Breast Reduction

Breast Reduction Photo Gallery

Women with very large breasts may often suffer from problems such as chronic back and neck pain, recurrent skin irritations, posture problems and general discomfort. The breast reduction procedure removes fat, breast tissue, and excessive skin, and reduces the size of the areola (the darker skin surrounding the nipple). This results in the breasts being smaller and lifted, which gives you a breast size in proportion with your body and alleviates the discomfort associated with overly large breasts. The goal of the procedure is to make your breasts smaller, lighter, firmer and in better proportion with your body.

Breast reduction is a good option for you if:

• You are physically healthy
• You have realistic expectations
• You don't smoke
• You are bothered by the feeling that your breasts are too large
• Your breasts limit your physical activity
• You experience back, neck and shoulder pain caused by the weight of your breasts
• You have regular indentations from bra straps that support heavy, pendulous breasts
• You have skin irritation beneath the breast crease
• Your breasts hang low and have stretched skin
• Your nipples rest below the breast crease when your breasts are unsupported
• You have enlarged areolas caused by stretched skin

Your consultation

The success and safety of your breast reduction procedure depends very much on your complete candidness during your consultation. You'll be asked a number of questions about your health, desires and lifestyle.

Be prepared to discuss:

• Why you want the surgery, your expectations and desired outcome
• Medical conditions, drug allergies and medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
• Previous surgeries
• Family history of breast cancer and results of any mammograms or previous biopsies

Your visit may also include:

• An evaluation your general health status and any pre-existing health conditions or risk factors
• An examination of your breasts, and including detailed measurements of their size and shape, skin quality, placement of your nipples and areolas
• Photographs for your medical record
• Discussing your options and recommend a course of treatment
• Discussing likely outcomes of breast reduction and any risks or potential complications
• Discussing the use of anesthesia during your breast reduction

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Get a baseline mammogram before surgery and another one after surgery to help detect any future changes in your breast tissue
• Stop smoking well in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

• What to do on the day of surgery
• Post-operative care and follow-up

You'll need help

Breast reduction procedures are typically performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

What happens during breast reduction surgery?

Breast reduction is usually performed through incisions on your breasts with surgical removal of the excess fat, glandular tissue and skin.

In some cases, excess fat may be removed through liposuction in conjunction with the excision techniques described below. If breast size is largely due to fatty tissue and excess skin is not a factor, liposuction alone may be used for breast reduction.

The technique used to reduce the size of your breasts will be determined by your individual condition, breast composition, amount of reduction desired, your personal preferences and the surgeon's advice.

Step 1 - Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your anesthesiologist will recommend the best choice for you.

Step 2 - The incision

Incision options include:

• A circular pattern around the areola
• A keyhole or racquet-shaped pattern with an incision around the areola and vertically down to the breast crease
• An inverted T or anchor-shaped incision pattern

The incision lines that remain are visible and permanent scars, although usually well concealed beneath a swimsuit or bra.

Step 3 - Removing tissue and repositioning

After the incision is made, the nipple-which remains tethered to its original blood and nerve supply-is then repositioned. The areola is reduced by excising skin at the perimeter, if necessary.

Underlying breast tissue is reduced, lifted and shaped. Occasionally, for extremely large pendulous breasts, the nipple and areola may need to be removed and transplanted to a higher position on the breast (free nipple graft).

Step 4 - Closing the incisions

The incisions are brought together to reshape the now smaller breast. Sutures are layered deep within the breast tissue to create and support the newly shaped breasts; sutures, skin adhesives and/or surgical tape close the skin. Incision lines are permanent, but in most cases will fade and significantly improve over time.

Step 5 - See the results

The results of your breast reduction surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover.

The risks include:

• Unfavorable scarring
• Infection
• Changes in nipple or breast sensation, which may be temporary or permanent
• Anesthesia risks
• Bleeding (hematoma)
• Blood clots
• Poor wound healing
• Breast contour and shape irregularities
• Skin discoloration, permanent pigmentation changes, swelling and bruising
• Damage to deeper structures - such as nerves, blood vessels, muscles, and lungs - can occur and may be temporary or permanent
• Breast asymmetry
• Fluid accumulation
• Excessive firmness of the breast
• Potential inability to breastfeed
• Potential loss of skin/tissue of breast where incisions meet each other
• Potential partial or total loss of nipple and areola
• Deep vein thrombosis, cardiac and pulmonary complications
• Pain, which may persist
• Allergies to tape, suture materials and glues, blood products, topical preparations or injectable agents.
• Fatty tissue deep in the skin could die (fat necrosis)
• Possibility of revisional surgery

You should know that:

• Breast reduction surgery can interfere with certain diagnostic procedures
• Breast and nipple piercing can cause an infection
• Your ability to breastfeed following reduction mammaplasty may be limited; talk to your doctor if you are planning to nurse a baby
• The procedure can be performed at any age, but is best done when your breasts are fully developed
• Changes in the breasts during pregnancy can alter the outcomes of previous breast reduction surgery, as can significant weight fluctuations

Following your physician's instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Be sure to ask questions: It's very important to address all your questions directly with your plastic surgeon. It is natural to feel some anxiety, whether excitement for the anticipated outcome or preoperative stress. Discuss these feelings with your plastic surgeon.

Recovery

When your procedure is complete, dressings or bandages will be applied to the incisions. An elastic bandage or support bra may be worn to minimize swelling and support the breasts as they heal. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

You will be given specific instructions that may include: How to care for your surgical site(s) following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon

Results

The results of breast reduction surgery will be long-lasting. Your new breast size should help relieve you from the pain and physical limitations experienced prior to breast reduction.

Your better proportioned figure will likely enhance your self image and boost your self-confidence.

However, over time your breasts can change due to aging, weight fluctuations, hormonal factors and gravity.

Cost may include:

• Surgeon's fee
• Hospital facility cost
• Anesthesia fee
• Prescriptions for medication
• Medical tests

Breast reduction surgery is generally considered a reconstructive procedure and may be covered by health insurance when it is performed to relieve medical symptoms.

Many insurers define breast reduction surgery as reconstructive based on the amount of tissue that will be removed.

However, pre-certification is required for reimbursement or coverage. Each insurance policy varies greatly. Carefully review your policy to determine coverage.

Other Breast Procedures

With both the breast lift and breast reduction procedures, additional benefits may include areola reduction, nipple reduction and/or inverted nipple correction. However, if you are concerned about your areola size, nipple size, or your inverted nipples and are not a candidate for, or not interested in, a breast lift or breast reduction, we are also able to do those procedures separately.

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