For women with excessively large heavy breasts, breast reduction surgery can dramatically change the way they feel and look. The surgery, which involves removing excess breast tissue through a small incision, alleviates the physical discomfort and inconvenience of large breasts, and gives a better proportioned body. For many women, breast reduction surgery results in them feeling more comfortable and confident about their bodies. Breast reduction may be a medically insured procedure for women who have medical problems due to the size of their breasts and who meet the requirements set by MSP.
Breast reduction surgery may be helpful if you:
In most cases, breast reduction isn't performed until a woman's breasts are fully developed. However, it can be done earlier if large breasts are causing serious physical discomfort. You must be emotionally mature, understand your motivations for having this procedure, and have realistic expectations about what the surgery can achieve. It's important that you are not at smoker as the risks of serious complications, including nipple loss and breathing problems around the time of the surgery, would become much higher.
During your initial consultation, your surgeon will do a physical examination and go over your concerns and expectations. As every patient is an individual -- your age, the size and shape of your breasts, and the condition of your skin can all impact the procedure chosen and the final result -- your surgeon will discuss the procedure that best fits your goals and body. At this time, you will be given a basic understanding of the procedure, including how it can help, how it's performed, what results you can expect, and its risks and limitations
A breast reduction is performed under general anesthesia, which means you will be asleep through the entire operation. The surgery is approximately 1-2 hours and you will spend approximately 3 hours in the recovery room, so plan to spend the whole day at the hospital. You will be given a prescription for pain-killers and possibly antibiotics. There are a few variations in breast reduction technique but they all have three common components:
The techniques differ in where the excess breast tissue and skin are removed from, where the mound under the nipple is situated, and what the scars will look like. The following three procedures are the most common:
Wise pattern breast reduction leaves an anchor-shaped scar that circles the areola, extends straight downward, and then follows the natural curve of the crease beneath the breast. It is often used for women who have excessively large breasts or women with breasts that sag a lot and need a lot of skin removed to lift them.
Short scar or vertical breast reduction leaves a lollipop scar that extends around the areola and down the lower part of the breast.
No vertical scar breast reduction leaves a scar that extends around the areola and under the crease of the breast. The exact choice of breast reduction depends on many factors, such as the size of breasts, skin quality, and amount of breast sag. Scars are permanent but can be easily concealed by clothing and even a bathing suit. In most cases, the nipples remain attached to their blood vessels and nerves through a pedicle or mound of breast tissue. However, in rare cases, if the breasts are very large or pendulous, the nipple and areola may have to be completely removed and grafted onto a higher position (this will result in a loss of sensation in the nipple and areolar tissue). Breast reduction surgery does not remove fat on the sides of the chest under the armpit, although some patients who have a significant roll in this area have it flattened with liposuction. Liposuction will lessen the bulk in this area, although this addition to the breast reduction is not covered by insurance.
Your mammograms should be up-to-date because results may be skewed for any mammogram taken during the first 6-12 months after surgery. It is best to be at a body weight that you want to maintain after your breast reduction. The operative result is more predictable with a stable weight and the operative risks are less in patients who are not significantly overweight. You should not smoke for at least 4 weeks before surgery and 2 weeks after and you should stop taking all over-the-counter pain or fever medicines (except Tylenol) and blood thinners for two weeks prior to your procedure. Many herbal medicines can also cause bleeding and so need to be stopped before surgery, including ginkgo biloba, St. John's Wort, and high doses of fish oil, flax seed oil, or vitamin E.
You will need someone to drive you home after surgery and you may need some help for the next few days. Following breast reduction surgery, most women are up and about the next day, but the breasts may ache occasionally for a couple of weeks. You should avoid lifting or pushing anything heavy for two weeks and avoid pools or hot tubs for 3 weeks. You can typically return to regular activity within a couple of weeks of surgery and feel normal after a month or so.
Although much of the swelling and bruising will disappear in the first few weeks, it may be six months to a year before your breasts settle into their new shape. Even then, their shape may fluctuate in response to your hormonal shifts, weight changes, and pregnancy. Your surgeon will make every effort to make your scars as inconspicuous as possible. Still, it's important to remember that breast reduction scars are extensive and permanent. They often remain lumpy and red for months, and then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be placed so that you can wear even lowcut tops.
Breast reduction is not a simple operation but it's safe when performed by a qualified plastic surgeon. The more common complications are still infrequent and often go away on their own or with minimal treatment. Issues specific to this surgery include, but are not limited to, asymmetry, numb skin/nipples, and scar tissue around the incision. Your surgeon will discuss all potential complications at the time of consultation.