become comfortable
with their smaller breasts and feel very pleased with the results
of surgery. In fact, the level of patient satisfaction resulting
from breast reduction is among the highest of any plastic surgery
procedure.
Maintaining
a Relationship with Your Plastic Surgeon
You will return to your plastic surgeon's office for follow-up
care at prescribed intervals, at which time your progress will
be evaluated. Once the immediate postoperative follow-up is
complete, many surgeons encourage their patients to come back
for periodic checkups to observe and discuss the long-term results
of surgery.
Please remember that the relationship with your plastic surgeon
does not end when you leave the operating room. If you have
questions or concerns during your recovery, or need additional
information at a later time, you should contact your surgeon. |
Content provided by The American Society
for Aesthetic Plastic Surgery (ASAPS).
For advertising info, please contact Terry McGovern terry.mcgovern@latimes.com
at (213) 473-2599
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