Breast Reduction

ARE YOU CONSIDERING BREAST REDUCTION?…

Women with very large, pendulous breasts may experience a variety of medical problems, from back and neck pain and skin irritation to skeletal deformities and breathing problems. Bra straps may leave indentations or scalloping of their shoulders. Unusually large breasts during breast-feeding can make a woman feel extremely self-conscious.

Breast reduction, technically known as reduction mammoplasty, is designed for such women. The surgical procedure removes fat, glandular tissue, and skin from the breasts, making them smaller, lighter, and firmer. It can also reduce the size of the areola, the darker skin surrounding the nipple. The goal is to give the woman smaller, better shaped breasts in proportion with the rest of her body.

THE BEST CANDIDATES FOR BREAST REDUCTION:

Over time, a woman’s breasts begin to sag and the areolas become larger.

Breast reduction is usually performed for medical indications rather than simply cosmetic improvement. Women who have the surgery complain of the following:

• Very large, sagging breasts that restrict their activities
• The breasts cause them physical discomfort, posture trouble and back pain.
• In spite of well-fitting bras they experience neck spasm and shoulder scalloping.
• In the folds beneath the breast, irritation and eventually infection repeatedly occurs and requires treatment that is often ineffective.
• Being unable to find properly fitting affordable bras.

In most cases, breast reduction isn’t performed until a woman’s breasts are fully developed, so reoperation can be avoided. In certain cases it can be done earlier if large breasts are causing serious physical discomfort. Younger women should ideally have stopped growing before undergoing breast reduction surgery, usually at age 24 or greater, to reduce hypertrophic scars as well.

The best candidates are those who are mature enough to fully understand the surgical procedure and have realistic expectations about the results. Breast reduction is not recommended for women who intend to breast-feed. Morbid obesity can cause breast enlargement, which will improve with weight loss.

ALL SURGERY COMES WITH SOME UNCERTAINTY AND RISK:

Breast reduction is not a simple operation, but it’s normally safe when performed by a qualified plastic surgeon. Nevertheless, as with any surgery, there is always a possibility of complications, including bleeding, infection, or reaction to the anesthesia.

Some patients develop small sores around their nipples and incisions after surgery; these can be treated with antibiotic creams. You can reduce your risks by closely following our advice both before and after surgery.

The surgical procedure does leave noticeable, permanent scars, although they’ll be covered by your bra or bathing suit. (Poor healing and wider scars are more common in smokers). The procedure can also leave you with slightly mismatched breasts or unevenly positioned nipples.

Future breast-feeding may not be possible, since the surgery removes many of the milk ducts leading to the nipples. Some patients may experience a permanent loss of feeling in their nipples or breasts. Rarely, the nipple and areola may lose their blood supply and the tissue will be lost (The nipple and areola can usually be rebuilt, however, using a skin graft from elsewhere on the body).

PLANNING YOUR SURGERY

In your initial consultation, it’s important to discuss your expectations frankly with Dr. Dolynchuk, and to listen to his opinion. Every patient, and every physician as well, has a different view of what is a desirable size and shape for breasts.

The surgeon will examine and measure your breasts, and will probably photograph them for reference during surgery and afterwards. (The photographs may also be used in the processing of Medicare coverage.) He will discuss the variables that may affect the procedure such as your age, the size and shape of your breasts, and the condition of your skin. You should also discuss where the nipple and areola will be positioned; they’ll be moved higher during the procedure, and should be approximately even with the crease beneath your breasts.

The surgeon will describe the surgical procedure in detail, explaining its risks and limitations and making sure you understand the scarring that will result. He should also explain the anesthesia he will use, the facility where the surgery will be performed, and the costs. Medicare will pay for breast reduction if it’s medically necessary; however, they may require that a certain amount of breast tissue be removed and that symptoms are present due to breast size. You may require a mammogram (breast x-ray) before surgery. You’ll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. We may suggest that our patients try to be around an ideal weight before the operation. Breast reduction doesn’t usually require a blood transfusion. However, if a large amount of breast tissue will be removed, we may advise you to take an iron supplement ahead of time. While you’re making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.