Who Would Best Represent an Ideal Candidate For Breast Reduction Surgery?
- Patients with back, neck, or shoulder pain caused by the weight of their breasts
- Patients whose nipples sit low on the breasts and have large areolas
- Patients with breasts that are too large in proportion to the rest of their body
- Patients who are uncomfortable with the size and weight of their breasts
- Patients whose activities are limited because of the size of their breasts
- who have one breast that is much larger than the other
- who are in good health
- Patients who understand the risks and have realistic expectations
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What Are the Risks and Limitations of Breast Reduction?
As with any surgery, there is always a possibility of complications. Though rare, patients may experience bleeding, infection, or reaction to the anesthesia. Some patients develop small sores around their nipples after surgery; these can be treated with antibiotic creams. By closely following your doctor's instructions, both before and after surgery, you can greatly reduce the risk of complications.
The procedure does cause some scaring. (Poor healing and wider scars are more common in smokers.) The procedure can also cause slightly mismatched breasts or unevenly positioned nipples, though these can be corrected with an additional procedure. Future breast-feeding may not be possible, since the surgery removes many of the milk ducts leading to the nipples. Also, patients typically lose some feeling in the breasts or nipples that may be permanent.
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Preparation Before the Breast Reduction Procedure
It is important to discuss your expectations with the doctor during the initial consultation. Listen to his or her opinion and keep in mind that patients and physicians have different views of what is a desirable size and shape for breasts. Above all, the breasts need to be properly proportioned to reduce any physical problems they may be causing.
The doctor will examine your breasts in detail, and may ask to photograph them for reference after the surgery. (The photographs may also be used in the processing of insurance.) He or she will discuss any variables that may affect the procedure-such as your age, the size and shape of your breasts, and the condition of your skin. Be sure to discuss how the nipple and areola will be positioned. They will be moved higher during the procedure, and should be approximately even with the crease beneath your breasts.
Your doctor will also describe the procedure, explaining risks
and limitations and making sure you have realistic expectations of the outcome.
The doctor may require you to have 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. Some surgeons suggest that their patients diet before the operation.
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The Breast Reduction Surgery
Breast reduction is a procedure where excess breast tissue, fat, and skin are removed. The nipple and areola are lifted, and skin that was located above the nipple is brought down, pulled together and sutured to improve the shape and contour. The type of incision used depends on the size and shape of the breasts. The incisions are designed so that they will be concealed under the bra, however the resulting scars are permanent. Most scars fade over time. Occasionally, when only fat needs to be removed, liposuction alone can be used to reduce breast size, leaving minimal scars.
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Recovery from the Breast Reduction Procedure
Within the first week any drains will be removed.
Bandages will also be changed. Within two weeks, mild exercise and non-strenuous
work may be resumed, bruising will begin to fade, and swelling will go down.
After a few months your breasts will settle into a more natural shape. As
with any procedure, the cosmetic effects will take about a year before the
final results are realized. Without the excess weight you may find that
you enjoy life much more, and can participate in physical activities you
did not think possible.
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Your new look:
It may be six months to a year before your breasts settle into their
new shape, but swelling will begin to diminish after only a few weeks. Even then, their shape may fluctuate in response to any hormonal shifts, weight changes, or pregnancy.
The doctor will make every effort to reduce the scaring as much as possible. Still, it's important to remember that breast reduction scars can be extensive and permanent. They often are red and lumpy for months, gradually becoming less obvious, sometimes fading to a thin white line. Fortunately, the scars can usually be placed so that you can wear even low-cut tops.
Of all plastic surgery procedures, breast reduction results in the quickest body-image changes. You will be rid of the physical discomfort of the excess weight, your clothes will fit better, and you will look more proportioned. Keep in mind that you will need time to adjust to your new image, as will your family and friends. Be patient with yourself, and with them. Remember the purpose of the surgery, and chances are, like most women, you too will be pleased with the results.
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Sam Gershenbaum, DO
Adam J Rubinstein, MD
Brian Joseph, MD,FACS
Moises Salama, MD
