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BREAST REDUCTION

Excessively large breasts are not only detrimental to one's self-esteem but also to one's health. Complaints due to excessively large breasts include constant neck and back pain; breast pain; poor posture; skin rashes and irritations; and painful grooves in your shoulders from the weight of your breasts in your bra. The dramatic improvement to a woman's figure and her quality of life are reasons enough to undergo breast reduction surgery.

HOW IT'S DONE

A breast reduction is more than removing excess tissue and fat. The breast itself needs to be sculpted into a smaller shape. The techniques and incision patterns used are essentially the same as those used in a breast lift. There's been a focus on lessening scars and improving shape so that some fullness is restored to the upper portion of the breast. Today, incisions include all, or any combination of:

• Concentric or donut-shaped around the areola
• Vertically down from the areola to the breast crease
• Horizontally at the breast crease Breast fat and tissue are removed through these incisions. In some cases, liposuction may be used in conjunction to remove fat in and around the breast. The nipple is repositioned (while remaining attached to its nerve and blood supply), and the entire breast is reshaped. The overlying breast skin, and possibly the size of the areola, are reduced to match the shape, position and proportion of the new breast.

The results of breast reduction are seen and felt immediately. Remember, breast reduction is major surgery and all the recovery considerations and cautions mentioned for breast augmentation apply. Keep in mind that skin and breast tissue that has been thinned and stretched from the weight of the breast is at increased risk for raised, wide or irregular scars. After breast reduction, significant weight gain or loss and pregnancy can affect breast size and the results of your surgery. From a quality of life perspective, the psychological impact of breast reduction can be life-altering. A whole new world of clothing and lingerie options opens up for a woman who has been hiding under baggy tops for years.

Anesthesia

Either under general anesthesia or local anesthesia with sedation.

In or Out

Breast augmentations, breast lifts and, in many cases, breast reductions are commonly outpatient procedures. Surgery takes place in an office-based surgical suite, a freestanding ambulatory facility or a hospital surgical facility. For some women, an overnight hospital stay is occasionally recommended.

After Breast Reduction Surgery

You'll wake up after surgery wearing a support bra that was either purchased before surgery or supplied by your plastic surgeon. In the case of breast reconstruction, you may be simply wrapped with a surgical dressing like gauze. You may have small, thin tubes placed in your incisions to drain any excess fluid, or a tube that is attached to a pain pump. You'll be stiff and sore; however, alert your doctor immediately if you experience severe pain or develop a tense, swollen breast. You should be up and walking around the day of surgery. If you are not staying in the hospital overnight, you will need a responsible adult to care for you and monitor your condition for at least 24 hours after you arrive home.

Side Effects

• Breast tenderness
• Swelling and minor bruising
• Regional tightness or discomfort
• Redness, discomfort or itching at the incision sites
• Heightened or decreased breast sensation

Special Considerations

Sleep on your back in a reclining position for the first few days following your breast reduction surgery. During recovery, follow all instructions for proper breast support, including sleeping in your support bra if instructed. A cotton bra that closes in the front may be the most comfortable. Do not wear underwires until your plastic surgeon gives you the green light. Long-term support is essential for the well-being and longevity of your new breast appearance. Start walking around and doing light activity as soon as possible, but avoid pushing, pulling, lifting, twisting and strenuous exercise until your plastic surgeon gives you the go-ahead.

Back to Work

Return to work within a week or two, give or take a few days, depending on the extent and type of procedure and physical activity required at your job. Scars begin to fade within three months; topical steroid cream or silicone gel can promote healing and reduce the chance of developing raised, red or irregular scars.

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