What is Breast Reduction?

Breast Reduction, or Reduction Mammoplasty, involves the removal of fat, glandular tissue, and skin from the breasts and makes them appear smaller, lighter and firmer. Reduction of the size of the areola, the darker skin around the nipple, can also be done. The objective here is to give the breasts a better shape that is in proportion with the rest of the body.


Effects of Breast reduction

The choice of getting a Breast Reduction can have a significant effect in your life. This is where you decide to re-establish your health, sense of femininity, and most of all, your self-confidence. Picture yourself with a proportional body, with an excellent posture, and free from any pain without the discomfort of large, pendulous breasts that lead to headaches, back, neck and shoulder pain, humiliation, and the lack of ability to engage in many physical activities. Wherever you choose to have breast reduction surgery, you deserve to achieve your preferred figure.


Candidates for Breast reduction

Overly large breasts can cause a lot of problems, both physical and emotional. The best candidates for this procedure are women who are distressed by very large and sagging breasts that restrain them from doing activities and cause physical discomfort. If you have one or more of the following conditions, you may be a good candidate for Breast Reduction:

  • Breasts that are too large in proportion to your body frame. 

  • Breasts that are heavy and pendulous where nipples and areolas point downward. 

  • One breast is bigger than the other. 

  • Presence of back, neck, or shoulder pain due to the weight of your breasts. 

  • Presence of skin irritation underneath your breasts. 

  • Grooves in shoulder due to tight bra straps. 

  • Limitation in physical activities due to size and weight of breasts. 

  • Discontentment or self-consciousness about the size of breasts. 

It is advised that breast reduction not be done until breast growth has stopped, although this procedure can actually be performed at any age. If you plan to breast feed in the future, it is important that you discuss this first with your plastic surgeon since childbirth and breastfeeding may have major and unpredictable effects on the size and shape of your breasts. On the other hand, many women come to a decision to go through breast reduction before having children thinking that they can address any succeeding changes later. 

It is also important that the patient is mature enough to fully comprehend the procedure and have expectations about the outcome that are realistic. 


Your Consultation

Prior to your surgery, the surgeon will discuss how you want your breasts to look like and also let you know if your expectations are actually realistic for your body frame. The doctor will help in choosing the breast reduction procedure that is suitable for you. 

Before going into surgery, it is essential that you are in good physical and mental condition. It is also important that you quit smoking as it affects the healing process. Smoking inhibits the ability of the body to deliver oxygen to the organs which is very vital during surgery and recovery. Patients who are diabetic may have problems with healing after the procedure, so they are asked to maintain a certain level of health before undergoing the operation. Also, patients who are under the age of 18 are advised to wait until such time that their breasts have stopped growing before going through with this procedure. 

The Breast Reduction Procedure

The Breast Reduction procedure is done on an outpatient setting under general anesthesia. The surgery will take about two to four hours. 

There are different techniques and procedures to choose from. From the consultation that you had with the surgeon, you will have picked the procedure that best suits your goals. 

The most common method used in breast reduction surgery involves three incisions. One incision is made surrounding the areola then another runs vertically from the lower edge of the areola to the crease beneath the breast. Lastly, the third incision follows the natural curve of the breast crease. 

The nipple and areola are moved to a higher position after the surgeon has eliminated the excess breast tissue, fat, and skin. The areola is also proportionally reduced in size as this becomes stretched in large breasts. The skin that was previously positioned above the nipple is brought down and together to give the breasts a better shape. For the improvement of the contour of the upper arm, liposuction may be utilized. 

Most of the time, the nipples and areolas stay connected to the underlying mounds of tissue which allows for preservation of sensation. The possibility of breastfeeding may also be preserved by this technique, but is not a guarantee.


Recovery

After the surgery, there will immediately be a noticeable difference in breast size. A few days after the procedure, a bra should be worn to provide support and to diminish swelling. To encourage healing and to make certain that you get the breasts you wish for, a surgical bra should be worn constantly for several weeks. Most of the patients take a break, at least one to two weeks, from work or normal activity. It is not advisable to participate in strenuous activities for about six weeks after undergoing the operation. 

Aside from the reduction in the breast size, there are other noticeable changes. You may observe an improvement in your backache, neck ache, shoulder ache, and posture. Most importantly, it will change the way you feel about yourself. 

Recovery time takes between three and four weeks to be able to go back to work, around six weeks to resume strenuous activities, and several months to a year or more for the scars to fade. 


risks

Major complications from breast reduction are very rare. Yearly, many women go through this surgery and are very happy with the outcome. Those who are contemplating this procedure must be aware of both the benefits and the risks of surgery. 

Some of the potential complications of this procedure include bleeding, infection and a reaction to anesthesia. After surgery, there are instances when the breasts may be slightly asymmetrical or there may be slight variations in the nipple height. If preferred, slight adjustments can be done at a later time. Rarely, permanent loss of sensation in the nipples or breasts may occur after the procedure. 

In certain events where there is poor healing of the incisions, a revision surgery can be performed. Skin grafts may also be utilized for reconstruction in the unlikely event of damage or loss of the nipple and areola. 


Frequently Asked Questions

Q: How will my plastic surgeon conduct the evaluation for Breast Reduction surgery?

A: At this time, the surgeon will examine your breasts, take measurements, and photograph your breasts for your medical record. The doctor will carefully evaluate the size and shape of your breasts, the quality of your skin, and position of the nipples and areolas. 

Your medical history will be also discussed during the consultation so you must be prepared to provide pertinent information about any medical conditions, allergies to medications, medical treatments received, surgical history including breast biopsies, and current medications. It is important that the information you provide is complete. 

If you are planning to lose a significant amount of weight, notify your plastic surgeon, especially if you have noticed that your breasts become smaller with weight loss. Stabilizing one’s weight before undergoing the procedure may be recommended by your surgeon. 

Q: How should I prepare for surgery?

A: A baseline mammogram may be recommended depending on your age or if there is a history of breast cancer in your family. This is done both before surgery and several months after. Doing so will help detect any future changes in your breast tissue. After the procedure, breast self-examination can still be performed. Risk of breast cancer development is not increased by undergoing breast reduction surgery. 

Smoking should be stopped in advance before going through with the surgery. Aspirin and certain anti-inflammatory drugs should be avoided for a period of time before surgery as these can cause increased bleeding. Additional pre-operative instructions will be provided by your surgeon. 

However, even if you are released on the day of surgery or the next day, it is imperative that you have someone to drive you home and to stay with you for at least one to two days. 

Q: What will the day of surgery be like? 

A: Breast reduction surgery may be done in a hospital, a free-standing ambulatory facility, or an office-based surgical suite. 

Most of the time, administration of a general anesthetic is used. After completion of surgery, you will be closely monitored in a recovery area. In most cases, small drain tubes will be placed in your breasts to avoid fluid accumulation. Gauze dressings with an elastic bandage or a surgical bra will be used in order to cover your breasts. 

Q: How will I look and feel initially?

A: A day after surgery, you are encouraged to get out of bed for short periods of time. You will be able to move more freely and comfortably after several days. On the other hand, some activities such as bending and lifting must be avoided as they may cause increased swelling or even bleeding. You may also be advised to sleep on your back so as to keep pressure off your breasts. 

If surgical drains are placed, they may be removed one or two days after the procedure, at which time dressings may also be changed or removed. A support bra should be worn for a few weeks until there is diminished swelling and discoloration of the breasts. Over a period of approximately three weeks, your stitches will be removed in stages starting about one week post-surgery. 

There will be noticeable loss of sensation around the nipple and areola areas; however, this is usually temporary. On the other hand, return of normal sensation may take weeks, months, or even more than a year. Your breasts may also need some time to acquire a more natural shape. Initially, the incisions will be red or pink and will stay this way for many months following the procedure. 

Q: When can I resume my normal activities?

A: After undergoing the procedure, depending on the kind of job that you have, you may possibly return to work within a few weeks. Several weeks after the procedure, you may resume the majority of your normal activities. However, mild intermittent discomfort may be felt during this time but is expected. On the other hand, when severe pain is felt, it should be immediately reported to your doctor. 

Sexual activity should be avoided for at least one week or so. After that period, you must be extremely gentle with your breasts for a minimum of six weeks. 

Q: How long will the results last? 

A: Your breast size will remain stable unless you gain or lose a large amount of weight or if you become pregnant. However, because of gravity and the natural process of aging, your breast size and shape will eventually change. If after several years you are not satisfied with how your breasts appear, a breast lift procedure may be done to re-establish a more youthful shape of your breasts.